Top 25 Connected Facilities: The Refining of Radiology

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This year’s Top 25 Connected Facilities are an impressive group that has extended the reach of images from PACS to the EMR, either via links to key images or full image sets. Many extend PACS and EMR access to referring physicians and share data with a health information exchange (HIE) internally and/or externally. They are reaping across-the-board benefits—accelerating and improving patient care with anytime/anywhere access to patient data, virtual subspecialty interpretation and razor-thin report turn-around times that hover near 15 minutes for STAT studies. They are cutting costs, increasing productivity and fueling growth.

Although 17 of the top 25 are located East of the Mississippi River, there is a great deal of diversity among winners. Academic medical centers are well-represented as are large, regional and community health delivery networks, but the top connected group includes a rural community hospital that completes fewer than 100,000 studies annually, an imaging center group and two physician group practices.

Interoperability is the common denominator. Many hospitals, health systems and healthcare providers are investing smart by building vendor-neutral archives, developing unified worklists and deploying server virtualization. Others are squeezing every penny out of PACS by sharing services with other providers, refining radiology workflow and sharing resources with other hospital departments.

Read on for complete profiles of this year’s winners.


The Fine Print

Online nominations were accepted from June 7th through July 2nd. The ballot included 19 multiple response questions and two open response questions. Nominations required the input of senior-level IT executives  such as CIOs, chief medical or clinical information officers, chief technology officers, medical informatics officers, VPs of information systems and directors of IT. Among the factors differentiating the  winners are integration of PACS and EMR, HIE access to images, the number of physicians and referring physicians with remote access to  clinical images and patient data, the number of methods for physician  access, the number and breadth of clinical IT systems deployed, the number of departments that share patient data and images with the EMR  and PACS, the number of imaging technologies that share images and information with PACS and the economic and clinical impact of greater  physician connectivity with images and patient data.

Advanced Radiology Consultants | Trumbull, Conn. | adrad.com

Advanced

Advanced Radiology Consultants extends connectivity to referring providers. The imaging center supports three different interfaces in three separate EMRs to send results and images directly to the patient folder in the EMR and also electronically communicates critical values to referring physicians’ cell phones.

The practice recently expanded IT services to provide a unified worklist and structured reporting to support two disassociated hospitals and eight imaging centers. The IT upgrade delivers the clinical throughput needed to maintain productivity and quality at all sites. Advanced Radiology Consultants is leveraging a RIS upgrade to introduce order management with American College of Radiology Appropriateness Criteria.

The connected imaging practice has realized comprehensive financial benefits and reports that average operating costs have been reduced by an average of 25 percent over prior years through increased efficiencies, shortened procedure times, reduced material and contrast costs and decreased denials.
Facility
Licensed Beds: not applicable
Annual Imaging Procedures: 397,000
Employed Physicians: 26
Referring physicians: 800
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 26-30%
Referring physicians who regularly utilize remote access to clinical images: 21-25%
Outside entities with access to images: other department or facility, internal HIE, external HIE
Clinical images and data delivery mechanisms : EMR, VPN, web portal, CD or DVD, OR
Devices used to view clinical images and data: office PC, hospital PC, iPAD
EMR image display options: not applicable
Radiology report turn-around time: 8 hours
Change in annual imaging studies (2009-2010): +11-15%
Annual data storage: 9 TB
Change in imaging data (2009-2010): +26-30%
Across the enterprise
Departments that share clinical images with PACS: cardiology, emergency, HIS, orthopedics, radiology
 
Banner Health | Phoenix, Ariz. | bannerhealth.com

Banner

Banner Health is well on its way to achieving Stage 7 EMR adoption (HIMSS Analytics’ EMR Adoption Model). More than 50 percent of its 22 facilities have converted to CPOE, and the health system anticipates 100 percent physician adoption of CPOE by the end of 2011. A completely integrated PACS, RIS, HIS, voice recognition and ADT system allows providers to order, start, complete and have a final report populate the patient’s chart in less than an hour.

The health system deployed voice recognition in 2007 and saves $1.1 million annually in transcription costs in Arizona. Radiologists have achieved 90 percent self-editing for dictation, making it possible for caregivers to receive reports at bedside within minutes of report completion. Average emergency room report turn-around time stands at 34 minutes, driving ER wait times at Banner Estrella Medical Center to 29 minutes for its 84,000 annual patients and 36 ER bays.

