Window on Cardiology

"The aim is to make myself redundant"
Reflections from 17 years as a cardiology information system expert

Photo: Mr. Kendrup

Interview of Mr. Ingvar Kendrup, biomedical engineer Malmö University Hospital, Malmö, Sweden

Original text edited and adapted for publication in the Clinical Window Web Journal by Ilkka Kalli, MD, Editor-in-Chief

The article also available in PDF: 253KB

Malmö University Hospital is one of the Nordic sites where more than 100 ECG devices are connected to the MUSE® Cardiology Information System. We interviewed the biomedical engineer responsible for the system at the hospital Mr. Ingvar Kendrup. An innovator of the highest order, he has developed a lot of additional functionality to the system described in this article.

Malmö University Hospital

The Malmö University Hospital, also called UMAS, is one of the leading university hospitals in Sweden. It serves the 270,000 inhabitants of the city of Malmö as well as some 1.6 million people in southern Sweden. The hospital has close to 1000 beds and also treats approximately 2000 outpatients daily. Some 7000 people work at the hospital.

The department of clinical physiology employs approximately 65 people working in a variety of disciplines: ECG, pulmonary function, ultrasound and nuclear medicine. This is where Ingvar Kendrup has worked since 1965 as a biomedical engineer in the areas of ECG and pulmonary function.

Malmö University Hospital (Photo: Jimmy Wahlstedt, UMAS)

17-year experience in storing ECGs

The first ECG data storage unit, DEC MUSE, was installed at the department of clinical physiology in May 1988. "The training program began in April the same year. We started with four ECG machines, two sets of exercise testing equipment and the MUSE system," explains Mr. Kendrup, who has been involved right from the start. In the mid-1990s, the hospital replaced their old ECG data storage system with the Windows-based MUSE NT.

"The transition to a Windows environment is by far the most significant change in MUSE that has taken place over the years," says Mr. Kendrup. The Windows environment made it possible for the software program to communicate with other programs.

"Thanks to the openness of the system, we can easily make adjustments to adapt it to other systems we use, such as the Melior case records system," he adds.

Now working with MUSE via a web interface

An almost equally dramatic revolution took place five years ago when clinical physiology at Malmö started working with MUSE via a web interface.

"I’ve built a web reader, which means that there's a button function called ECG in the case records system that has a direct connection to MUSE via the web, without any extra MUSE login process. Login, user ID and password are controlled in their entirety by the records system, which makes it very user-friendly," Mr. Kendrup explains.

It goes without saying that the simplicity of this method of gaining access to earlier ECGs is much appreciated by the clinics.

"At care centers where they don't use a case records system, I've built a simple program which at startup checks the user's authority and where subsequently all the staff need to do is to key in the patient's personal code number in order to log onto MUSE.

"The clinics are extremely satisfied with the web function. Now they can get at previously stored ECGs quickly and simply without having to wait, compared with waiting times using pneumatic dispatch or only being able to order ECGs during clinical physiology's opening times," Mr. Kendrup adds.

Great clinical value of comparing with earlier ECGs

Various departments such as primary care centers, emergency departments and others access the MUSE web function each month and look at approximately 6000 ECGs. A little over one hundred ECG machines are connected to MUSE in Malmö.

Some 60,000 ECGs are now sent in annually. Before the web function came into operation, the benefits of storing ECGs were not so great and only some 40,000 ECGs were stored. Being able to compare a new ECG with an earlier one is extremely valuable for the cardiologist when diagnosing a patient.

Photo: Mr. Ingvar Kendrup, in his office at the Malmö University Hospital

Providing services and getting paid, developing automated invoicing

"We were the first in Sweden to get going with this web function," says Mr. Kendrup with pride. Getting paid for supplying a service is a matter of course in hospitals today. At Clinical Physiology in Malmö, they charge for the ECGs studied. "One problem was that it was taking far too much time and energy to check the use of the ECGs every day," he explains.

Mr. Kendrup dislikes getting stuck in routine work, and so he started developing a program that each day obtains information automatically from MUSE, converts the information and adapts it to the hospital's administrative system. It then automatically dispatches the information on to the finance department. "This program has functioned extremely well and has enabled me to work on other things entirely."

A practical solution to facilitate information flow

One situation that can arise when working with telephone modems is that they sometimes need to be restarted. Mr. Kendrup tackled this by creating a program that automatically goes in and restarts the communications servers at 4:30 a.m. every morning, and as a result the data communication via the modems is working without interruption.

"This program has really saved time and a lot of phone calls. I look at it this way: if there’s a recurrent problem or repetitive routine work I ask myself – can it be automated? Thanks to the openness of the system, the answer is generally 'yes'. My aim is actually to make myself redundant," he summarizes.

Any plans for further development?

"Well, not just now, as I feel that now everything's working perfectly!" Mr. Kendrup says, a trifle sadly. "Our customized MUSE system has proved to be very stable and has saved us a great deal of time. But above all it has brought gains in terms of quality," he concludes.

Diagnostic Center, Malmö University Hospital, Sweden (Photo: Jimmy Wahlstedt, UMAS)

This article was translated and edited from an article entitled "Målet är att göra mig själv överflödig" published in GE Healthcare's Swedish customer newsletter.

Last updated: 1 September 2005Created
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