· Software Solutions for Small, Medium Facilities
· Better Turnaround Time Linked to Voice Recognition
· Taking Image Distribution on the Road
· Bridge to the EMR
Software Solutions for Small, Medium Facilities
Health care software company 7 Medical Systems, Minneapolis, received the IT Software & Hardware, Communications and Infrastructure Award in the small-and-growing-company category at the 2008 Tekne Awards, held at the Minneapolis Convention Center on October 30. The awards, which honor superior technology advancement and leadership in Minnesota, are presented annually by the Minnesota High Tech Association, along with Enterprise Minnesota and LifeScience Alley.
7 Medical provides on-demand software solutions—such as PACS, electronic medical records, and data backup and recovery—for a monthly fee. These products are designed primarily for small to medium-sized health care facilities, such as critical access hospitals, radiology groups, imaging centers, and ambulatory clinics.
“The goal was to provide a low-cost, capital-less, predictable, fully managed PACS service for the small and midsized market,” said Jason Studsrud, CEO of 7 Medical Systems.
When considering a PACS system, Studsrud says it is important for radiologists to consider every line item when weighing a 5-year commitment. He notes that there are sometimes unwelcome surprises in the second or third year of the contract, which add to the cost over time.
“The reality of it is, we’ve just seen the small/mid market being taken advantage of, and that’s another reason why we’re here,” he said.
The on-demand, software-as-a-service model provided by 7 Medical Systems is designed to address these concerns. “Eliminate the surprise, eliminate the capital, and go with something extremely predictable and a fixed, understood cost that includes everything as it relates to your PACS environment,” Studsrud said.
Studsrud notes that the Tekne Award has already helped to build credibility for the 4-year-old company. “The demand is high,” he said. “We have a huge pipeline of activity.”
—Ann H. Carlson
Better Turnaround Time Linked to Voice Recognition
For many of the radiologists at Baptist Memorial Health Care (BMH), Memphis, Tenn, the news that the health care network would be transitioning from traditional transcription to a voice-recognition dictation system was unwelcome at first. But since 10 of the 15 hospital facilities have begun using the Dictaphone PowerScribe for Radiology system from Nuance Communications, Burlington, Mass, in January, the staff has noticed a 70% improvement in turnaround times.
“Before we implemented PowerScribe, we were averaging 11.6 hours from the time the exam was completed until we had a final report available for the physicians,” said Linda Murphy, radiology director. “And since implementation of PowerScribe, we’re averaging around 3.5 hours.”
The improved turnaround gives the physicians the information they need much earlier than before—which directly affects patient care. “The ER now waits for the final report on the x-ray to come over before they discharge the patient,” said Dexter Witte, MD, president of Mid-South Imaging and Therapeutics and BMH chief of the musculoskeletal section. “That would have been inconceivable before.” Witte adds that the faster turnaround has greatly reduced the number of telephone calls from nurses with requests for preliminary reports.
Before implementing PowerScribe, BMH radiologists had to sign out of one hospital’s system before signing in to another hospital’s system to get their next case—a process that added minutes to each case. Now, radiologists can go from one case to the next without logging out of the system, even if they are reading cases from different hospitals.
“The best thing for me has been the efficiency of the sign-out process,” said Andy Ellzey, MD, BMH radiology residency program director. “For us, dictating [reports] is a little slower than using transcriptions, but the sign-out is so much more efficient than what we did before, and the turnaround process is so much better, that it kind of makes up for it and then some.”
The interface also facilitates risk management. “It’s easier to track what time [the report] was dictated and how long it sat in the system, and I can look to see how the resident handled his piece of it,” said Nina Armstrong, RIS manager and PowerScribe administrator. “It’s a good tracking mechanism.”
Version 5.0 of PowerScribe incorporates features such as enhanced voice recognition, designed to reduce word-error rates by 35%. It also supports RIS environments, features a redesigned graphical user interface based on customer feedback, and provides seamless integration for critical test result management as well as for order decision support and business intelligence.