Finally, Banner Health is tapping into IT investments to extend radiology services and instantly read remote studies acquired across Arizona to inform transport and treatment decisions and help reduce repeat studies.
Facility
Licensed Beds: 4,563
Annual Imaging Studies: 1.7 million
Employed physicians: 600
Referring physicians: 7,000
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 91-95%
Referring physicians who regularly utilize remote access to clinical images : 91-95%
Outside entities with access to images: other department or facility, internal HIE, academic/teaching database
Clinical images and data delivery mechanisms : EMR, VPN, web portal, .jpeg files, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, netbook computer, laptop computer
EMR image display options: links to key images
Radiology report turn-around time: 2 hours
Change in annual imaging studies (2009-2010): +0-5%
Annual data storage: 248 TB
Change in imaging data (2009-2010) : +26-30%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dental, EP, emergency, endoscopy/gastroenterology, nuclear medicine, oncology, orthopedics, radiation therapy, radiology, surgery/OR, vascular
 
BJC Healthcare | St. Louis, Mo. | bjc.org
BJC The multi-hospital organization increased procedures from 710,000 in 2005 to 1.2 million without adding staff, improved report turn-around time from more than 24 hours to two hours and reduced patient exam wait time to one day.
Facility
Licensed Beds: >1,500
Annual imaging studies: 1.2 million
Employed physicians: >2,000
Referring physicians: 11,000
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 66-70%
Referring physicians who regularly utilize remote access to clinical images: 46-50%
Outside entities with access to images: other department or facility, internal HIE, academic/teaching database
Clinical images and data delivery mechanisms: EMR, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, netbook computer, laptop computer
EMR image display options: not available
Radiology report turn-around time: 2 hours
Change in annual studies (2009-2010): +6-10%
Annual data storage: 60 TB
Change in imaging data (2009-2010): +11-15%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dental, emergency, HIS, nuclear medicine, oncology, orthopedics, radiation therapy, radiology, surgery/OR, vascular
 
Brigham and Women’s Hospital | Boston, Mass. | brighamandwomens.org
BWH Implementation of decision support and CPOE at Brigham and Women’s Hospital reduced utilization of high-cost radiology exams by 15 percent over three years. Decision support tools also automate presentation of relevant lab data, patient history and medication information to radiologists. Immediate electronic access to images by referring physicians helped reduce “leakage” by 25 percent. The radiology department tracks key performance indicators via a quality dashboard.

Brigham and Women’s Hospital has realized multiple financial and management benefits since implementing digital management. It cut $500,000 in operating costs with the closure of the film library in 2009 and slashed another $750,000 by moving medical records offsite. Radiologists’ productivity jumped 20 percent with PACS, and technologists’ productivity increased 30 percent with the transition to digital radiography and digital mammography. On the patient care side, expedited clinical decision making has improved patient outcomes and produced record high inpatient satisfaction scores.
Facility
Licensed Beds: 790
Annual imaging studies: 752,000
Employed physicians: 3,000
Referring physicians: 10,000
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96 - 100%
Referring physicians who regularly utilize remote access to clinical images: 96 - 100%
Outside entities with access to images: other department or facility, internal HIE, external HIE, RHIO, national registries, academic/teaching database
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, mobile or SmartPhone, netbook computer, laptop computer
EMR image viewing options: links to images, key images, full image set
Radiology report turn-around time: 4 hours
Change in annual studies (2009-2010): +0-5%
Annual data storage: 30 TB
Change in imaging data (2009-2010): +6-10%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, EP, emergency, HIS, nuclear medicine, oncology, orthopedics, radiology, surgery/OR, vascular
 
Carolinas HealthCare System | Charlotte, N.C. | carolinashealthcare.org
Carolinas Point of care access to clinical data and images across this 32 hospital/25 imaging center network dramatically improved clinical decision making and medical management strategies related to transport of critical patients as part of its trauma, stroke, heart and pediatric programs.

The implementation of filmless radiology, cardiology and diagnostic imaging allowed Carolinas HealthCare System to reduce and redeploy film management staff, reduce film budgets and improve workflow by 25 percent. The combination of EMR, PACS and voice recognition enabled the system to deliver reports with 30 minutes of dictation.

The health system saw a 30 percent leap in imaging procedures from 2009-10 after merging with a local hospital and several associated physician practices. After the merger, Carolinas adapted its IT infrastructure to leverage a common PACS and extend specialty coverage.
Facility
Licensed Beds: 2,429
Annual Imaging Studies: 1.2 million
Employed physicians: 1,181
Referring physicians: 3,493
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 61-65%
Referring physicians who regularly utilize remote access to clinical images: 61-65%
Outside entities with access to images: other department or facility
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, netbook computer, laptop computer
EMR image viewing options: links to images
Radiology report turn-around time: 4 hours
Change in annual studies (2009-2010): +31-35%
Annual data storage: 59 TB
Change in imaging data (2009-2010): +36-40%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, EP, emergency, endoscopy/gastroenterology, nuclear medicine, orthopedics, radiation therapy, radiology, surgery/OR, vascular
 
Community Hospitals of Indiana | Indianapolis, Ind. | ecommunity.com
Community Image and clinical data access is nearly ubiquitous at the health system with full image sets available in the EMR across the enterprise. Historical reports and relevant priors are readily available at all hospitals within the network.

