Due to the incongruent makeup of imaging departments and centers, the myriad challenges that arise in attempting to ease workflow are being solved with a variety of tailor-made solutions.
The weight of paper
“Paperwork has been the traditional obstacle to workflow in imaging departments,” says Roger Growcock, electronic imaging manager at Carolinas Medical Center-Union in Monroe, N.C. “The Joint Commission steadily increases the documentation requirements, making it more challenging.”
Carolinas, which completes about 95,000 studies annually, has seen improved turnaround times and reduced costs through digitizing various modalities—from a $350,000 annual film budget to $1,200 currently.
From a technologist’s viewpoint, he or she needs to gather together all appropriate forms in a timely manner, including the physician’s order form, contrast media check list, IV consent forms and patient order form.
“These documents inform the technologist about the ‘who, what, when and where’ of each scan,” Growcock says. To assist with these forms, Carolinas began using PACSGear’s PacsSCAN scanning software five years ago.
“We saved the cost of an FTE [full-time equivalent] by eliminating the previous scanning required in our medical records department,” Growcock says.
However, CT remained Carolinas’ “biggest challenge” in speeding patient throughput, according to Growcock.
“Patients undergoing an abdomen CT or pelvic CT have to consume contrast,” he notes. “There is a physiological delay to that process, but we didn’t want to add to that delay with waiting on lab results, patient consent and so forth.”
About a year-and-a-half ago, Carolinas’ outpatient setting began using PACSGear’s Forms product for converting imaging department forms into electronic versions, primarily for CT and MR.
The fields on the forms can be pre-populated with data from a DICOM Modality Worklist. After the patient is discharged, the electronic forms are sent to the PACS.
“This deployment has saved us between one to two minutes per patient, as well as reducing the cost of paper and toner cartridges,” Growcock says. “In CT, we have shaved 17 minutes off the technologist’s time for each procedure, including seven minutes by switching to electronic forms.”
Synching workflow across an enterprise
About a year and a half ago, Seattle’s Medical Imaging Northwest (MINW), whose 25 radiologists read about 350,000 studies per year for three imaging centers and two hospitals, became a digital environment.
“We have been seeking improved interoperability due the technological disparities between our various healthcare environments,” says Annette Simmons, IT manager and network administrator at MINW. “Each of our facilities continuously sees the same patients, and pulling prior reports on each was a manually intensive process due to the multiple RIS, HIS and PACS across our enterprise.”
The MINW imaging centers employ individuals to query all the appropriate information. However, this process is expensive, labor intensive and not available in the network’s hospital setting.
“It became a patient care issue because we couldn’t provide the same services in the hospital setting that we can in the imaging center,” she explains. “It’s also a management nightmare.”
Simmons turned to MEDxConnect software from Compressus to connect the existing imaging systems and databases, making them accessible with one worklist.
“Now, we can search both PACS to provide priors to our radiologists, without the imaging assistants having to undergo any manual moving or copying of reports,” she says.
Simmons says the biggest difference for the radiologist at the hospital is that data are available anytime, including weekends.
Modality mix, patient volume, service sites and contracts all play a role in determining the best possible workflow for a practice. However, with the proper application of third-party tools, a streamlined workflow can be implemented and enjoyed.