Why Web-based PACS Works for the Community Hospital

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Case Study: Bayhealth Medical Center  |  Dover & Milford, Del.

Sponsored by an educational grant from GE Healthcare & Dell

  PACS Administrator Laura Roy and CIO David Walczak access the Dell server rack console display in the data center at Bayhealth Medical Center in Dover, Del., that is adjacent to Kent General Hospital.

Bayhealth Medical Center is a two-hospital, 364-bed integrated delivery network located in Dover and Milford, Del., comprised of Kent General Hospital, Milford Memorial Hospital, Middletown Medical Center, as well as seven outpatient imaging centers, with more than 2,900 employees and 450 physicians. The two hospitals have an approximate annual imaging volume of 260,000 studies. By transitioning from a client/server-based PACS to Web-based PACS from GE Healthcare, the health system has seen increases in radiology productivity while decreasing its film and storage costs.

As part of the Delaware Health Information Network (DHIN), Bayhealth Medical Center is a founding member of a statewide health information and electronic data interchange network for public and private use for timely, reliable and relevant healthcare information. The legislation was signed in 1997; however, it took DHIN and the medical center several years to determine what role it would play within the network. “It wasn’t until recently that we decided that health IT could help improve care and perhaps reduce cost that we found our true mission,” says David Walczak, assistant vice president for technology and CIO who is responsible for telecommunications, clinical engineering and health information management at Bayhealth.

“We have been working very hard over the last three years and have deployed a system that is now automating the delivery of our results to our physicians’ offices,” he says.

The medical center saw the benefits of deploying health IT by deploying online medical records, electronic surgical systems, patient tracking systems in its emergency department, online clinical documentation for patient care services and electronic medication administration. About six years ago, the health system first deployed client/server PACS plus a Web distribution solution from Dynamic Imaging, now part of GE Healthcare, which was migrated over to a fully Web-based PACS—Centricity PACS-IW—in 2006.

“All of this was designed to provide additional information to caregivers to make more informed decisions which improve patient outcomes and patient safety,” says Walczak.

Prior to Web-based PACS, Bayhealth utilized a client/server-based system that worked very well within the imaging departments and worked OK outside of the imaging departments; however, Walczak says they quickly realized it would be difficult to extend that to every location that was needed within and outside of the hospitals to referring physicians. 

Since deploying Web-based PACS, the biggest challenge the medical center has faced was the change management in business operations. “With both technologists and radiologists going from a film-based to an electronic world, that was really our biggest challenge,” he says.

Another advantage is that the system uses the medical center’s own 1,800 PCs in its network to access PACS images and results. The ability to add additional imaging centers or equipment is really very transparent because of the way the architecture is laid out.  “We simply extend our network to wherever it’s needed, be it an off-site imaging center, be it to another new imaging piece of equipment coming into one of our hospitals,” Walczak says. “The ability to integrate our existing imaging modalities has been very straightforward—it is, for all intents and purposes, simply plug-in-play—it is that simple.”

A key feature is the integration of the Web-based PACS with the health system’s physician portal, giving physicians access to online dictation, lab results, x-ray results as well as images, points out PACS Administrator Laura Roy. “Our PACS also is integrated with the Commissure voice recognition system, which enables radiologists to populate the report from the PACS without having to type in or look up information on that patient from another PC,” Roy adds.

Since adding Web-based PACS, radiologist productivity has increased from 85 percent to approximately 95 percent. Report turn-around times that once took 24 to 48 hours for off-site reports, depending on when couriers came back to the hospital, now take roughly 24 hours,