Community Hospitals of Indiana has seen comprehensive gains with the deployment of digital image management and EMR technologies including fewer manual entry errors with DICOM and HL7 feeds, faster results, reduced time from diagnosis to treatment, better staff availability and instant information. The changes have fueled a 10-fold improvement in overall customer satisfaction at the health system. In addition, staff has been reallocated to different roles, and workflow has been rearranged to streamline physician communication regarding critical or unusual results.
Facility
Licensed Beds: 828
Annual imaging studies: 325,000
Employed physicians: 505
Referring physicians: 2,000
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 86-90%
Referring physicians who regularly utilize remote access to clinical images: 86-90%
Outside entities with access to images: other department or facility, internal HIE
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, laptop computer
EMR image viewing options: links to images, key images, full image set
Radiology report turn-around time: 1.3 hours
Change in annual studies (2009-2010): +6-10%
Annual data storage: 8 TB
Change in imaging data (2009-2010): +6-10%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, emergency, endoscopy/gastroenterology, nuclear medicine, orthopedics, radiology, surgery/OR, vascular
 
Crouse Hospital | Syracuse, N.Y. | crouse.org
The community hospital partnered with two regional hospitals and 19 private imaging centers to develop an integrated regional imaging network. All network data are available to physicians at the hospital and in their offices through the PACS/RIS portal or HIS web portal, creating a market advantage for the emergency department and outpatient and inpatient services.

The transition to digital image management was budget neutral because it enabled a 22 percent reduction in film handling FTEs and increased technologist productivity as well as eliminating film, processing and storage expenses. In addition, a per-click PACS usage fee delivers digital benefits and paperless workflow to small physician practices and lowers PACS costs for Crouse Hospital by nearly $60,000 annually.

The hospital has increased radiologist availability through offsite shared reading while operating with 20 percent fewer on-site radiologists. 3D software is integrated with PACS, improving communication between radiologists and treating physicians.
Facility
Licensed Beds: 506
Annual imaging studies: 199,273
Employed physicians: 30
Referring physicians: 800
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 81-85%
Referring physicians who regularly utilize remote access to clinical images: 81-85%
Outside entities with access to images: other department or facility, internal HIE, external HIE
Clinical images and data delivery mechanisms: EMR, VPN, web portal, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, netbook computer, laptop computer
EMR image viewing options: links to images
Radiology report turn-around time: 2 hours
Change in annual studies (2009-2010): +31-35%
Annual data storage: 7.2 TB
Change in imaging data (2009-2010): +46-50%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, EP, emergency, endoscopy/gastroenterology, HIS, nuclear medicine, oncology, orthopedics, radiology, surgery/OR, vascular
 
Heritage Valley Health System | Beaver, Pa. | heritagevalley.org
Heritage The hospital’s EHR provides wired and wireless access to longitudinal lab results, radiology reports and images and medical history at all points of care. More than 250 physicians use a wireless handheld device application that provides access to three years of online clinical data from any Wi-Fi or broadband connection, up from 30 when the application was launched in 2007. More than 200 primary care and specialist physicians and 1,600 clinicians and support staff access the EHR through a clinical portal on daily basis.

On the financial side, Heritage Valley Health Systems reduced its clerical workforce by 10 FTEs to save $300,000 and cut its annual operational supplies budget by $550,000 with the conversion to digital data.

The hospital documented an 80 percent improvement in emergency result cycle time with full PACS/RIS implementation, and a “PACS note” tool allows radiologists to provide immediate feedback to ED physicians.
Facility
Licensed Beds: 547
Annual imaging studies: 320,000
Employed physicians: 400
Referring physicians: 1,600
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 91-95%
Outside entities with access to images: other department or facility
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, mobile or SmartPhone, netbook computer, laptop computer
EMR image viewing options: links to images, key images, full image sets
Radiology report turn-around time: 5.5 hours
Change in annual studies (2009-2010): +0-5%
Annual data storage: 7 TB
Change in imaging data (2009-2010): +0-5%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dental. emergency, endoscopy/gastroenterology, orthopedics, radiology, surgery/OR, vascular
 
Inland Imaging | Spokane, Wash. | inlandimaging.com
Inland Inland Imaging developed a comprehensive suite of workflow, quality and reporting software tools to streamline workflow and integrate disparate systems. A single enterprise worklist helps attract and retain radiologists and boosts efficiency. The IT systems eliminate unneeded work and allow radiologists to perform their work regardless of location or systems, which helped the practice move into new growth markets.

Patient care has been improved as well. Clinical decisions and patient communication are faster. Patient wait times average 10 minutes or less, and emergency report turn-around time is 30 minutes or less.

On the quality side, Inland Imaging captures and tracks operational data including quality reports to quickly achieve compliance with American College of Radiology and The Joint Commission requirements. Peer review systems have improved reporting and clinical outcomes.
Facility
Licensed Beds: 966
Annual imaging studies: 850,000
Employed physicians: 70
Referring physicians: 5,000
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 26-30%
Referring physicians who regularly utilize remote access to clinical images: 26-30%
Outside entities with access to images: other department or facility, external HIE
Clinical images and data delivery mechanisms: EMR, VPN, web portal, OR
Devices used to view clinical images and data: office PC, hospital PC, laptop computer, home PC
EMR image viewing options: links to images, full image set
Radiology report turn-around time: 24 hours
Change in annual studies (2009-2010): no change
Annual data storage: 45 TB
Change in imaging data (2009-2010): no change
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dental, emergency, endoscopy/gastroenterology, nuclear medicine, oncology, orthopedics, radiation therapy, radiology, surgery/OR, vascular
 
INTEGRIS Health System | Oklahoma City, Okla. | integrisok.com
INTEGRIS INTEGRIS increased utilization of corporate IT resources to drive operational and capital enhancements. The health system virtualized key PACS components to reduce hardware, consolidate physical space and improve performance. Transitioning PACS hardware management from the vendor to internal resources delivers $170,000 savings on annual service and maintenance contracts. A planned “software only” contract should net additional savings. The creation of a virtualized parallel system has resulted in zero downtime related to PACS upgrades and patches.

