The Imaging Center: RIS/PACS & Operational Efficiency

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GE Healthcare Centricity PACS-IW system
Implementing a RIS/PACS presents an imaging center with major changes to operations, workflow and practice. Physicians and administrators can realize enormous benefits from the introduction of the technology, provided the A, B, Cs of their master plan includes a D for proper deployment.

Multicenter connectivity
South Jersey Radiology Associates (SJRA), a full portfolio imaging group with 43 physicians centered in Voorhees, N.J., employs RIS/PACS at all 10 of its imaging center facilities. The GE Healthcare Centricity PACS-IW system five years ago replaced a prior-generation system that lacked web-based capabilities, says PACS Administrator Kim Baldwin.

One measurable benefit of RIS/PACS has come in reduced distractions from fewer phone calls between the imaging centers. “We have about 8,000 physicians that refer [patients] to SJRA. The PACS gives them real-time access to reports and makes it easy for the physicians to view images,” says Baldwin.

SJRA sees a large case mix, including CT, PET CT, mammography, DEXA x-ray, MRI, ultrasound and nuclear medicine studies. “We are completely digital, every modality is connected to the PACS,” she says.

South Jersey Radiology is a super-user of sorts. Each day, the imaging centers together generate about 1,000 reports. And the RIS/PACS has many more users than the previously installed system. “The old system had five referring users,” she says. “Now we have more than 2,000, with close to 100 logged in throughout the day.”

Baldwin confirms the system has been well received by referring physicians. Of the 400 employees working for SJRA, about one quarter are technologists, with 43 radiologists currently employed. Baldwin notes that the system is useful to almost every employee. The technologists find the quality control (QC) feature most useful, as well as the capability to change patient history and information for the referring physician. However, it is the radiologists who have gained the most from the system.

“The features our radiologists like the best are the embedded 3D, spine labeling, and triangulation function, end-user definable worklists and the ability for free form window layouts. It is web-based so they can read from home and have the same functionality as in the office,” Baldwin explains.

As the system’s administrator, Baldwin appreciates its web capabilities and the fact it is “user friendly and very intuitive.”

Integration & interoperability
Flexibility is the main feature Clay Hinrichs, MD, of Hackettstown Diagnostic Imaging appreciates from the facility’s Infinitt RIS/PACS. The system is installed at all three of the group’s imaging centers in Hackettstown, N.J.

“I was looking for an integrated vendor, so I would not have to select a registration, billing, RIS and PACS. I was favoring a system that had a turnkey approach,” Hinrichs says.

This turnkey approach enables Hackettstown to use the system through the entire continuum of care—from the point at which the patient is registered, to the point when the bills are submitted to payors.
“When I went with Infinitt, there were few, if any vendors offering this. I’ve been using [Infinitt’s system] for three to four years now,” he says.

The deployment of the RIS/PACS has brought about workflow benefits for the five radiologists who work at the imaging centers. “Flexibility is one thing we like,” Hinrichs says. “For any study coming in, we are able to produce reports quickly, but on the other hand, we are able to take advantage of using transcriptionists to improve our workflow and being able to interpret many more studies.”

The 12 technologists at the centers, like the radiologists, appreciate the “inherent flexibility” of the system—especially with regard to making sure the patient information is correct, making sure the images get to where they need to be and are accompanied by the appropriate documents.

In fact, all Hackettstown employees make use of the RIS/PACS because “everything is generated easily, [and the system] makes everything seamless,” says Hinrichs.

Growth has been a challenge, but RIS/PACS has eased the growing pains. “One of the big issues is we’ve moved from having one imaging center, and now we have just opened our third,” says Hinrichs. “One thing we wanted to do was share scheduling resources between the centers. We now have the ability to schedule at any of the three centers by any of our staff.”

Perhaps most noteworthy for Hinrichs is the easy useability of the RIS/PACS installed in his imaging centers, whose referral base includes northwest New Jersey. Staffing wise, he is able to reduce the number of front desk personnel because the system allows for the same phone line to ring at all three imaging locations and any staff member to schedule at any location.

“I think the real true test of a RIS/PACS is when the problems occur,” Hinrichs says. “As I grow and open new centers, I am able to integrate and add-on an additional center quite easily. I don’t need to reinvent the wheel with Infinitt.”

Imaging centers and hospitals unite
The addition of RIS/PACS sparked efficiency changes for the three imaging centers of Schenectady Radiologists in Schenectady, N.Y., says Practice Administrator Jim Mooney.

Mooney’s imaging centers and 14 radiologists work with Ellis Hospital, a group of three hospitals. The goal was for the imaging centers and hospitals to have “separate systems, but the same product.” They chose an Amicas RIS/PACS.
“The beauty here is, whether my radiologists are working at the imaging centers or working at the hospital, they have two mirrored workstations next to one another,” Mooney explains.

Most noteworthy is the improvement to the group’s report turnaround time. “For our offices, turnaround time used to be 2 to 3 days, on average,” says Mooney. “Now our reports are faxed out within a half-hour of the patient being done.”

And as for the hospitals, Mooney explains, “Turnaround time used to be one to two weeks before a physician got a report in the mail. Now, those are pretty much same-day, too.”

Using the same PACS product across the imaging centers and hospitals has created an opportunity for cost-efficiency with regard to radiology workflow. Mooney explains that in the past, his radiologists had to work at one location for a half-day and drive to another location for the remainder of day because there was not enough work for a full-time radiologist at either location.

“If we have a day when one hospital is really busy and the other offices might be slower, I’m utilizing all my FTEs at the same time,” he says.

And in the evening, physicians never have to leave the comfort of their home, as they can read studies from that location as well, says Mooney.

“We looked at multiple companies, and AMICAS PACS was one of the favorites as far as what my radiologists like in a product,” he says. “I have AMICAS monitoring my RIS, my PACS and my billing, and they are all closely connected, so it makes the best of both worlds.”

Choosing the right RIS/PACS
So what does the voice of experience say when it comes to choosing a RIS/PACS? “Make sure the network can support and handle the volume and go with a web-based system,” Baldwin offers. “It gives more flexibility with what you can provide.”

“You definitely want to look at ease and reliability of service,” says Mooney. “Service is very important because once you make that commitment—you can’t have downtime. If your PACS is down, nobody works.”

Mooney adds that the RIS/PACS should be intuitive for radiologists, “because you’re really changing their work habits. They become reader, editor, transcriptionist—you don’t want a system that they are not going to be happy with.”

“Ask as many friends as [you] can about their experiences are from implementation of the RIS/PACS to the final functionality they had,” says Hinrichs. “I think that a lot of the vendors try to sell you that they are able to do everything and that they are able to offer you the world. But at the end of the day, you want to have a functioning, simple system that works.”