Shifting attitudes about technology and healthcare are driving changes in the way IDNs, hospitals, imaging centers and group practices are melding the two and planning for their futures. We’ve been hearing about digital, filmless, paperless healthcare environments for years but the majority of institutions have a long way to go. But, many facilities are well on their way.
The next big thing?
Until recently, PACS was just for the radiology department, says Richard Wiggins, director of imaging informatics at University of Utah Hospital. “Now, the idea is enterprise-wide PACS — any image, anywhere, any time. The next big thing is any data anywhere, any time.”
But first PACS. When Lehigh Valley Hospital & Health Networks decided to implement PACS, everyone expected certain cost reductions and productivity improvements, says Harry Lukens, senior vice president and CIO. But he was surprised at the quick acceptance of the change. As one of the first institutions to implement CPOE, Lukens says it took years for everyone to trudge through and begin to use. So the rapid success of PACS was a pleasant surprise. In fact, the quick acceptance has allowed the organization to move on to new projects, such as cardiac PACS. The facility installed a wireless network in 1997 and now more than 600 deployed laptops are used by clinicians in any location in the organization.
In some cases, acceptance of PACS takes a little more effort. Physicians at Centra Health in Lynchburg, Va., were used to receiving film they could view on a lightbox. With PACS, images were put on CDs. However, the PACS implementation team had to show them how to read CDs, and provide a process for deploying PCs in their offices. “We had to come up with a new workflow process for them,” says Randall Shortt, PACS administrator.
Oftentimes, the real challenge of new technologies is getting the people who use them to change. “That’s a bigger challenge than learning to use the equipment,” says Mike Cheatwood, infrastructure services manager for Centra. Despite that, “we’re doing a better job with patient care and have improved efficiency,” he says. “Sometimes that gets lost in all this.”
“Healthcare embraces change when the added benefit is proven,” says Brien Vokits, PACS administrator at Desert Orthopedic Center in Las Vegas. “We embrace technology in healthcare because it can get us a result. In the last 10 years, I think healthcare has changed for the better in terms of acceptance of IT.”
Vokits says the Desert Orthopaedic surgery practice has a “long-term objective to try and become as electronic as possible.” Leadership decided to replace x-ray film processors and move to PACS. “It became very clear very early on that there’s no reason for us to support legacy technology,” Vokits says. The orthopedic surgeons were attracted to the portability aspect of PACS since they are so mobile themselves.
The transition went well, Vokits reports. It took an enterprise-wide cultural change. “It was an involved, complicated journey,” he says. “The first three months were an education.” But after that initial learning curve, the clinicians were asking for more options and capabilities. Now the practice is producing more volume without increasing staff.
While most facilities devote a lot of resources to the tedious nature of migrating from old to new, some have the luxury of starting out with a digital environment. Alegent Health System’s nine hospitals are ahead of the curve when it comes to technology, but its Lakeside Hospital is considered a “smart hospital” with all wireless technology, a filmless/paperless environment and all-digital diagnostic center. Any user can access enterprise-wide information seamlessly and reliably from any computer on campus. That ability introduced new technological challenges, says Jeff Broz, operations director of imaging applications. When radiology and cardiology images became available virtually anywhere, he had to increase desktop speed by replacing switches and/or network cards.
To gear up physicians for the “smart hospital” environment when Lakeside first opened, Broz set the clinicians’ expectations and provided training, daily rounding and around-the-clock support. “This allowed us to prove to them the efficiencies that were inherent with all of the technology in their day-to-day workflow processes. The physicians then became the champions of the technology and demanded it at the other campuses.” Most recently, Alegent completed rollout of its wireless infrastructure. The next step is to leverage that infrastructure with an RFID initiative.
A technology lag
When comparing technology and connectivity in the healthcare industry to advances in other industries, most agree that healthcare is woefully behind. “It’s very unfortunate that this industry has allowed itself to get behind other industries,” says Lukens.
But it’s difficult to compare healthcare to other industries. “Fundamentally, healthcare systems have a different outcome,” he points out. “If your bank system goes down, you can’t use your ATM card and you’re annoyed. If a system goes down here, there may be 20 babies attached to it on the other end. You have to keep them going 24/7/365. Manufacturing probably does that but doesn’t have to.”
A slight lag can be helpful, some believe. “In some ways it’s good to be behind [other industries] a little bit. We can let someone else work out the bugs,” Wiggins says. Since so many companies in other industries are managing their data so well, “we can model our systems after theirs,” he adds.
Even if healthcare is playing catch up, change is a constant, says Cheatwood. “It’s an ongoing process. In the past three to five years, we have made great leaps. Once the healthcare industry started embracing technology, it hasn’t stopped,” he adds.