Operational efficiencies include a 14 percent increase in diagnostic x-ray volume with a concurrent 21 percent drop in FTE utilization. Paperless workflow, coupled with the digital patient database, led to a 30 percent improvement in report turn-around time while inpatient volume increased 7.6 percent.

The health system uses a TeleStroke Network with videoconferencing to provide rural hospitals with instant access to neurologists and enable remote patient exams. Specialists review images on PACS to confirm diagnosis and recommend treatment, including administration of time-sensitive tissue plasminogin activator (tPA) and/or patient transfer.
Facility
Licensed Beds: 1,704
Annual imaging studies: 529,198
Employed physicians: 259
Referring physicians: 1,877
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96 - 100%
Referring physicians who regularly utilize remote access to clinical images: 96 - 100%
Outside entities with access to images: other department or facility
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: office PC, hospital PC, mobile or SmartPhone, netbook computer, laptop computer
EMR image viewing options: links to images
Radiology report turn-around time: 3.5 hours
Change in annual studies (2009-2010): +11-15%
Annual data storage: 11 TB
Change in imaging data (2009-2010): +21-25%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dental, dermatology, EP, emergency, endoscopy/gastroenterology, nuclear medicine, oncology, orthopedics, pathology, radiation therapy, radiology, surgery/OR, vascular
 
Lehigh Valley Health Network | Allentown, Pa. | lvhn.org
Lehigh Six years after deploying PACS, Lehigh Valley Health Network continues to reap across-the-board benefits. The health system leverages the ability to view and dictate images from home as a radiologist recruiting tool and reports that 30 percent of radiologists are equipped with dedicated PACS workstations in their homes with the remainder using home PCs to view images. The model supports patient care in emergent situations and enabled the network to expand support to more remote locations.

In addition, remote image viewing—specifically links to reports and images in the EMR—and consults with radiologists have improved productivity among referring physicians. The network also includes a remote ICU, where a “data wall” and PACS workstation provide immediate access to images and data to facilitate rapid decision-making. Finally, use of portable devices allows bedside image viewing within three seconds across the enterprise.
Facility
Licensed Beds: 984
Annual imaging studies: 585,000
Employed physicians: >400
Referring physicians: >1,100
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 66-70%
Referring physicians who regularly utilize remote access to clinical images: 66-70%
Outside entities with access to images: other department or facility
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files. Mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, mobile or SmartPhone, netbook computer, laptop computer
EMR image viewing options: links to images
Radiology report turn-around time: 10 hours
Change in annual studies (2009-2010): +0-5%
Annual data storage: 20.5 TB
Change in imaging data (2009-2010): +11-15%
Across the enterprise
Departments that share clinical images with PACS: EP, nuclear medicine, orthopedics, radiology, vascular
 
Main Line Health | Bryn Mawr, Pa. | mainlinehealth.org
Main Main Line Health uses an integrated approach to digital imaging. All images, including radiology, cardiology and OR, are available in real-time in a single system across the enterprise and remotely. Radiology reading workstations provide integrated access to imaging, speech recognition, 3D and clinical systems applications to support a streamlined filmless and paperless workflow. Integrated PACS, RIS, 3D and speech recognition have reshaped the radiology department, delivering a 65 percent decrease in the time from the end of the procedure to signed results. The hospital saves $460,000 in film costs annually and has eliminated 10 clerical FTEs since going live with PACS and speech. Improved communications between the radiology and emergency departments have translated into reduced patient wait times in the ED. The health system reported similar efficiency improvements in the OR with immediate image availability. Finally, an enterprise image archive ensures data stability and availability.
Facility
Licensed Beds: 1,093
Annual imaging studies: 680,000
Employed physicians: 262
Referring physicians: 2,202
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 56-60%
Referring physicians who regularly utilize remote access to clinical images: 91-95%
Outside entities with access to images: other department or facility, academic/teaching database
Clinical images and data delivery mechanisms: EMR, VPN, .jpeg files, CD/DVD, OR
Devices used to view clinical images and data: diagnostic displays, office PC, hospital PC, netbook computer, laptop computer
EMR image viewing options: links to images
Radiology report turn-around time: 6 hours
Change in annual studies (2009-2010): +0-5%
Annual data storage: 28 TB
Change in imaging data (2009-2010) +6-10%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, EP, emergency, nuclear medicine, orthopedics, radiology, surgery/OR, vascular
 
