· Teaming Up on Mobile Computing
· Inspired Solution for Single-Site Centers
· Echo Solution Not a One-Size-Fits-All
· M*Modal, Transolutions Offer Integrated Services
· Communicating Critical Results

Teaming Up on Mobile Computing

GE Healthcare IT recently kicked off its collaboration with Intel Corp and Motion Computing, a team seeking to provide a mobile computing solution that will eliminate manual collection of patient vital data.

The offering will be deployed at the University of California-San Francisco Medical Center, where nurses will have access to a mobile, clinician-centric workflow. Here, the Motion C5 mobile clinical assistant from Intel will be incorporated into vital sign collection using Centricity Enterprise’s inpatient electronic medical record software and GE Healthcare’s DINAMAP patient monitoring devices. In this regard, the mobile solution is anticipated to have a beneficial impact on radiologists.

“Since Centricity Enterprise is really an underlying core of health care IT, radiologists benefit by accessibility to universal data from their imaging solution to the central IT base, or Centricity Enterprise,” said Graham Hughes, MD, general manager, GE Healthcare IT. “Many of our enterprise customers today use cross-functional properties of the Centricity portfolio, all essential for the overarching operation and execution of the health care organization.”

Replacing the use of computers on wheels (COWs) to gain access to Centricity Enterprise electronic medical records, the solution is made possible by the creation of a new cable system and Java applet that permits vital sign collection on GE DINAMAP monitors to flow directly into Centricity Enterprise. Also, a new user interface has been optimized for navigation and data input using the Motion C5 pen and stylus capabilities.

The UCSF pilot hopes to serve as the first example of how ultramobile PCs are at the forefront of how clinical teams deliver care, Hughes said. The pilot’s initial benefits have included enhanced patient interaction, reduced documentation delay, and greater portability by the use of required clinical logins.

“Real-time information availability at the point of care has become increasingly vital to patient outcomes and safety,” Hughes said. “Our partnership with UCSF magnifies this trend by connecting mobile devices to literally the continuum of care, including real-time access to our Centricity portfolio, and imaging components, such as PACS, EKG, and Fetal Strip images. The ability to arm care teams with comprehensive, real-time information improves the quality of care from every angle.”

—Elaine Sanchez

Inspired Solution for Single-Site Centers

Medical imaging software and services provider Merge Healthcare, Milwaukee, recently announced the release of eFilm RIS/PACS, an informatics solution designed for single imaging centers that perform up to 10,000 studies annually.

According to Merge, the solution is a cost-effective way for small imaging centers and specialty practices to receive basic RIS/PACS functionality.

“eFilm RIS/PACS is an economical option for imaging sites with modest annual study volumes,” said Gary Bowers, president, Merge Healthcare North America. “Furthermore, low-volume centers already using eFilm Workstation can maximize their earlier investment by simply upgrading to eFilm RIS/PACS.”

To begin the immediate usage of the solution, Merge or on-site resources must complete installation of the Web server, which comes equipped with eFilm RIS/PACS software. Start-up is further simplified through a single feature configuration, providing a comprehensive set of workflow features that range from schedule to report creation. Additionally, a distributed radiology data model was developed to provide user access to reports and images from any Web-enabled device, whether at home, a private office, or the scanner site.

A Web portal for referring physicians enables rapid report distribution and availability. The administrator-defined security model features various levels of user rights and privileges, so that given data can be limited to users that require it.

The eFilm RIS/PACS is compatible with eFilm Workstation and allows for integration with existing eFilm Workstation clients. The system fosters streamlined document management, as all scanned and imported documents are available to the radiologists. Clinicians can then access relevant information necessary to make a diagnosis, which increases productivity and diagnostic quality while eliminating paper storage and time spent searching for documents.

Furthermore, users can create MIPs, MPRs, and slab MPRs to facilitate image reading. Billing information export tools permit HL7 interface to outside billing vendors, working to ensure data integrity and acceleration of billing and reimbursement. Other features address portability and auditing concerns. Merge officials say CD burning can reduce costs of produced films, while surveillance and recording of patient and exam records secure patient privacy and support HIPAA compliance.

—E. Sanchez

Echo Solution Not a One-Size-Fits-All

After 12 years inside what can be considered the world’s largest echo lab—the Mayo Clinic—the Kardia echocardiography information management system from Kardia Health Systems Inc is now being released commercially.

Together with Dell, Kardia aims to streamline the delivery and management through a combination of technologies. Dell will offer its infrastructure and services to deliver an easily navigable Web-based system that reduces and eliminates manual processes, thereby enabling time- and cost-savings.

Among its benefits, the Kardia solution manages the scheduling of patients, lab personnel, equipment, and logical template-guided entry of echo study information.

“It’s so clinically rich that it can provide more evidence-based guided impression results than any other product on the market,” said Wayne Schellhammer, executive vice president of Kardia. “This is clearly one of its strengths, the fact that they are guided impressions, which accelerate the physician’s ability to move through the echo report.”

Schellhammer said Kardia would be able to fulfill its global demand through its relationship with Dell, a partner that could deliver the required hardware as well as technical and client services. Specifically, Dell has developed a system to run the Kardia solution, and it will spearhead the implementation of the technology, selecting servers, storage, and desktop computers based on the size of the cardiology practice.

“We don’t want to sell excess server capacity,” said Scott Jenkins, director of healthcare solution sales at Dell.

Smaller practices without a data center or IT staff will receive a Dell PowerEdge 1900 or 2900. On the other hand, larger practices will operate on the Dell PowerEdge 1950 III or PowerEdge 2950 III with storage on PowerVault MD 3000s.

Rather than offer a one-size-fits-all solution, Dell and Kardia have focused on providing a solution that optimizes a practice’s individual style and work patterns.

