Change is coming down the health imaging and IT pipeline at breakneck speed. This change spurs a number of questions for healthcare leaders:
- How do new trends and technologies fit together in the 21st century healthcare facility?
- How can a hospital or imaging center effectively deploy solutions to create a better healthcare environment, with improved efficiencies and a stronger bottom line?
- What unknowns do we need to watch out for?
As you probably already know, top trends tend to gravitate. And as you read through the Top 10 Trends that Health Imaging & IT has identified, interwoven themes abound.
One cannot consider any facet of radiology or cardiology without touching on the ongoing staff shortage among radiologists, especially specialists, interventionalists, cardiologists, RTs and nurses. And so, as healthcare facilities look at solutions, they must think about its impact on workflow and people.
Then there is new technology itself; each new advance opens multiple doors and possibilities - and brings many challenges. For example, 3D is facilitating image-guided radiation therapy (IGRT) and joining multislice CT images into image volumes. Lung CAD is tied to multislice CT, too, as well as RIS-PACS. PACS vendors are rushing to establish ties with 3D software makers and integrate both products to ease workflow. Wireless networks, tablet PCs and integrated RIS-PACS are changing the very practice of radiology, rapidly disseminating real-time images and information beyond radiology and throughout the healthcare enterprise. That leaves teleradiology - or remote reading - as some now call the means for reading images on-call, for nighthawk coverage or for expert reads, which today is rarely done without the help of PACS. And then there's molecular imaging, where again, multislice CT plays a vital role in combination with PET (positron emission tomography).
For change to be truly effective, decision-makers and thought-leaders need to understand the implications, benefits and challenges of individual trends. Then they need to examine how a specific solution works in their enterprise and begin to plan or modify their plan for the future.
1. Integrated RIS-PACS
Most large PACS providers are in the RIS game as well, and if they're not, they're partnering to create an integrated RIS-PACS. Why? Because radiology departments - and healthcare enterprises - need to gain back the integrity of the radiology workflow process to increase efficiency. To effectively manage images in a digital environment, you need the combined resources of the RIS - radiology order entry and management, scheduling, auto-fax or email of radiology results, billing and charge capture, film tracking, inventory control, report generation and quality control and transcription and/or speech recognition - and the benefits of the PACS - image acquisition from the modality and image viewing, archiving and distribution.
Until recently, RIS and PACS served as distinct solutions. RIS doesn't understand DICOM, so RIS can't handle PACS imaging data without an interface or broker. And the PACS doesn't understand HL7. But the wave of future is a single database, brokerless, software-based, fully integrated RIS-PAC system. About eight integrated RIS-PACS offerings are on the market today, with varying degrees of functionality. Overall, the systems' objective in having a single database across the RIS, imaging suite and PACS is to provide a single instance of patient and image data throughout a multi-facility, often multi-site, healthcare enterprise. Integrated RIS-PACS synchronizes and provides more consistent data with greater integrity and fewer overall errors.
An integrated solution is a data miner's dream; it is a repository for complex data that can be analyzed for advanced business planning and management. Thus, RIS-PACS facilitates productivity on many levels as a single location for all image and business data.
Still, the integrated RIS-PACS nirvana is far from reality for most hospitals. While vendors are pushing forward on the RIS-PACS front, the current best-of-breed world with separate RIS and PACS tools suits most hospitals just fine. Migrating to an integrated RIS-PACS is not as easy as purchasing individual components. Hospitals often have to contend with two legacy systems, and in most cases, it isn't feasible to upgrade both systems to current technology at the same time.
Future directions: Look for more integrated RIS-PACS offerings - as vendors look