Taking it Up a Notch: Streamlining Workflow, Driving Cost Effectiveness

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San Diego Imaging’s integration of the AMICAS PACS and AMICAS Reach has produced 20-minute report turnaround times, improving patient care and workflow.
RIS/PACS solutions have alleviated the concerns of misplacing patient records and lags in turnaround times for radiology departments and imaging centers, allowing for the rapid retrieval of patient images and reports from remote locations. Yet, in addition to streamlining data and patient information flow, the integration of these workflow solutions have immeasurably improved patient care and facility-wide effectiveness.

Federated system solutions for interoperability
The University of Pittsburgh Medical Center (UPMC) is a multi-faceted operation comprising 20 academic, community and specialty hospitals with more than 4,200 beds. To conjure workflows that ensure optimal patient care, UPMC has updated its existing PACS infrastructure by creating the SingleView platform in all of its 20 hospitals and 30 imaging centers.

The facility has steered away from its previous “siloed workflow” which put RIS, PACS and 3D imaging head-to-head with one another, to integrate a new system, a “radiology workspace,” something that is “increasingly patient centric and workflow based,” says Rasu B. Shrestha, MD, medical director of digital informatics and chief of the division of radiology informatics at UPMC.

The SingleView application is a “federated system” with a “true imaging interoperability platform.” The application, according to Shrestha, was added as an upgrade to the existing Philips iSite PACS and GE Imagecast RIS solutions.

SingleView allows patient exams and records to be visually presented across all instances of the PACS, which he notes prevents any repetition of patient records. Shrestha says that before the upgrade, 23 percent of patient studies were found in additional hospital vaults other than the primary vault. This facilitated additional “unnecessary” patient tests and “suboptimal” readings of patient reports. Installation of SingleView, however, has alleviated these problems and improved workflow since physicians are spending less time per case. Shrestha estimates that on average the SingleView platform saves radiologists 3 to 5 minutes per case.

For the facility, the integration of the application has led to time efficiency, increased accuracy, and decreased the unnecessary repeat of scans and claim denials leading to facility-wide cost-savings, says Shrestha.

Optimizing care with swift, tailored solutions
Opening a new outpatient imaging facility was a stressful time for Debra J. Jennings, managing director of San Diego Imaging. Adding to that stress was deciding which enterprise solution system to integrate into the 20-employee facility that opened its doors in January 2007. Built from the bottom-up, the San Diego imaging center now treats almost 600 patients per week and about 31,000 per year.

Jennings, who has never looked back on her decision to utilize AMICAS’ PACS/RIS and AMICAS Reach solutions, says the systems have considerably improved patient care and workflow. With AMICAS Reach, says Jennings, information can be viewed at other facilities via web interface using a physican’s access portal. “Say I get a patient who walks in for an x-ray here and he or she has a doctor’s appointment in 15 minutes. We can say, you can go to your doctor office visit and the doctor will be able to see the images instantly regardless of how robust a system he has or not. He or she can see that with this web-based portal.”

Because the computerized system allows for physicians and administrators to track and store patient images and data, she says it “doesn’t let anything fall through the cracks.” The system allows for a 20-minute report turnaround.

Jennings says PACS make it easier to ensure that patients and physician notes are taken care of by using an administrator-tailored, color-coded tracking system. “It makes it so easy for us to track patient data—we don’t lose track of any stats.”

According to Jennings, the system also gives her the ability as an administrator to tailor exams for each referring physician by building notes into the RIS, such as always sending a patient CD with an exam or having a physician present during certain procedures. “I know if I build it in the RIS, it’s going to pass over to the PACS and it’s going to be compatible,” she says. This feature has lead to increased physician approval and efficiency for patients.

Decreased turnaround, better care
Matt Trites, director of medical imaging at the Marina Del Rey Hospital in California, a 60-bed facility, uses the Infinitt PACS. The PACS is tailored for smaller facilities like his that perform about 36,000 radiology exams per year.
The PACS’ biggest asset is the fact that radiologists never have to search for a film, which he pinpoints as the “biggest problem in the old days.”

“This whole filmless system where everything is located in a computer gives us the ability to look at images in doctors’ offices. It has just streamlined everything. We can view a study and have a report typed and printed in 15 minutes, which is almost four to five hours quicker than ever before.”

Because PACS is a completely paperless solution and there are no films to “hunt down,” hang up or to file away, Trites says, “I probably use four less people a day due to its efficiency.”

15-minute turnaround = efficiency
At Alamance Regional Medical Center in Burlington, N.C., the upgrade from Siemens Magic platform to Siemens’ RIS/PACS syngo suite has broken barriers at the 240-bed acute care hospital. “The RIS/PACS integration has really changed the way we practice radiology at our facility,” says Chris DeAngelo, RIS/PACS system administrator at the facility. “It’s been a huge success for us.”

The facility reaped benefits after installing the RIS/PACS solutions. What once was a 24- to 48-hour turnaround for patient reports is instead a 15-minute to 3 ½-hour turnaround—what DeAngelo calls “a huge advantage in efficiency for the patients.”
Since its adoption in 2006, exam volume also has increased 20 percent. Six full-time radiologists manage 120,000 radiology exams per year and while DeAngelo notes that this increased workload has resulted in the facility hiring more staff, “If you have much more work and the same amount of people, obviously something’s working right for you.”

The RIS also enables radiologists to route a procedure for review and transcription immediately upon the end of the exam. “We’ve obviously noticed this is a huge advantage,” DeAngelo says, recalling that previously, without the computer-based systems, technologists would let completed procedures pile up before they walked them to the radiologist’s office for review.

DeAngelo notes that the upgrade allows exams to be conducted, immediately sent to radiology work lists and eventually into an EMR, giving physicians access to it without much delay. “Everything can be easily signed off on within 12 hours.” Prior to the current film-less workflow, DeAngelo says that one patient exam could consist of hanging 25 films and 1,000 CT images. “A challenging solution,” he says.

After the transition to the Siemens PACS, DeAngelo notes that productivity at Alamance has increased by almost 15 percent.

Paramount practice with paperless
Printing patient reports has become a thing of the past. RIS/PACS solutions work as the nucleus of an imaging facility, outsourcing patient information quickly and effectively and fueling higher productivity of staff and better patient care. The days of misplaced patient data, superfluous testing and long lag time between radiologists completing and referring physicians receiving reports are long gone. RIS/PACS have become the architect of optimized patient care, cost-effectiveness and more efficient workflow.