RIS/PACS Propels the Community Hospital

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Sponsored by an educational grant from GE Healthcare

United Memorial Medical Center | Batavia, N.Y.

  Carol Vanderberg, specialist assistant in radiology, at United Memorial Medical Center reviews CR-based digital mammograms on the GE Healthcare Centricity RIS-IC that links the healthcare organization’s five campuses.

In some respects, United Memorial Medical Center (UMMC) of Batavia, N.Y., is a typical community hospital. It is composed of five campuses including a 111-bed hospital and four imaging centers. The group completes 50,000 imaging studies annually. Imaging modalities include multidetector CT, CR-based digital mammography, ultrasound, MRI, CR and digital fluoroscopy.

As the only hospital in the county, UMMC is somewhat challenged. For starters, it employs a single radiologist (supported by a specialist assistant in radiology), which can make it difficult to manage imaging volume, provide acceptable report turnaround time and review the breadth of modality procedures, especially subspecialty and ER reads. Four external radiologists based in Buffalo, N.Y., help manage the center’s daily workload, so robust digital image management processes are critical. Secondly, the metropolitan areas of Rochester and Buffalo are within an hour’s drive; it’s important to maintain high-quality local care to keep patients local.

The organization’s decisions to deploy GE Centricity RIS-IC in 2001 and to pioneer PACS with integrated RIS and voice recognition in 2006 play a vital role in UMMC’s ability to provide optimal, local patient care. What’s more, workflow and report turnaround time are significantly improved with integrated RIS/PACS and RIS-driven workflow.

RIS rules

Centricity RIS-IC is the workhorse behind the smoothly functioning radiology department at UMMC. The rationale behind the staggered, RIS-first deployment is quite simple. The RIS provides a means to capture accurate information and populate the PACS, says Lisa Foss, medical imaging supervisor. An interface with the HIS also facilitates patient processing and scheduling. “RIS-driven workflow helps bring the patient through the department a lot smoother. Data like patient registration flows from the HIS to the RIS, leading to fewer data entry errors and less manual work for technologists,” says RIS/PACS Administrator Mary Niland.

Physicians, both referring doctors and radiologists, benefit, too. The RIS centralizes all radiology reports and imaging files, providing streamlined access to reports and images for referring physicians. It also provides a line of communication between radiologists and technologists, which boosts workflow. For example, the radiologist can view images immediately after acquisition. If a study requires additional views or a retake, the radiologist can relay that information to the technologist—without leaving his chair or breaking workflow.

Both parties in the image reporting equation—referring clinician and radiologist—also gain from embedded voice recognition. Prior to Centricity, UMMC used a third-party system that required an additional server, interface and HL7 message. The Centricity system streamlines management, says Niland, and allows the radiologist to manage reports from a single home page, which, in turn, helps cut turnaround time.

Dan Ireland, vice president of clinical support services, credits the center’s workflow success story to a complete pre-RIS workflow analysis. “Our goal was to use technology to streamline activities,” Ireland says. By strategically locating status boards within the department and placing barcode scanners in radiology rooms, UMMC has slashed its paper consumption, replacing paper with electronic data flow. The workflow analysis helped the hospital track pressure points to help it determine where to place PACS workstations. Wall-mounted units and mobile carts complement fixed workstations to provide physicians access to images and lab results anywhere in the hospital, including at the patient bedside.

Centricity RIS-IC enables electronic billing, another critical workflow booster. Prior to Centricity, UMMS used a courier service to ship hundreds of billing reports to its billing company every day. Now, reports are generated automatically within Centricity and sent electronically to the billing company, saving the time and dollars associated with the paper approach. In addition, bills can be generated more rapidly, which translates into accelerated collections.