Marshfield Clinic | Marshfield, Wis. | marshfieldclinic.org
Marshfield Marshfield Clinic uses an internally-developed EMR integrated into all other self-developed applications such as lab, patient alerts, immunizations, radiology reports and images. All images available in the archive are also available through the clinical image viewer integrated into the EMR. The next steps for the radiology department include the replacement of the legacy PACS and the development of an integrated decision support electronic order entry system for radiology. The clinic is also piloting voice recognition/natural language processing for radiology reporting.
Facility
Licensed Beds: 500
Annual imaging studies: 500,000
Employed physicians: 800
Referring physicians: 800
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 96-100%
Outside entities with access to images: other department or facility, internal HIE, external HIE, academic/teaching database
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, netbook computer, laptop computer
EMR image viewing options: links to images
Radiology report turn-around time: 2 hours
Change in annual studies (2009-2010): +16-20%
Annual data storage: 60 TB
Change in imaging data (2009-2010): +16-20%
Across the enterprise
Departments that share clinical images with PACS: critical care/ICU/CCU, nuclear medicine, oncology, orthopedics, radiation therapy, radiology, surgery/OR, vascular
 
The Nebraska Medical Center | Omaha, Neb. | nebraskamed.com

Nebraska

The combined deployments of radiology PACS, web-based 3D reconstruction and voice recognition fueled a healthy productivity increase at The Nebraska Medical Center. Radiology report turn-around time decreased by 26 percent while reading capacity increased by 25 percent, which accommodates increased volumes without additional radiologists.

Referring physicians and surgeons also report improved productivity and physician satisfaction since the deployment of web-based PACS and 3D. The medical center also credits increased collaboration enabled by digital clinical image management and patient data systems as a factor in its increased physician satisfaction.

The PACS deployment at The Nebraska Medical Center eliminated lost films, decreasing the need to repeat exams and reducing radiation to patients. Additionally, the facility was able to convert to a paperless workflow for radiology, which improved efficiency.
Facility
Licensed Beds: 624
Annual imaging studies: 280,000
Employed physicians: 900
Referring physicians: 900
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 71-75%
Outside entities with access to images: other department or facility, internal HIE, national registries, academic/teaching database
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic displays, office PC, hospital PC, mobile or SmartPhone, netbook computer, laptop computer, surgical displays
EMR image viewing options: links to images, key images, full image sets
Radiology report turn-around time: 6.5 hours
Change in annual studies (2009-2010): +0-5%
Annual data storage: 13 TB
Change in imaging data (2009-2010): +16-20%
Across the enterprise
Departments that share clinical images with PACS: critical care/ICU/CCU, dental, emergency, HIS, nuclear medicine, oncology, orthopedics, radiology, surgery/OR, vascular
 
Northern Michigan Regional Health System | Petoskey, Mich. | northernhealth.org
Northern
Northern Michigan Regional Health System (NMRH) shares PACS and RIS with two smaller rural hospitals, and PACS is accessible by five referring practices. The common repository translates into significant film and storage cost reductions and streamlined consulting across the area. In addition, one partner hospital replaced locums staffing with remote reading by NMRH radiologists to cut radiology expenses while increasing service. Remote access to full image sets in the EMR further amplifies digital image management benefits.

PACS changed the patient experience at the rural regional medical center. Prior to PACS, patients waited 30 minutes for films to print prior to physician appointments, resulting in delays that frustrated both patients and physicians. Now, images are immediately available for radiologists and referring and consulting physicians, which accelerates patient care. For example, in the new model, cardiologists read stress echo studies during the patient appointment.
Facility
Licensed Beds: 214
Annual imaging studies: 89,000
Employed physicians: 20
Referring physicians: 200
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 96-100%
Outside entities with access to images: other department or facility, internal HIE, external HIE, academic/teaching database
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, netbook computer, laptop computer
EMR image viewing options: links to images, key images, full image set
Radiology report turn-around time: 24 hours
Change in annual studies (2009-2010): +0-5%
Annual data storage: 3.5 TB
Change in imaging data (2009-2010): + 0-5%
Across the enterprise
Departments that share clinical images with PACS: emergency, nuclear medicine, radiology, surgery/OR, vascular
 
NorthShore University Health System | Evanston, Ill. | NorthShore.org
NorthShore The health system makes available EMR data and clinical images at its four hospitals, offsite facilities and physicians offices. Immediate, system-wide online access to images delivers the ability for specialists to evaluate images to inform quick and critical patient treatment decisions.

PACS also delivered several key operational benefits. After the health system implemented PACS, the need to repeat imaging exams dropped by 85 percent. In addition, the transition to digital clinical images and patient data allowed NorthShore University Health System to reduce staff by 10 FTEs and cut patient wait time by 20 percent. Film costs have been cut by 90 percent. Finally, both patient care and patient satisfaction have improved, partially because the health system eliminated lost films.

