Radiologists, administrators and IT professionals have worked hard to refine the acquisition, manipulation and storage of diagnostic images. But what about the special needs of referring physicians who increasingly want to access radiological images along with reports—including 3D renderings? Surprisingly, it’s not all that complicated.
The PACS route
Joseph Dilone, CIIP, CPAS, LMRT, ARMRIT, is the radiology administrator for 1960 Digital Imaging, an outpatient center in Houston, with five radiologists. The facility gets referrals from urologists, orthopedic surgeons, general surgeons, oncologists and others. Several years ago, Dilone and colleagues installed the AccessNet PACS from Aspyra. All of their referring physicians have the AccessNet ImageWeb viewer installed at their facilities that allows them to access the diagnostic images—anywhere, anytime.
Some referring physicians, such as orthopedists doing follow-up, are content with static images. Orthopedic surgeons, on the other hand, increasingly want access to interactive tools to manipulate, magnify and rotate 3D images. In those cases, Dilone tweaks the templates to give these subspecialists enhanced interactive image capabilities. Neurosurgeons and cardiologists command a more sophisticated access. Dilone sets them up on a virtual private network (VPN) so they can have access to high-resolution, diagnostic-quality, 3D-rendered images for precise pre-operative measurement and planning. They dial into a Vitrea workstation and can manipulate and rotate the images, as well as do fly-throughs.
Dilone recently set up a group of seven family physicians in nearby Tombalt, Texas, with the Access.Net ImageWeb browser for use on their tablet PCs. The group seeks to enhance point-of-care services for patients and now they are able to streamline patient care by having a quicker turn-around time of diagnostic information, Dilone says.
One referring physician, Philip L. Leggett, MD, a general and laparoendoscopic surgeon at Houston Northwest Medical Center, likes having access to CT scans of the chest, upper GI and colon, as well as MRI studies. “Before, we had to go to the hospital and pull the x-ray,” he says. “This is really a technology that benefits patients. You can make decisions while they are in your office. It expedites care.”
Leggett also likes that if he has a question about something in the report, he and the radiologists can look at the image together while they talk on the phone.
Maimonides Medical Center in Brooklyn, N.Y., is a 705-bed hospital with 18 radiologists and more than a dozen radiology residents. The facility has used the AccessNet PACS for more than a decade. Several years ago, they explored other PACS options but decided to stay with AccessNet, according to Maxine Fielding, assistant vice president for the MIS department at Maimonides.
Fielding says that within the last two years, the demand from referring physicians to access to diagnostic images has dramatically increased. All physicians within the hospital have access to radiological images. Most of them are taking advantage of it, Fielding says. Several groups, such as cardiothoracic surgeons, neurologists and ER physicians, can access images remotely. Referring physicians are able to perform rudimentary functions such as magnifying the image or rotating it. To manipulate 3D images, they must go to the radiology department’s 3D workstation.
Outsourcing is an option
Borgess Medical Center, a 424-bed healthcare facility in Kalamazoo, Mich., experienced a dramatic increase in its CT volume. While the radiologic technologists were skilled at post-processing and 3D modeling, the increase in CT studies—and the concomitant increase in the need to post-process images—began to interfere with workflow. “It got to the point where our technologists were treating the 3D modeling as a deferrable task, something that could be done later,” says Radiology Director Tom Mushett.
Mushett and colleagues considered the option of creating an in-house 3D lab, but cost and space were an issue. While the department uses Vitrea advanced visualization software from Vital Images to create 2D, 3D and 4D images, it would have