PACS Across the Enterprise

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Children’s Hospital of Alabama: Part of Children’s Health System
  • Beds: 275
  • Annual imaging procedures: 101,373
  • Annual ER patient visits: 55,000
  • RIS/PACS user since: 2003
  • Stat: Only children’s hospital in Alabama

The benefits of integrated RIS/PACS in radiology are absolutely clear: improved workflow, faster report turnaround time and enhanced patient care. Enterprise care, however, is equally important, and digital image management solutions such as the Siemens RIS/PACS and related solutions can deliver powerful benefits to clinicians across the enterprise.

Take for example Children’s Hospital of Alabama in Birmingham. PACS is an enterprise project at Children’s. Clinicians across the Children’s Health System use Siemens Web-based Viewer image and report distribution and web-based 3D to access radiology images and reports and improve clinical processes. The approach delivers advantages across the enterprise. Consider:

  • The ICU has eliminated the historical challenge of the sneaker net where a resident trails a tech to deliver urgent films. Siemens Web-based Viewer facilitates immediate image review and feedback, which, in turn, expedites patient care.
  • Enterprise-wide, web-based 3D provides neurosurgeons and other clinicians additional information in difficult cases such as skull fractures.
  • Siemens PACS has helped to deliver tremendous improvements in patient throughput and quality of care in the ER, says Director of Emergency Medicine Peter Glaeser, MD. For example, specialists can review images from home to provide immediate input.
  • The ability to review and manipulate digital images prior to orthopedic surgery helps surgeons place pins, screws and bolts more accurately during procedures to treat complex deformities of the spine, hips or knees.
  • Enterprise PACS is a complex undertaking; success hinges on careful planning and communication and collaboration among all stakeholders. But, as Children’s Hospital demonstrates, the enterprise approach reaps significant dividends.

The integrated ICU

Imaging needs and applications differ across the enterprise. Optimizing digital image management requires configuring solutions to each department’s needs. Children’s Hospital developed systems and processes to ensure maximum gains with the Siemens PACS and Web-based Viewer deployments.

The ICU traded conventional viewboxes for the Web-based Viewer thin-client viewing systems about four years ago. Today, intensivists can view images on every computer in the unit or at a Plasma screen viewing station. In addition, mobile physicians can access reports on handhelds via Palm-compatible software.

The differences between conventional film-based care and RIS/PACS-enabled digital processes are significant, says Intensivist Margaret Winkler, MD. Radiologists and intensivists still meet for morning rounds, but the process of reviewing digital images is less cumbersome and much faster, says Winkler. Specialists gather around the large central ICU viewing station to review and discuss images every morning. During the day, the process of reviewing random urgent x-ray and CT studies is more efficient and facilitates better patient care. Residents no longer chase after techs to ensure that radiologists review stat studies. Instead, radiologists review ICU studies immediately without the physical intervention of a resident. In addition, radiologists call intensivists with urgent results like a pneumothorax. “If I miss something, the radiologist catches it and immediately brings it to our attention,” explains Winkler. Finally, she and other intensivists can review images with on-call subspecialists who use Web-based Viewer to view studies from home. The approach eliminates the ambiguities and delays associated with film. That is, intensivists don’t need to describe a small subdural hematoma by phone; nor do subspecialists need to drive in at night to review films.

In addition, electronic imaging empowers ICU staff, Winkler says. For example, nurses can place a feeding tube, order the x-ray, review the image and let an intensivist know that the tube is in place so the department can start feeds. Extra staff training focused on image interpretation provided staff the skills needed to adopt this approach.

The web-driven operation

Neurosurgeons at Children’s rely on a configuration similar to that in the ICU. Most view images in their office via Web-based Viewer, but the department conference room is outfitted with a 60-inch, flat-screen plasma display