A need for imaging and IT systems that would allow for significant growth, improved service and state-of-the-art technology led a forward-thinking, Georgia-based healthcare organization to implement PACS, go filmless and drive better productivity. Two vendors partnered to establish a digital platform and the storage, archiving and monitoring systems needed to keep it running smoothly.
WellStar Health System, the largest not-for-profit hospital system in Georgia, serves one of the fastest-growing counties in the state—Cobb County—and three adjacent counties in the Atlanta area. WellStar was established in 1997 and has been growing ever since. The system now includes five hospitals, multiple associated physician groups and urgent care centers, and 10 imaging centers.
A strong product line
WellStar decided to implement PACS and become filmless to improve its service to referring physicians and patients. “We wanted to reduce competition inside the hospitals between ED patients, inpatients and outpatients for services. At the same time, we recognized that outpatient imaging would be a strong product line for us,” says Robert Mandler, executive director of medical imaging.
WellStar also wanted the ability to offer state-of-the-art medical technology. “When we started looking at investments in technology, we wanted to make sure we had the electronic infrastructure to support our investments.” A digital environment would provide the foundation needed to let the organization install the most advanced imaging modalities.
The effort began with two new imaging centers designed to be digital from day one, says Mandler. Soon after construction began, WellStar contracted with Agfa HealthCare to install the digital technology and provide IMPAX PACS as an application service provider, while leveraging an EMC information infrastructure. Mandler says WellStar chose Agfa because of the company’s ability to integrate multiple legacy systems.
Agfa’s IMPAX Basix system was installed to accommodate the transfer of digital information. The first two imaging centers opened equipped with Agfa’s IMPAX Basix Server with RAID (redundant array of independent disks) on-site storage, an IMPAX Basix dual black-and-white diagnostic station and multiple CS 5000 clinical review stations. The two centers also had the Agfa Diagnostic Center (ADC), a complete computed radiography package that was installed at each of the eight other new imaging centers WellStar built. Two more have been added since then.
Agfa linked WellStar’s existing digital images and RIS to the Basix with a broker data center so that prior studies would be automatically available with any new studies. Agfa also installed its web server, IMPAX WEB 1000, to transport all images and reports to referring physicians. This set-up was replicated at each of the new imaging centers.
WellStar decided that an enterprise-wide PACS would best maximize efficiency and productivity. A central Oracle server and database archive linked each facility. One key advantage with Agfa, Mandler says, is its consistency over the years. “Almost every other major PACS vendor out there has made acquisitions or completely changed their platform.” Since starting to purchase Agfa equipment in 2001, none of the systems have become obsolete so “we’ve had no ‘sunk funds.’”
Getting up to speed
To get all of the physicians up to speed with the new equipment, marketing representatives worked with each practice, says Carol Scoggins, WellStar’s director for radiology informatics and marketing. The reps helped physician practices learn how to load images, pull them up on their computers and use the various tools.
Another part of the job is to periodically check in with practices to promote services and make sure WellStar is meeting their needs, from training to order forms to patient information brochures. These are positions Scoggins “definitely recommends” for a large, diverse organization.
The initial issue was getting the images out to physician practice, says Scoggins. “Practices had variations in their connectivity and their computer systems.” That ranged from DSL to dial-up connections to one practice that did not even have one computer—everything was done manually. “It was eye-opening for us just as much as it was for them,” she says. She and her team worked internally as much as possible to allow for easier image access through the physician portal and some practices upgraded their systems. “Physicians upgrading their