Deploying PACS capabilities beyond a single radiology facility provides the opportunity of extending the reach of diagnostic imaging to a greatly expanded customer base. The benefits to imaging center practitioners are straightforward—increased market share and greater efficiencies from existing personnel.
However, unlike large academic medical facilities, private practice diagnostic imaging centers face different challenges to extending a PACS throughout their enterprise—primarily extremely tight budgets and a limited pool of technical support employees. A pair of multi-site practices recently met these challenges and succeeded in extending the reach of their PACS, through a migration or integration.
Easing the migration headaches
At one point during his enrollment in business school, Randy Hicks, MD, MBA was assigned a paper detailing how he might go about reorganizing his Flint, Mich.-based radiology group to make it a more efficient, prosperous practice. Very quickly, Hicks concluded that Regional Medical Imaging (RMI) needed to embrace a distributed model for reading so that the practice could provide subspecialty interpretation to multiple clients without having radiologists present at every RMI site.
Having to perform this academic exercise inspired Hicks to explore the possibility of acquiring such technology for RMI. Unfortunately, at the time (about 10 years ago), PACS was not a particularly practical investment at the practice level. These were systems intended for large hospital applications, judging by the price point of the systems at the time. However, he accomplished what he could with the deployment by of a collection of mini-PACS in the practice.
This solution, while acceptable at first, did not meet the needs of RMI as the practice grew to five imaging centers with 110 employees. About three years ago, Hicks made the decision to migrate RMI from its mini-PACS installations to a complete, enterprise-level PACS from Amicas.
“Amicas PACS gives me the ability to read all of my exams from one workstation,” says Hicks. “It has developed a single workstation that has all the mammography workflow, 3D tools and patient information that I need, which reduces the number of places I have to go to read a case to one.”
Once a system was selected, Hicks began preparing the practice for migration. His first step was to involve stakeholders from every area that would be touched by the new PACS product: IT, radiologists, technologists, scheduling, reception, billing and administration. As part of its migration strategy, RMI took these representatives to a one-week training session on the Amicas system prior to its implementation.
“This is a key element to the successful adoption of a new technology,” he says. “Involving stakeholders early, and often, create champions of the project in each group.”
Carrie A. Berlin, RIS and PACS director for RMI, noted that the migration of data from the old system to PACS was a challenge for the group.
“The integrity of the data that were being migrated definitely slowed the process,” she notes. “We were relying on the technologists to manually enter the data in our old PACS and, as you can imagine, there were a lot of errors.”
The practice utilized the services of DeJarnette Research Systems to assist in the data migration, Berlin says.
“We migrated approximately 66,000 studies and we began migrating only four months in advance,” she says. “We were approximately 60 percent done at go live. We would have been further along, but had a lot of data that needed to be cleaned up manually. We were fortunate that DeJarnette provided us with a QC tool that allowed us to quickly fix and migrate any study needed by a radiologist that had not yet migrated.”
Berlin advises that a practice contemplating a PACS migration candidly assess its data migration task as part of project. Looking back on her experience, she notes that she would have started the process at least a couple months earlier.
RMI, like many practices, is accelerating the return on investment of its PACS by uncovering and developing opportunities to transform the systems from cost centers to profit centers.
“The way medicine is being practiced is being changed by the digitization of radiology;