ICT Group helps cardiothoracic surgeons improve patient outcomes

The European Association of Cardio-Thoracic Surgery (EACTS) is a professional organization dedicated to supporting the education of surgeons to improve outcomes for patients suffering from heart and lung conditions. In recent years, the organization has been focusing on data-driven quality improvement and research, which led to building the Adult Cardiac Database (ACD), a centralized database collecting data sets from various hospitals across Europe.

Collect risk factors and results

Every record in the ACD represents a cardiovascular intervention, such as an operation on the heart or major blood vessels near the heart. Edgar Daeter, a Cardiothoracic Surgeon at the St. Antonius Hospital in Nieuwegein and the Chair of the Quality Improvement Programme Committee at EACTS, illustrates the process: “We collect risk factors and results, which can include a successful operation, an infection, a reintervention, or the unfortunate death of a patient. Hospitals upload their intervention data into this system.”

Daeter has been involved with the ACD since its inception. “We previously had a database, but when the collaboration with our external provider lapsed, we had to rebuild it”, he reflects. “Because of this experience, we wanted to own the database and infrastructure this time.” Without access to the database, hospital quality programs were hindered, making it urgent for EACTS to have the new database operational as soon as possible. “The database is only useful if hospitals contribute their data”, Daeter explains, “but naturally, contributions would’ve stopped when they couldn’t access the database anymore.”

Short time frame

Faced with this challenge, EACTS looked for a technology partner to develop this software infrastructure, compliant with European regulations like the GDPR (General Data Protection Regulation). This partner also needed to be experienced in the medical sector and have a development team capable of delivering in a short time frame. They published a tender with their specific requirements. For instance, the database required a system for mapping data in hospital-specific data formats to a common format. It also demanded a permissions system where, for example, the ability to compare a hospital’s performance with others would be subject to the chief surgeon’s authorization.

The deployment model was a critical consideration as well. “A few candidates proposed on-premises solutions, but we required a centralized, cloud-based system”, Daeter explains. Cost considerations, including maintenance fees, were also important. “Taking all these strict selection criteria into account, ICT Group’s proposal was the best of all candidates”, Daeter concludes.

“We now have the database we envisioned, equipped with a sleek, intuitive interface for surgeons” - Edgar Daeter, a Cardiothoracic Surgeon St. Antonius Hospital in Nieuwegein and the Chair of the Quality Improvement Programme Committee at EACTS

In addition, hospitals can get access to custom reports, which show more detailed information not available in the viewer. “Hospitals that contribute data receive even more detailed insights, enabling them to benchmark their performance against the average”, Daeter adds.

Daeter was a member of the project’s steering committee during development, engaging in regular meetings with ICT Group’s developers. “There was a hiccup with the first version, but ICT Group immediately solved this in a very professional way. And I saw this attitude all the time. We could always count on their professionalism, flexibility, and open communication. I really liked collaborating with them.” Development and testing progressed in sprints, building different parts of the interactive viewer concurrently. “We now have the database we envisioned, equipped with a sleek, intuitive interface for surgeons”, Daeter concludes.

Advancements in quality improvement research

EACTS is currently collecting the data for its database, which Daeter acknowledges will always be a work in progress: “We’ll introduce new filters to the viewer, incorporate additional data sets, and include other variables in the database. So this will require continuous cooperation with ICT Group, surgeons and researchers.” For example, recently a working group has been established to explore robotic data in cardiac survey. Paola Quattroni, recently appointed as the Quality Improvement Director at EACTS, explains: “For each robot-assisted intervention, we want to record the type of robot, its specific use and the patient outcomes. Coupled with existing data, such as surgery duration, this will enable us to analyze surgeons’ learning curves with the technology.”

Quattroni adds that members will also be able to use these data in the future for quality improvement research, assessed by a scientific panel before data access is granted: “Researchers can analyze correlations in cardiovascular interventions across Europe. This will be anonymized data, ensuring patient and surgeon confidentiality, and with a secure access mechanism developed by ICT group. This is just one of many steps where we expect to make use of ICT Group’s technical expertise to advance cardiac surgery.”