Investing to Improve Workflow

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Dr. Jim Busch, CEO of Specialty Networks in Chattanooga, Tenn., uses syngo Workflow, syngo Voice and syngo Imaging which are part of syngo Suite from Siemens Medical Solutions.Efficient workflow is the Holy Grail of imaging today. To be a competitive player and grow the business, outpatient imaging centers are investing in advanced systems such as RIS-PACS, voice recognition, and digital x-ray and mammography systems to facilitate digital workflow. The investment, implementation and integration of these technologies into daily workflow increases efficiency in many forms. Operations tend to run a lot smoother, and radiologists are able to read more imaging studies from a variety of locales. Most imaging centers that have invested in IT report increased patient throughput and shortened report turn-around times. At the same time, improving workflow increases patient satisfaction and strengthens relationships with referring physicians.

Declining reimbursement is a significant challenge that imaging centers face today. According to Jon Copeland, CEO of Inland Imaging, the Deficit Reduction Act of 2005 is their No. 1 problem because reimbursement has dropped significantly since January. Increasing patient volume is one way to solve the conundrum. However, imaging centers can only achieve this goal by improving workflow, increasing patient throughput, and promising referring physicians rapid report turn-around time.

Headquartered in Spokane, Wash., Inland Imaging is comprised of outpatient diagnostic imaging facilities in the Northwestern United States. More than 60 radiologists affiliated with Inland provide imaging services to 20 hospitals and clinics across Eastern and Western Washington. Its outpatient imaging centers alone perform 265,000 imaging exams annually. “We have to admit, treat, discharge, and get the diagnostic results back all in the same day,” Copeland explains as the main difference between in-patient and outpatient healthcare.

As a result, an outpatient imaging center’s workflow has to be more streamlined and more specialized. “Systems have to be a lot more efficient and a lot more specialized specifically to one purpose,” says Copeland.

To reengineer workflow, Inland Imaging implemented GE Healthcare’s Imagecast RIS and Philips Medical Systems’ iSite PACS, centralized its scheduling and billing and created outbound HL7 interfaces to receive orders electronically from electronic medical record (EMR) systems. A core advantage of PACS is quick, any-time delivery of images to radiologists. Inland Imaging’ radiologists are sub-specialized, says Copeland, and specific exams can be electronically and seamlessly moved throughout the enterprise and delivered to the appropriate doctor to read, in priority by urgency. “This makes the radiologists more efficient and increases job satisfaction,” adds Copeland.

A filmless enterprise also means that films are not delivered around town to referring physicians. “Using the Philips iSite Web Viewer, referring physicians can log on and look at the exams online from their office or home computer,” he says. Improved physician satisfaction helps to ensure their loyalty and continued patient referrals. Inland Imaging has expanded rather quickly since investing in IT systems. “Eight years ago, we were a 12-person radiology group,” says Copeland. “Now we are a 65-person radiology group, and we have not outgrown our systems.”

Digital efficiencies

Diagnostic Imaging Services (DIS) in New Orleans runs three multimodality clinics, an open MRI facility and a dedicated Women’s Center. Nine radiologists cover the five facilities. DIS has experienced many workflow improvements and a surge in patient volume since installing Canon Medical Systems’ digital radiography technology that include the CXDI-22 Sensor Panels and CXDI-50G Portable Sensor Panels. The third clinic is due to upgrade to DR and be completely filmless by December 2007.

The key workflow advantages of having DR are numerous, says Michael St. Germain, director of imaging services. “First, speed and efficiencies are improved dramatically because of eliminating the manual wet processing of films, as well as reducing our repeat rates,” he explains. Prior to DR, it took technologists at DIS an average of two minutes per film to develop the x-ray using a multiloader and wet processing. With DR, images are acquired and appear on the computer screen in three to five seconds. “Our average imaging time for a seven view lumbar spine series went from 20 minutes to five minutes,” says St. Germain. “This improved efficiency allowed us to increase capacity during normal business hours.”

The two centers that utilize