The health system extends connectivity to patients as well. Specifically, it implemented NorthShore Connect, a secure network that lets patients schedule appointments online and also receive lab and procedure results online.
Facility
Licensed Beds: 874
Annual imaging studies: 508,400
Employed physicians: 666
Referring physicians: 2,284
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 46-50%
Referring physicians who regularly utilize remote access to clinical images: 46-50%
Outside entities with access to images: other department or facility, national registries
Clinical images and data delivery mechanisms: EMR, web portal, CD/DVD, OR
Devices used to view clinical images and data: office PC, hospital PC, laptop computer
EMR image viewing options: links to images, full image set
Radiology report turn-around time: 12 hours
Change in annual studies (2009-2010): +6-10%
Annual data storage: 30 TB
Change in imaging data (2009-2010): +26-30%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, EP, emergency, endoscopy/gastroenterology, nuclear medicine, oncology, orthopedics, radiation therapy, radiology, surgery/OR, vascular
 
OhioHealth | Columbus, Ohio | ohiohealth.com

OhioHealth

OhioHealth estimates ongoing PACS and voice recognition savings of nearly $10 million at its four hospitals with gains derived from reduced film and FTE costs and recovered space. At the same time, imaging volume has grown 6 to 8 percent annually. Other results gained from digital clinical image and data management include global radiologist coverage, improved workload balancing, subspecialist coverage, decreased historical case retrieval times and reduced unbilled and unread cases.

OhioHealth internally developed a web portal to provide referring physicians access to reports and images. Recent initiatives connect the healthcare community on the front end and the imaging archive on the back end. A teleimaging solution allows remote physicians to consult with clinical teams at OhioHealth in advance of patient transportation, which improved time to care and reduced repeat imaging procedures by 67 percent in the first year of deployment. On the back end, updated storage architecture applies individual lifecycle management rules to better manage storage cost and performance.
Facility
Licensed Beds: 2,000
Annual imaging studies: 759,527
Employed physicians: 210
Referring physicians: 2,800
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 96-100%
Outside entities with access to images: other department or facility, internal HIE, external HIE
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, laptop computer
EMR image viewing options: links to images, key images
Radiology report turn-around time: 27 hours
Change in annual studies (2009-2010): +6-10%
Annual data storage: 30 TB
Change in imaging data (2009-2010): +6-10%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dermatology, EP, emergency, endoscopy/gastroenterology, nuclear medicine, oncology, orthopedics, pathology, radiation therapy, radiology, surgery/OR, vascular
 
Penn State Milton S. Hershey Medical Center | Hershey, Pa. | pennstatehershey.org

Penn State

This academic medical center reports annual savings of $1 million in film costs, $325,000 in transcription costs and $400,000 in image library staff costs. Penn State Hershey Medical Center also realizes $406,000 in annual savings via the elimination of 15 FTE image library staff. At the same time, patient care is improved with subspecialty review available in real-time at any clinical location.

The center saw image data volume skyrocket in the last year. It replaced three CT scanners, upgrading 16-slice systems to 40, 64 and 128-slice devices. Image datasets, including reprocessed data, are gobbling storage space. Compounding the situation are new high-end cardiac ultrasound systems that deliver much higher resolution than previous systems. Finally, the academic medical center implemented a storage solution for outside CDs/DVDs that integrates patient data into an internal record for patients, which also accounts for a portion of the storage burden.
Facility
Licensed Beds: 484
Annual imaging studies: 375,000
Employed physicians: 656
Referring physicians: 200
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 96-100%
Outside entities with access to images: other department or facility
Clinical images and data delivery mechanisms: EMR, VPN, web portal, CD/DVD, OR
Devices used to view clinical images and data: diagnostic displays, office PC, hospital PC, laptop computer, remote PC
EMR image viewing options : links to images, key images, full image sets
Radiology report turn-around time: 5 hours
Change in annual studies (2009-2010): +6-10%
Annual data storage: 15 TB
Change in imaging data (2009-2010): +71-75%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, EP, emergency, endoscopy/gastroenterology, nuclear medicine, oncology, orthopedics, radiation therapy, radiology, surgery/OR, vascular
 
Riverside Radiology & Interventional Assoc. | Columbus, Ohio | riversiderad.com

Riverside

In 2004, practice leadership created an IT division and charged it with generating operational efficiencies. At the time, the group comprised 24 diagnostic imaging radiologists and eight interventional radiologists. The IT division developed software that integrates two voice recognition systems and drives a unified worklist that yields staffing efficiencies between 10 and 20 percent. A “commonview” database of PACS images identifies previous procedures and shares clinical data among non-affiliated hospitals. The team also developed informatics systems to track turn-around metrics and quality monitoring. The practice averages eight minute turn-around time for emergency studies and three hours for other studies.

