Keeping Referrals Coming: Neuroradiology Group Reaps PACS Benefits

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Case Study: Western Neurological Associates  |  Salt Lake City, Utah

Sponsored by an educational grant from GE Healthcare & Dell

  Linda S. Monty, R/T (R)(MR)(CT), imaging manager at Western Neurological Associates, looks at images in the central PACS reading room, located just steps from a CT and an MR scanner.

Western Neurological Associates first installed PACS in 2002, but soon thereafter decided to upgrade. “We wanted a system that was user-friendly, affordable and scalable to our size,” says Imaging Manager Linda Monty, RT(R)(MR)(CT). “We needed something that would work for us and for our referring physicians, and the Web-based product that we chose has really facilitated that.”

Western Neurological Associates implemented Centricity PACS-IW from GE Healthcare. “When you engage in a Web-based product, you are telling your physicians and your referring physicians that you are state of the art,” says Monty. That, along with the ability for the PACS to interface with other vendors’ imaging and IT systems and similar applications was important to the practice, she says. With a practice management system dating from 1982, “we needed to be able to marry not only the old PACS, but our practice management system, and of course all the new modalities coming in.”

The current storage system runs 2 terabytes of content. The query-retrieve process, pulling from the old archives, has added data to the system. “We are very fortunate that we have, just at a moment’s click, everything that we have ever processed,” says Monty. “It also makes sure that our referring physicians have access to the previous studies. That’s part of the continuity of care that you’re providing both the referring physicians and the radiologists as they read the scans.”

Efficiency & productivity

Western Neurological also incorporated voice recognition, which helps their practice turn reports around in an hour, on average. Physicians generate and self-edit their reports, which aids in getting them out to referring doctors quickly with no need to go back for a final sign-off.

The system also helps the practice’s technologists work more efficiently, Monty says. Two technologists work per shift and they pre-cue studies for the physicians, track special communications such as STAT exams and perform quality control on studies.

Another benefit of the PACS is the ability for referring physicians to show images directly to their patients. For example, a multiple sclerosis (MS) specialist with about 1,500 patients, can compare prior studies to see how many new lesions the patient has—an important tool in caring for MS patients.

The practice’s referring cardiologists appreciate the ability to see heart images in cine mode. The practice performs post-processing multiplanar imaging for the cardiologists to view ejection fractions, systolic and diastolic phases and more. “They’re sitting at home or in their office visualizing the heart in its real, true function, and that’s made a difference for them,” says Monty. “They want to see the flow of the blood, follow the bolus track and visualize the clot.”

As a stand-alone imaging center, “we pride ourselves in being able to make same-day appointments and have a quick turn-around time with reports,” says Neuroradiologist Stephen Carroll, MD.

Since images are acquired almost instantaneously, Carroll frequently can review images before the study is completely finished. “That allows me to go and intervene, if necessary, and follow the study as it’s being done or ask for further series.”

With a Web-based PACS, Western’s neuroradiologists can review images in real-time with referring physicians, all with exactly the same user interface and extensive set of Centricity PACS-IW viewing tools. “They’re able to discuss images with me, with a certain series number and image number. We can even review those things before our report is generated and sent to them,” Carroll says. The system lets referring physicians log on with a unique username and password to access their patients’ images and information. They can call the practice’s physicians to review cases. “We have those images available to us as well, so if there’s an urgent finding, [the referring physician] can be in touch with us closely by telephone and review those findings.” That allows for much more effective interaction and better patient care, he says.

Carroll likes the ability, afforded by Web-based PACS, to manipulate the frames