RIS IN THE 21ST CENTURY
Improvements in radiology information systems have been driven by newer technologies, such as PACS (picture archiving and communications systems), voice recognition software and electronic medical records (EMR). And a must of any effective RIS today is scalability to change with the department and enterprise.
"With new technology comes an amount of interfacing that needs to be streamlined and centralized toward the new EMR," explains Travis Turner, manager of radiology and director of PACS at Catskill Regional Medical Center, a 175-bed facility in Harris, N.Y., that uses Misys Healthcare Systems' Misys Radiology. "Having a RIS is key to this ultimate integration."
Basic RIS applications include patient registration order entry, data analysis, management reporting, scheduling, tracking and transcription functions. Newer versions include compliancy with industry standards, such as Integrating the Healthcare Enterprise) and HIPAA, integration with PACS and HIS (hospital information systems) and mammography support, and are more user friendly to minimize training.
"When RIS first hit the market, the systems were designed more for the department manager to capture information so they can report things that were happening within the department," says Don Taylor, product manager for Siemens Medical Solutions, Novius Radiology. "Now with the integration between systems, the RIS is more focused for the radiologist and for the referring physicians to get them information in a timely fashion."
Radiology information systems with distributed architecture are appealing to customers today as patient volume increases and the referring community demands quicker access to information. "The change has come about where radiology departments require more access to more clinical information than they may have in the past," opines Taylor. "As automation has expanded, there is a greater reliability in making sure that patient information is available at the same time you are trying to provide a diagnostic review."
The Internet is an integral force driving radiology information beyond department walls. A Web-based component is the main reason Indiana University Radiology Associates Inc. (IURA), a radiology practice of 70 radiologists in Indianapolis that interprets radiographs for multiple facilities, implemented Ximis Inc.'s Xiris, a Web-based RIS.
"The RIS is our foundation," says Rita McFarland, director of medical imaging at IURA. "We could not function without it because it distributes our workflow, houses reports, and distributes our reports automatically. The Web-based component is important because we can access it anywhere - this is extremely important for our referring physicians."
The RIS also helps IURA carefully monitor workflow. "Let's say a patient goes to one of our networked imaging centers for a study and the referring physician needs the report the next day," explains McFarland. "We monitor to see when the study went to the reading room and when it got read by the radiologists to make sure the referring physician has that report. Our out-reach staff monitors this and continuously looks at the unread worklist."
While IURA's nucleus is its two main imaging centers, it also offers an outreach service that is a profitable addition to the practice, which according to McFarland, would not exist without the RIS.
One of the goals of an automated healthcare system is to meet the unique criteria of any-sized facility and positively augment productivity, guaranteeing that patients are given the best care possible. Donna Seay, director of operations at Western Imaging Center in Culver City, Calif., praises the flexibility of their RIS because it meets the unique requirements of the multi-modality, independent imaging center. Needing a RIS that was affordable and more schedule-centric than billing savvy, Western Imaging Center installed Swearingen Software's RMS RIS.
"We need a good scheduling package that will be flexible because we have particular exams that we only want to do during certain hours," says Seay. "It allows us to look at the department as a whole, which is a valuable tool for managers and supervisors. We can pull up the entire department and look at the next day to see where the gaps are and where staff is needed most. You know what your volume is for the next day."
Upgrades are key to propelling workflow continually forward - but only if they don't disrupt workflow