by Laura Van Heel, RN, BSN, CCDS

Why do we care about data? Why do we invest hundreds of thousands of dollars, if not millions in our databases? One of the essential features of any database is the ability to glean information and analytics from it. But the database must be optimized and free of erroneous information to get useful insights. It is particularly true regarding Cardiac Implanted Electronic Devices (CIEDs) databases. Today’s clinics face a growing challenge, their systems are inundated with outdated, duplicate, and incorrect information.  

Managing hundreds or thousands of CIED patients efficiently and effectively depends on how well your CIED database is architected and maintained. 

A database can quickly get convoluted due to a variety of reasons: human errors in data entry, merging database systems, clinic or hospital acquisitions, or underutilization of the database. So what many organizations end up with is a costly system that creates more problems than it solves. 

But what if a CIED database is optimized? The data entry is streamlined and personnel using the system consistently work within the system. What if that database was a plethora of valuable information? What could that organization get out of it? A few things immediately come to mind. 

Such as:

• An accurate count of patients actively managed by a practice.
• How many patients does an individual physician have in their practice?
• The mix of types of devices: Pacemakers, ICDs, Pacemaker (PPM) & ICDs with Heart Failure monitoring capabilities (CRT-P & CDT-D), and Implanted Loop Recorders (ILRs). 
• How many patients are an add-on to program patients in a certain period?
• The number of patients that transfer to another clinic.
• Identification of patients inactive due to all measures exhausted. 
• The ability to track and manage patients without future appointments or lost to follow-up whether on remote monitoring or in the office only.
• The management of advisory patients, with advisory information attached to their records in the database with mitigation information.
• The number of patients on remote monitoring or wanting in-office visits only.
• The number of follow-up encounters over a period.
• The amount of non billable work being done.
• If protocols or changes were made to the practice, data on if those efforts had an impact. 

These are a few of the many questions administrators are asking for answers to and many clinics are left unable or unsure how to answer. However, we live in a world of solvable problems. 

The cleaning of a pre-existing database that has been underutilized and not maintained takes collaboration. The clinic and the database vendors must partner to correct the historical issues. Still, the investment of time and effort is worth it for all the beneficial information that can be obtained. However, for many teams, this project can feel near impossible. Many clinics do not have the time or experienced staff to optimize their CIED database. This is where experienced partners such as CV Remote Solutions (CVRS) have been game-changing. 

So what does a successful partnership look like? Let’s look at one real-life scenario of how we at CV Remote Solutions assisted in optimizing a clinic’s CIED database. 

When we first reviewed the information in the clinic’s CIED database, 23,000+ patients were listed as active. Immediately, we could see this was inaccurate but had occurred due to underutilization of the database over the years, system merging, staff turnover, inexperience, and time constraints. Something that many organizations face. We knew to ensure sustainable success we needed collective buy-in and partnership., clinic leadership, clinic IT, CV Remote Solutions, and the industry technical services team were able to clean up the system through a few strategic collaborative steps:

1. Over a period of 3 months, as we processed the incoming transmissions, we identified in the CIED database those patients that were remotely and followed in-clinic only.
2. We actively worked on cleaning up the disconnected monitoring lists on the industry’s remote monitoring sites.
3. Once we had identified whom the clinic was actively managing, we worked with the CIED database technical support team to purge the patients who were no longer being followed and moved them to a holding file for a designated time.

Now that the CIED database optimization process has been completed, we can focus on fine-tuning patient information. The clinic now knows there are 4962 active patients – over a 78% reduction in patients labeled as active. Now, the data can be refined to answer various patient management questions and the clinic can focus on providing better patient care.Interested in a database tune-up? In addition to our remote monitoring services, CV Remote provides consulting solutions to advise customers on the best ways to optimize and revitalize their systems and databases. If interested in an evaluation of your device clinic workflow, productivity, and future capability, please contact CV Remote Solutions via our website here.