The proliferation of freestanding medical imaging centers over the past several years has been propelled by a number of factors. Reimbursement systems reward the cost-effectiveness of studies produced in these facilities, since the overhead associated with hospitals is far less in an independent clinic. Patient demands support these trends too, since they often prefer the convenience of a smaller site, many of which have been designed to offer pleasant surroundings not found in the hectic radiology department of a medical center complex. Major vendors facilitate physician financing of expensive imaging equipment. And the entrepreneurial spirit is alive and well among radiologists. Combine these factors with radiology information systems more tailored for freestanding centers to efficiently and cost-effectively manage data and images, and the recipe for success is complete.
Defining the market
A glimpse into the reality of the growth in the in-office imaging sector (derived from a quick review of Part B Medicare statistics generated between 2000 and 2003 and shared by the American College of Radiology), shows it was much more rapid than aggregate increases in the number of imaging studies across all practice settings.
Between 2002 and 2003, there was a 17 percent overall growth in the number of imaging procedures throughout all sites of service - with a 26 percent increase in the professional component RVUs (relative value units). Within that context, analysis of the data suggests that increases in imaging center studies occurred at a more rapid rate than overall growth with a 22 percent increase in the number of procedures and 33 percent growth in the professional component RVUs. A corollary finding yields the conclusion that non-radiologists are gaining in their share of the professional pie in freestanding imaging centers.
A variety of vendors have designed radiology information systems to improve the specific workflow of imaging centers and impact the overall effectiveness of these sites. End-users report that adoption of RIS increases their efficiency, promotes good relations with referring physicians and speeds patient report generation as well as creates basic statistics necessary for reporting to governmental agencies and others.
There are a number of key ingredients to successful deployment of a RIS within a freestanding imaging center.
Vendor support is vital
John Ising, CRA, FAHRA, administrator of the Saint Luke's Outpatient Imaging Center in Kansas City, Mo., uses the new Windows version of the Swearingen Software Radiology Information System, RMS. He reports that the support from personnel at Swearingen is extraordinary, as they have smoothly integrated their software with other systems such as the billing service that the center uses. He relates that when the integration of these two systems was necessitated, Swearingen people worked onsite for a few days with imaging center personnel and the billing office to insure that the interfaces were working well.
The center is affiliated with St. Luke's Medical Center, where they are adopting a McKesson PACS that went live last month. Swearingen also has worked with their PACS integration team to smooth the transmission of images between facilities.
"We had been doing archiving since the end of August in preparation for the 'go live' in December, and the Swearingen interface was almost flawless," Ising says.
Besides their onsite support, Ising is impressed with Swearingen's efforts to bring end-users into product development. At their annual user meetings, customers list and then vote on suggested improvements. At the end of the meeting, the top suggestions are adopted and built into the next version of the software. If a suggestion involves a "quick fix," Swearingen will have the proposal implemented within the week, according to Ising.
Carmelita Joyce, office manager and CT, mammography and x-ray technologist at Parkview Imaging in Santa Monica (Calif.) concurs that Swearingen has been very supportive since their initial installation six years ago. The center uses x-ray, MR, ultrasound and CT for their three radiologists to image 65 to 70 patients per day. Without the RIS, the facility would be unable to perform at that level, she relates.
"This is the easiest system to operate," Joyce says. "From an IT standpoint, the Swearingen support group can help you with anything instantly. If we call, they PCP/IP into our system and fix problems whenever they occur."