“Our job is to enhance their workflow processes, not change it,” Jenkins said. Citing the solution’s ability for flexibility and optimized throughput, Schellhammer commented that wasted minutes matter, especially in the health care setting. “Millions of Baby Boomers are coming to an age when they require cardiac care, so it’s critical for health care facilities to manage the growing numbers of patients as efficiently and cost-effectively as possible,” he said.

“Information technology is a powerful tool in this effort, and Dell is providing world-class technology that is enabling Kardia to offer solutions that will enhance the delivery of cardiology services for patients across the country.”

—E. Sanchez

M*Modal, Transolutions Offer Integrated Services

Speech recognition firm M*Modal, Pittsburgh, and transcription services company Transolutions, Lake Bluff, Ill, recently announced an agreement to offer integrated services to Transolutions’ transcription clients. The partnership will work to streamline the ability to share patient data by bringing structured and encoded data from dictation into electronic health records.

M*Modal’s AnyModal CD, an on-demand conversational documentation service, can capture an audio file from spoken dictation. Radiologists also have the option of using existing voice recording processes.

The product utilizes speech recognition and natural language understanding to capture and comprehend clinical information from dictation, which it then turns into sharable electronic files. The information is automatically coded and structured into a Meaningful Clinical Document, a process that allows the information to be easily validated and corrected, and then later integrated into an electronic health record. The physician, or medical language specialist, can then edit and validate an electronic draft. Upon approval, M*Modal’s publishing service formats the encoded information into customized clinical documents shared with the client’s EHR system.

“M*Modal’s advanced speech-understanding technology and its ability to capture structured and encoded data from dictation is a good match with Transolutions’ tightly integrated platform and will provide unique benefits to our clients, transcriptionists, and business partners,” said Michael S. Carnrite, president of Transolutions. “Incorporating the AnyModal CDS technology will save the clinician time while providing the opportunity to create additional clinical value from their dictation, such as data mining.”

Available to health care organizations through a variety of delivery systems, Transolutions’ transcription services will now be able to offer organizations physician-dictated medical reports that contain relevant patient data retrieved from existing repositories.

“Our two companies have a shared vision—to increase productivity, physician satisfaction, and the quality of patient care through easier access to dictated health information,” said Michael Finke, CEO of M*Modal. “More advanced collection, integration, and analysis of patient data are the natural next step to advance the adoption and ultimate value of the EHR.”

—E. Sanchez

Veriphy-Ready HL7 Integration Server (VIS) is designed to quickly and effectively communicate critical test results, and to speed workflow in radiology facilities.

Communicating Critical Results

A physician sends a patient for a radiology exam, and the test results reveal an unexpected finding—a potentially malignant tumor. The results are mailed to the referring physician, but the paperwork gets misplaced before the physician can see it, and the radiologist never knows the physician was not alerted. After that, the patient’s cancer may get worse before it is detected.

To prevent those kinds of human errors, Nuance Communications, which is based in Burlington, Mass, has released a product called the Veriphy-Ready HL7 Integration Server (VIS). The system is designed to help prevent critical test results from getting lost in the shuffle, and to speed workflow in radiology facilities.

VIS is a Windows-based application platform that allows organizations to better integrate Vocada Veriphy, another Nuance-owned product, into their existing applications and systems. Vocada Veriphy, which automates the process of communicating critical test results from hospital diagnostic departments to ordering clinicians, is used at more than 175 hospitals nationwide.

“I wouldn’t want to practice radiology in the 21st century without it,” said Steven Defossez, MD, medical director at North Shore Magnetic Imaging Center in Peabody, Mass.

Defossez said he views the system, which is in place at his center, as a vast improvement on the old way of communicating critical test results. “We relied on the fact that these faxed reports are going to the doctors’ offices and the paper copies get mailed to the doctors’ offices,” Defossez said. “But it is an unfortunate reality that without Vocada, some of these important findings don’t make it to the treating physician.”

Less than 2.5% of radiology test results come back as critical, but when it happens, a radiologist often wants to alert the referring physician immediately, said Tom White, general manager of Veriphy in the Dictaphone Healthcare Division at Nuance.

“They pick the phone up, as a radiologist, and they’re dialing for dollars,” White said. “They want to get a hold of the referring physician ? but as everyone has gotten busier and busier, the opportunity to connect live has gotten rarer and rarer.”

With the Vocada Veriphy system, a radiologist records a short audio message about a patient’s test result. The radiologist classifies the finding based on its level of urgency.

The system then sends an automated message to the referring physician, calling her office line or mobile phone—or whatever means of contact the physician has said is the best way to reach her. For urgent messages, an automated call will go out every 10 minutes until the physician is reached, while for less urgent results the calls can be spaced hours apart.

When the physician answers the call, she will hear a recording telling her to retrieve the radiologist’s recorded message about her patient by calling a number. After the physician has listened to the message, the system automatically pulls the patient’s report and notes that the message has been communicated to the physician.

Defossez said that aspect of the system helps his center guard against malpractice lawsuits, because it generates a case history that can be used in court to vindicate the radiologist if a physician overlooks a critical test result. “Before we had this system, I would dictate a report and hope that the doctor got it, and hope that he would treat the patient well,” Defossez said. In radiology, more than 70% of malpractice lawsuits stem from a breakdown in communication, experts say.

North Shore Magnetic Imaging Center sends out more than 100,000 reports per year.

Physicians’ offices are flooded with paperwork, too, and sometimes nurses put critical test results in a patient’s file before the physician has a chance to see them, Defossez said. In that case, the physician may not see the result until the patient comes back for another office visit months later.

Company officials hope that more hospitals will start using Vocada Veriphy following the March release of VIS, which they say allows hospitals to overcome any integration challenges they may have with the system.

—Alex Dobuzinskis