With PACS being high on many minds, RIS — its highly organized cousin — often takes a backseat. But let it be known, current radiology information systems are a mature, robust, and flexible breed of management systems that can be tailored to the size and needs of any size imaging environment. With features that help increase patient throughput and workflow productivity, it’s no wonder that the U.S. market for PACS and RIS combined is expected to grow to $3 billion by 2010, so says Millennium Research Group. RIS users can’t imagine life without them. Some facilities choose RIS a la carte, while others pair it with an existing PACS, and still others prefer an integrated RIS/PACS. Whatever the choice, the objective of RIS is streamlining patient information and access.
From patient registration order entry, data analysis, management reporting, scheduling and tracking, to billing, integration into PACS and web-based communication with referring physicians, today’s radiology information systems do it all. “Performing an x-ray is a chain, and wherever a link is broken — you will have problems,” says Randall Stenoien, MD, a radiologist and CEO of Houston Medical Imaging. “The RIS follows that chain from the moment a healthcare facility receives the order to pre-registration, authorization, notification, registration the day of the exam, documentation when the exam is complete, radiologist dictation, transcription and final approval.”
HMI, which offers a full array of diagnostic imaging services to the greater Houston community, implemented XIRIS’s RIS (Extended Internet Radiology Information System) in August 2004. The goal of the project? Gain efficiencies, eliminate problems and consolidate office operations.
“We need to be able to run our practice efficiently because reimbursement is down,” explains Stenoien. “We need to be able to image a lot of patients quickly. The technologists need to have access to the information. We need to be able to identify all the problems before the patient arrives, so that when the patient gets here, we can get him or her through smoothly, and by the end of the day hopefully generate more revenue.”
In addition to the RIS, HMI is filmless and stores patient information in an electronic medical record system, making myriad information accessible to radiologists and offsite clinicians. The tight integration of all three systems allows HMI radiologists to read studies for several different, geographically dispersed locations, including clinics in South Texas, Panama and Vietnam. “A hospital in Panama can transmit their images to HMI, a radiologist will interpret the study, and then that [offsite clinician] can view the final reports and images over my RIS/PACS,” says Stenoien.
Patients benefit from the paperless environment because the RIS reduces the possibility for errors to occur or orders to be lost, says Stenoien. “If a patient does not show up, we are alerted so that we can call and notify the referring doctor’s office,” he explains.
Implementation & utilization are a team effort
University Diagnostic Medical Imaging, PC, in the Bronx, N.Y., is a large, privately owned outpatient facility that offers x-ray, fluoroscopy, PET/CT, x-ray, MRI, CT, nuclear medicine, and ultrasound. UDMI has a staff of more than 75 full-time employees, which includes seven full-time, onsite radiologists and onsite transcription. Turnaround time for final report is typically under 12 hours, says Robert Klein, UDMI’s administrative director.
First came PACS, and now UDMI is completing installation of Advanced Data Systems’ Medics Premier RIS. UDMI already uses a billing system from ADS, and the established relationship was one reason why UDMI selected the vendor for the RIS project. “In this day and age when adaptability of your tools to the situation is so important, you need a player that is going to listen to what you need, and to make that change for you quickly,” explains Klein. “I have a vendor that reacts quicker to my individual needs, and that is so important in the area of programming and computer management.”
So far, the RIS is helping UDMI proactively manage patient flow. “If I want to see how many patients are at the exam level of the process, I go to the RIS and click on ‘exam tab,’” says Klein. “I can then see every modality, every patient and every state that they are in. I can then click on the ‘dictation tab’ to see how my doctors are keeping up with the flow of dictation.