Healthcare systems and radiology practices are beginning to tap into health information exchanges (HIEs), with some exchanging HIE’s prized peacock: images. Early adopters are fueling growth, boosting efficiency and cutting costs as well as discovering the value of collaboration by embracing data sharing among competitors. Consider:
- One of the large referral sites linked to the OhioHealth (Columbus) Results Browser HIE has cut exam duplication by 85 percent since plugging into the HIE.
- HIE-enabled processes helped Spokane, Wash.-based Inland Imaging cut imaging exam turn-around time in half.
- By offering HIE image access, which eliminated the majority of film and storage costs, Michigan Regional Health System in Petoskey, Mich., saved more than $100,000 since going live with PACS at Northern Michigan Regional Hospital.
Driving efficiency and growth
Inland Imaging Business Associates has benefitted in several ways from its web-based HIE. From 2007, when the practice first implemented the HIE, to 2010, the practice cut exam turn-around times by 50 percent, reports CEO Jon Copeland.
Using a single enterprise worklist, the system stores 1.3 million radiology image exams per year and more than 1,000 users access the system every day. An internal algorithm lays on top of multiple radiology and hospital systems, which enables a single workflow for radiologists and radiologist assistants and creates a continuous workflow for tracking critical and urgent findings in reports, says Copeland.
The system augments and tracks statuses such as when the orders are entered, when an exam is completed and when the technologist marks an exam as ready as well when an exam is finalized. Additionally, the system tracks quality check statuses including transportation time and presentation of preliminary exams. “We’ve added extra statuses to track at a more granular level of the workflow throughout the hospital department,” says Copeland, who attributes radiologists’ 15 percent efficiency gain in the last three years to the HIE.
The HIE has stretched Inland’s growth into the Phoenix and Seattle markets. “Clinicians should be willing to share and agree to collaborate with patient exam data in an HIE model across competing entities in order to enable a seamless flow of patient data,” says Copeland. The combination of sophisticated tracking and routing 1,300 imaging devices to a single PACS database fuels the HIE’s growth. Driven by HIE participation, Inland brought four new customers onto its PACS in 2010.
Anatomy of an HIE
Web-based HIE systems are hitting the market at breakneck speeds. Take for example OhioHealth Results Browser (ORB). Some 3,000 users plug into the internal single sign-on-based application to provide image sharing and clinical decision support, says Scott Starkey, director of digital imaging at the nonprofit OhioHealth Information Services.
The HIE integrates PACS data with other clinical data from OhioHealth’s family of hospitals and 20 health and surgery centers throughout a 46-county area and pushes that data via a virtual private network to a web browser (or via cloud DICOM routing if the referring site’s bandwidth volume is insufficient for a particular exchange). The system stores one million studies—150 terabytes—annually. The application has been so widely adopted that Starkey reports that OhioHealth recently rolled a version of ORB onto the iPhone.
Smaller HIEs report similar success. Michiana Health Information Network (MHIN) in South Bend, Ind., formed in the mid-1990s with an original goal to deliver clinical results to providers. Currently, MHIN encompasses about 1,000 clinical providers sharing clinical data including surgical notes, radiology reports and clinical summaries during visits to provide a community regional record. An average of 500 to 600 providers access MHIN daily, with two million transactions occurring monthly, according to Tom Liddell, executive director for MHIN.
Medical information, including radiology reports, is fed into a single pipeline database which is bifurcated and routed naturally into a clinician’s inbox so users have up-to-date information depending on the type of practice. According to Liddell, a radiology exam and associated results can be routed to the radiologist’s inbox. “In many cases, though not all, we present the diagnostic image, and in other cases, if a radiologist’s security parameters are not strictly set, it will drop them to log on to PACS to