Managing the Flow in Radiology

Putting RIS to Work

As the technology evolves, imagers can use it to operate more efficiently

By Dana Hinesly

Davis Graham

Once the wave of the future, radiology information systems (RIS) have become a staple in modern imaging departments, where they help professionals organize patient registration and scheduling, manage reports, and drive workflow. As the reimbursement landscape shifts, imaging professionals are seeking solutions to help keep them abreast of what’s happening within their practices and to improve efficiency. RIS just might be the answer.

“It’s gotten to where a RIS is a RIS, so now the focus is on what you can do with all of that information to help steer your practice through the desert that the Deficit Reduction Act (DRA) is creating,” said Davis Graham, executive director and chief financial officer for Manatee Diagnostic Center (MDC), Bradenton, Fla. The solution Graham uses provides a detailed look at which area is losing compensation as a result of policy changes: “This capability is particularly important to us, because I think we’re only in the first wave with Medicare—I believe other insurers are going to follow—so economically, we are on a crash course, and something needs to be done.”

Neal Schafer

Graham crunches the numbers using a practice analysis capability that is part of the Fusion RIS from Merge Healthcare, Milwaukee, a solution that the company installed in October 2003. The feature makes easy work of creating “dashboards” that display information pulled from the system.

“These dashboards enable us to drive toward our goal of patient-minded efficiency,” Graham said. With a few clicks, he can see which modalities are busy and which rooms have availability in the scheduling. Armed with this information, the managers are able to improve service to their referring physicians. “If we see we have a slow day in CT, for example, we can send a flash fax to centers that we know order a lot of CTs, telling them we have openings and can accommodate their patients.”

Also, MDC employs the software to help the business determine when a return is realized on investments. For example, Graham and his staff began mailing reminder letters and implemented a telephone confirmation program in response to increasing no-show rates. “The software makes it so if I see a trend going on, I can do something about it,” he said. “In January, I had 20% no-shows in high-volume areas, so 20% was a high number; [since starting the reminder services,] that is down to single-digits. We are using the practice analysis tool to confirm what actually took place—to verify that the drop was a result of our efforts and not a coincidence.”

Manatee Diagnostic Center offers MRI, CT, mammography, ultrasound, x-ray, bone density, and nuclear medicine services.

MDC is a family-owned organization comprising four locations: three multimodality centers and one that houses an open MRI. Certified by the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL), American College of Radiology (ACR), and The Joint Commission, the company performed about 87,000 imaging procedures in 2006.

The Fusion RIS is run as a central business function with distributed capabilities for on-site workflow at each center. The software was selected based on a number of attributes, but its Windows-based operating system was particularly appealing to MDC’s IT team. “The fact that [the RIS is] based on a standard Microsoft SQL Server allows our developers to be able to access the database and pull data out however we want to,” said MDC’s IT director Neal Schafer.

It also makes it possible for the programmers on staff to create modules that enable the system to perform adjunct functions. “We were able to write our own interface between [our speech recognition system] and the Fusion RIS,” Schafer said. “We’ve also been able to create our own Web portal. If they used a proprietary database, we wouldn’t be able to do that.”

Still, those companies without in-house tech support can benefit from the software’s design. Every Fusion RIS is customized, with each solution created by selecting the right modules for the customer’s unique business needs. As those needs change over time, the RIS can be adapted by adding or removing functionality.

Graham also uses the software to develop detailed production reports, which he distributes directly to the management team. “I’ve created spreadsheets that display the previous day’s results, and I send it out to all supervisors,” he said. Information is stripped of all patient identifiers and used exclusively for internal purposes.

According to Graham, having robust RIS solutions is vital to radiology centers: “I would say, when dealing with the DRA, it’s like we went from a visual flight rating to an instrument flight rating—and that means the instruments become more and more important to helping us navigate the business.”

Dana Hinesly is a contributing writer for  Axis Imaging News. For more information, contact .