Imaging Centers Going with the Workflow

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Believe the ‘buzz’

There are few buzzwords bigger than ‘workflow’ within the radiology industry. It is uttered so much that it seems to begin to lose its meaning, at least until you visit an imaging center. Upon investigating multiple centers across the nation, it quickly becomes apparent that ‘workflow’ is not really a buzz word at all. It is simply a crucial piece of reality.

In this age of decreasing radiology reimbursements, increasing competition, rising costs of operation, and growing demands from referring physicians—just to name a few—imaging centers had better be running Cracker Jack operations. Knowing your workflow, addressing what needs fixing, and adopting the right technologies to facilitate your goals is the path to a well-oiled, fine-tuned imaging facility.

RIS/PACS integration

To improve workflow, no single element seems more essential than integrating the patient information in your radiology information system with the images and reports in your picture archiving and communications system. Of course, ‘integration’ also is a huge buzzword, but in the life of a radiologist, streamlining the process by which each image is acquired, read, and reported is vital. A PACS driven by a RIS can massively improve every department within an imaging center.

Centers that don’t have a strong RIS pine for one. That’s the case at US Imaging, a network of seven imaging centers across Texas. The multi-modality centers, which manage about 125,000 images each year, have seen turnaround times reduced 20 to 25 percent following the adoption of a ScImage PicomEnterprise PACS. However, the facility could potentially improve even further with the implementation of a new RIS system, says Chief Information Officer Kyle Richie.

US Imaging is proof, however, that a successful PACS implementation alone can provide big workflow benefits overall. At US Imaging, the ScImage system has allowed radiologists to work together at one facility so they can consult onsite with one another. Also, Richie says that they have been able to make productivity gains by adding more modalities due to some of the savings they’ve seen.

Yet, some imaging practices—those with the financial wherewithal at least—set out to structure their entire organizations around the idea that having an integrated RIS/PACS is essential.

“Integration is key. It has probably accounted for 80 percent of the efficiency that we’ve received,” says Jim Busch, MD, radiologist, director of Specialty Networks, Diagnostic Radiology Consultants, a private practice radiology group in Chattanooga, Tenn., that services North Georgia and Southeast Tennessee. “What RIS/PACS integration does is allow me to organize my workflow into a unified environment, which allows me to focus almost entirely on image interpretation because the reporting system is integrated with the images. And all of the patient data are already there and don’t have to be restated and rechecked every time I interpret an exam,” he adds.

Such efficiency is very important when you’re processing about 200,000 exams every year for hospitals, outpatient imaging centers and also multi-specialty practice groups. To handle the load, the group invested in a full syngo suite from Siemens, including a RIS ( syngo Workflow) and PACS ( syngo Imaging) and syngo Voice—an integrated voice recognition software. To boot, they added a NextGen EPM (enterprise practice management) system which handles all scheduling and registration. These technologies offer the entire platform from registration, scheduling, imaging at the technologist level, interpretation with a radiologist, and distribution. Billing will be added in the future, says Busch.

The whole goal was to improve efficiency. “I expected between 10 to 12 percent efficiency gained once the full system was in place. So far we have already seen the efficiency of a full FTE (full time employee) lost out of 11 doctors—which is a 10 percent increase already and we do not yet have 60,000 exams on the system yet,” says Busch. “A full FTE is very important. Probably the biggest cost for a radiology practice is the radiologist. If you can eliminate one, it goes a long way to pay for your system.”

Busch also is a big advocate for integrating your voice transcription software with your RIS. “What that does is provide functionality that you could never achieve with just a third-party voice transcription software interface. What happens is that when you open an examination, the RIS understands