Since the inception of the IT division, the practice has grown to nearly 70 radiologists and supports 14 hospitals and 20 outpatient facilities. The group also launched numerous business units supported by IT including enterprise-wide 3D processing, marketing, transcription and billing. The billing business has seen more than 200 percent growth in new business since 2006, while maintaining flat staffing. Leadership attributes the efficiency to customized software that works with third-party software to provide a paperless environment and proactive billing solutions.
Facility
Licensed Beds: not applicable
Annual imaging studies: 940,000
Employed physicians: not applicable
Referring physicians: >2,000
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 51-55%
Referring physicians who regularly utilize remote access to clinical images: 46-50%
Outside entities with access to images: other department or facility
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, netbook computer, laptop computer
EMR image viewing options: links to images, key images
Radiology report turn-around time: 3 hours
Change in annual studies (2009-2010): 6-10%
Annual data storage: 16 TB
Change in imaging data (2009-2010): +0-5%
Across the enterprise
Departments that share clinical images with PACS: emergency, nuclear medicine, oncology, orthopedics, radiation therapy, radiology, surgery/OR
 
Roper Saint Francis Healthcare | Charleston, S.C. | ropersaintfrancis.com

Roper

Roper St. Francis Healthcare comprises more than 90 locations in seven counties. PACS supported and enabled growth while improving financial metrics. The healthcare system cut more than $500,000 in film, chemistry and courier costs and reduced support staff to save another $250,000 annually. Average imaging study repeat rate has been reduced to 5 percent, with partial credit going to teaching files contained in PACS.

Digital image access helped improve report turn-around time and accelerated throughput, particularly in the emergency room, which embraced a new goal of an average ER visit of two hours. Roper St. Francis is deploying an ER discrepancy tracking tool to track and report variances in ER findings and final reports.

The health system calculated the annual environmental impact of PACS and determined that it reduces landfill and incinerated waste by 7.9 tons, eliminates 2,410 non-recyclable plastic containers and saves nine tons in CO2 emissions.
Facility
Licensed Beds: 742
Annual imaging studies: 277,324
Employed physicians: 162
Referring physicians: 2,284
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 21-25%
Referring physicians who regularly utilize remote access to clinical images: 21-25%
Outside entities with access to images: other department or facility
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, mobile or SmartPhone, netbook computer, laptop computer
EMR image viewing options: links to images, full image set
Radiology report turn-around time: 13.75 hours
Change in annual studies (2009-2010): +6-10%
Annual data storage: 11.7 TB
Change in imaging data (2009-2010): -0-5%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, EP, emergency, nuclear medicine, oncology, orthopedics, radiology, surgery/OR, vascular
 
Shields Health Care Group | Quincy, Mass. | shields.com

Shields

The Massachusetts-based health services provider performs nearly 160,000 imaging exams annually. The volume would require a $2.2 million budget, but the combination of PACS, EMR interfaces and an online portal trimmed the 2010 film budget forecast to $289,000. Hospital and RHIO interfaces eliminated another $30,000 annually; and offsite storage cut another $80,000. The increased connectivity eliminated the need for manual courier services, reducing the budget by another $98,000. The practice has another hefty savings in the crosshairs with a 17 FTE reduction in progress.

Surveys indicate an all-time high in patient recommendations; staff spend more time with patients and less time recording data. Consequently, employee satisfaction also climbed, jumping 15 percent between 2009 and 2010.
Facility
Licensed Beds: not applicable
Annual imaging studies: 161,000
Employed physicians: 11
Referring physicians: 15,000
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 86-90%
Referring physicians who regularly utilize remote access to clinical images: 56-60%
Outside entities with access to images: other department or facility, RHIO, national registries
Clinical images and data delivery mechanisms: CD/DVD
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, netbook computer, laptop computer and upcoming iPAD, mobile iPhone application
Primary EMR image mode: full image set
Radiology report turn-around time: 0.5 hours
Change in annual studies (2009-2010): 0-5%
Annual data storage: 12 TB
Change in imaging data (2009-2010): +26-30%
Across the enterprise
Departments that share clinical images with PACS: radiation therapy, radiology
 
Trinity Health | Minot, N.D. | trinityhealth.org
Trinity More efficient, digital-driven image handling helped Trinity Health reduce one film handling FTE across its 130,000 study volume health system and improve radiologists’ production by 10 to 15 percent. In addition, report turn-around times have been reduced by 50 percent, and area critical access facilities’ turn-around time dropped from 72 hours to less than 24 hours. Finally, the health system eliminated nearly all of its annual $400,000 film costs.

Trinity Health has realized improved patient care in several ways. Instant access to acute images by all specialists, local or remote, provides immediate multi-specialty response and optimal management of acute or trauma patients. Immediate availability of images in the OR has helped reduce surgery times. All referral images are available for radiologist and specialist review at the time of consultation, which translates into fewer repeat studies. Finally, enhanced, image-informed collaboration between radiologists and physicians helps minimize unnecessary referrals of patients from area facilities.
Facility
Licensed Beds: 450
Annual imaging studies: 130,000
Employed physicians: 120
Referring physicians: 210
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 96-100%
Outside entities with access to images: other department or facility
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, laptop computer
EMR image viewing options : links to images, key images, full image set
Radiology report turn-around time: 8 hours
Change in annual studies (2009-2010): +6-10%
Annual data storage: 2.5 TB
Change in imaging data (2009-2010): +6-10%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dental, nuclear medicine, oncology, orthopedics, radiology, surgery/OR, vascular
 
University Health System | San Antonio, Texas | universityhealthsystem.com

University

During an eight-year digital transformation, University Health System (UHS) continuously reviewed and optimized workflow. The combination of RIS, PACS, voice recognition and CPOE has cuts costs, increased efficiencies and reduced errors. Installing RIS helped the health system identify up to $2 million a year in unbilled charges related to missing codes. UHS realized return on investment on its voice recognition system in less than six months by cutting report turn-around time from 100 hours to 35 and reducing its transcription workforce reduction from 10 to eight.

