PACS and the Imaging Center: Boosting Flexibility and Patient Care

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Imaging centers are benefiting from what PACS has to offer - better organization, redistribution of images and workload, a more streamlined working environment, an increase in productivity, faster report turnaround time, improvements in patient care and a significant reduction in hard-copy film costs. Health Imaging & IT spoke with four freestanding imaging centers utilizing PACS about the benefits PACS has brought to day-to-day operations.

Radiology Affiliates Imaging

Radiology Affiliates Imaging, a free-standing imaging center in Hamilton, N.J., is using NovaRad's NovaPACS to electronically acquire, store and transmit electronic patient images and data. The practice's 20 physicians provide coverage for two area hospitals, its Hamilton, Lawrenceville and East Windsor facilities as well as provide outside read services to networked healthcare facilities throughout the state. The PACS allows a radiologist to be physically present at one center but read images for any other facility in the enterprise.

"We would not have these other reading contracts - where we can increase the number of studies per day with the same physician staffing - without PACS," says CIO Pete Higgins.

The PACS has improved workflow and the services provided to the referring physicians, controlled operating costs, decreased the need for film and made the practice more competitive in the marketplace, says Higgins. A hospital may only have two doctors on site, but in reality the PACS allows the hospital to have access to 20 doctors in real time. Patient care is improved by enabling specialists to be consulted on cases in real time.

A voice recognition system (Dictaphone's Powerscribe) integrated with the PACS is another boost to workflow. "Our transcription system is web-based, so all of the transcription is done through the Radiologists Affiliates' network under one URL," says Higgins. "Usually within 10 minutes of a completed exam, the dictation also is completed." Transcription department FTEs have decreased from 4.5 to 1.25 with the integrated voice recognition software, as well as eliminated some costs associated with transcription services.

Return on investment can be seen in a number of areas, including a 50 percent reduction in film usage. "On the PACS side is the physician component," says Higgins. "The tools and the access to exams make it easier for the physicians to be more productive. Everything is at their fingertips. They are not struggling to find films. Previous exams are presented automatically through pre-defined hanging protocols. They are not juggling tapes. Films are not getting lost by the couriers."

"The physicians turn out volume," continues Higgins. "For the average physician, the number of cases they can read per day have increased significantly."

Borg Imaging Group

Borg Imaging Group in Rochester, N.Y., is an independent diagnostic imaging center consisting of eight sites that offer a wide range of medical imaging services, including CT, MRI, x-ray, digital fluoroscopy, digital mammography and ultrasound. The practice went live with Kodak Health Group's DirectView PACS System 5 at the end of 2004. Thirteen radiologists read for the practice - that has a volume of 100,000 imaging exams annually.

Borg Imaging is on their second-generation PACS. "The first generation was more of a learning experience than anything else," says Luke Bernier, director of business systems. "We learned a lot, especially in terms of the need for reliability."

Borg's experience with the first generation PACS also made the practice much more storage savvy the second time around; the facility implemented an enterprise-wide storage architecture from Kodak. "We wanted not only the PACS on the storage architecture, but we also wanted our RIS and some of our business systems," he says. "PACS drives storage, but if you engineer it correctly, you can take that engineered solution and leverage it toward other business systems."

A newer generation RIS will soon be integrated with PACS, which Bernier says will improve workflow for both the radiologists and technologists. "We guarantee the report within 24-hours, but normally deliver it in four hours," says Bernier.

PACS has improved business operations at Borg Imaging. "When you look at handling digital images as opposed to film, there are huge savings," says Bernier. "Radiologists and technologists are more productive and the network eliminates the needs for couriers. In the future, we will not need to send