The digital workflow also improved patient safety. CPOE rules address common safety issues, and a complete barcode system eliminates technologist errors. The health system reduced the number of retakes related to lost studies. Finally, physicians no longer postpone patient care while waiting for imaging results because digital image and data management makes available data needed to inform patient care.
Facility
Licensed Beds: 604
Annual imaging studies: 330,000
Employed physicians: 1,600
Referring physicians: 3,200
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data 86-90%
Referring physicians who regularly utilize remote access to clinical images: 86-90%
Outside entities with access to images: other department or facility, academic/teaching database
Clinical images and data delivery mechanisms: EMR, VPN, web portal, .jpeg files, mobile or SmartPhone, CD or DVD, OR, iPAD
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC, mobile or SmartPhone, laptop computer, iPAD
Primary EMR image mode: links to images, key images, full image set
Radiology report turn-around time: 7 hours
Change in annual studies (2009-2010): +6-10%
Annual data storage: 10 TB
Change in imaging data (2009-2010): +81-85%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dental, emergency, endoscopy/gastroenterology, HIS, laboratory, nuclear medicine, oncology, orthopedics, pathology, radiology, surgery/OR, vascular
 
University of Pittsburgh Medical Center | Pittsburgh, Pa. | upmc.edu

UPitt

24x7 teleradiology support allows radiologists to read emergency studies after hours for several hospitals from a central location, which reduced after-hours emergency turn-around time. UPMC federated PACS within its network to provide a complete radiological history of patients with current exams to share critical information in real-time. University of Pittsburgh Medical Center credits real-time availability of imaging studies across the network with improving efficiency of both radiologists and clinical physicians. Nearly 100 percent of employed and referring physicians regularly utilize remote access to patient data and clinical images.
Facility
Licensed Beds: 4,200
Annual imaging studies: 2.1 million
Employed physicians: 2,700
Referring physicians: 1,300
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 96-100%
Outside entities with access to images: other department or facility, internal HIE, external HIE
Clinical images and data delivery mechanisms: EMR, VPN, web portal, mobile or SmartPhone, CD/DVD, OR
Devices used to view clinical images and data: diagnostic display, office PC, hospital PC
EMR image viewing options: clinical context linking between EMR and PACS
Radiology report turn-around time: 9.75 hours
Change in annual studies (2009-2010): +0-5%
Annual data storage: 35 TB
Change in imaging data (2009-2010): +0-5%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, dermatology, EP, emergency, endoscopy/gastroenterology, laboratory, nuclear medicine, oncology, orthopedics, pathology, radiation therapy, radiology, surgery/OR, vascular
 
WellSpan Health | York, Pa. | wellspan.org

Wellspan

WellSpan Health, a mature PACS site, recently developed a five-year clinical and technical vision and has started to deploy the infrastructure that will allow it to implement and support its vision for “the next five years.” The project started with a RIS refresh. In addition, server virtualization improved management capabilities and fault tolerance, and transitioning from direct attached storage to a SAN model better utilizes internal resources and expertise. The system plans to deploy a PACS neutral archive to help manage growing data and store non-DICOM images to better serve the “ologies.”

More than 50 percent of employed radiologists are equipped with diagnostic workstations at home, which provides improved turn-around time and better load balancing. The health system plans to go live with speech recognition later this summer, which will drive further improvements in turn-around time and efficiency.

Finally, improved critical results reporting and ED discrepancy reporting help the system provide better patient care.
Facility
Licensed Beds: 648
Annual imaging studies: 525,000
Employed physicians: 362
Referring physicians: 886
Image access, reporting and data
Referring physicians who regularly utilize remote access to patient data: 96-100%
Referring physicians who regularly utilize remote access to clinical images: 96-100%
Outside entities with access to images: other department or facility, internal HIE, external HIE, national registries
Clinical images and data delivery mechanisms: EMR, VPN, web portal, OR
Devices used to view clinical images and data: office PC, hospital PC, netbook computer, laptop computer, computer on wheels
Primary EMR image mode: links to images, key images, full image set
Radiology report turn-around time: 33.75 hours
Change in annual studies (2009-2010): +0-5%
Annual data storage: 16 TB
Change in imaging data (2009-2010): +21-25%
Across the enterprise
Departments that share clinical images with PACS: cardiology, critical care/ICU/CCU, EP, emergency, HIS, nuclear medicine, oncology, orthopedics, radiation therapy, radiology, surgery, OR, vascular