Taking Image Distribution on the Road
As physician practices become more mobile, so too must their tools. But technology and, therefore, physicians have been limited by components and infrastructure. Previous radiology systems were unable to transmit images with ease. Obstacles to swift and clear transmission include growing image data volumes, network congestion, inadequate Internet bandwidth, limited client hardware resources, and viewing software that occupies a large footprint.
Fortunately, technology marches on, and advances in both hardware and software at Kjaya Medical, Stamford, Conn, have produced VoXcell, a solution that enables real-time viewing of images with advanced visualization. The next-generation thin-client image distribution and visualization system received 510(k) clearance from the FDA this past fall. The platform delivers images at any time to any basic desktop or mobile PC that can access a cable, DSL, or cellular broadband Internet connection.
Physicians can load patient studies, display 2D images, and perform desired reconstructions instantly over the Internet from any location. Preliminary and full reads can be easily completed at once. According to Kjaya, these capabilities create more effective workflows, for both the individual physician and the health enterprise, which may result in higher patient volumes and increased revenues. Most importantly, however, the technology can also contribute to better outcomes.
With greater access to diagnostic-quality, 3D images, physicians are more likely to use and manipulate the films, producing greater confidence in their diagnoses. Referring physicians and specialists can simultaneously view images without having time or location restrictions, making conferences easy and more productive.
VoXcell and Xcell
VoXcell works by conducting real-time 3D processing of large-volume data sets. The system streams the 2D axial slices and 3D reconstructions of MRI, CT, and PET-CT scans so they are available on demand. Image quality is maintained at diagnostic levels, and multiple formats are available for streaming and interactive viewing.
The Xcell hardware incorporates completely off-the-shelf components, including the latest generation of graphics processing units (GPUs). The strategy keeps costs down and flexibility up. According to the company, its NIVIDIA and ATI GPUs are approximately 30 times faster than current Intel central processing units. Techies might appreciate knowing the system delivers 2.4 TFLOPS of 3D processing power; laypeople will appreciate the unlimited storage and scalability.
Kjaya’s VoXcell can integrate with existing PACS, HIS, RIS, and EMRs, and is available as a managed service, which eliminates the need for significant capital. The package includes the hardware, software license (for an unlimited number of users), hardware and software support, hardware and software upgrades, HIPAA compliance, storage and archiving, and a data center.
The many components are integrated in a configuration that is intended to be seamless to the physician users, who benefit from no longer being tethered to a dedicated workstation or reading room. “Accessing pediatric images ubiquitously is a challenge today. I know this firsthand as a pediatric surgeon covering six different hospitals,” said Donald C. Lui, MD, PhD, surgeon-in-chief at the University of Chicago Comer Children’s Hospital. The ability to view images over the Internet is, as Lui puts it, “of great clinical relevance.”
Bridge to the EMR
In the last decade, the CardioGram system from CompuMed has become the telecardiology solution of choice for a significant number of the state correctional prison systems across the nation.
Fueled by the success of its flagship system, the Los Angeles-based medical informatics company has developed the CompuBRIDGE telecardiology electronic medical records (EMR) solution.
“Nowhere is the challenge of providing quality health care more complex than in a correctional facility,” said Maurizio Vecchione, CEO of CompuMed. “Electronic medical records have been shown to have an impact on the safety, effectiveness, and cost of health care by having the right information at the right place at the right time. CompuBRIDGE, built with the experience of our correctional industry success, can help correctional health care customers as well as any other health care providers who use ECGs extensively transition into integrated digital medical records.”
Designed to capture and integrate electrocardiogram (ECG) results and over-reads into an existing EMR system, CompuBRIDGE EMR does not require the practice to employ additional software, hardware, or specialized servers. It offers hosted solutions for facilities without a general EMR system, providing these institutions with access to ECG data via any Web-enabled computer.
“CompuBRIDGE EMR is part of our strategy to help health care providers implement an integrated digital information solution,” Vecchione said. “We use a standards-based architecture for ease of integration and optimal interoperability. It allows our clients to automatically integrate ECGs and over-reads with most EMR systems.”
Users of CompuMed’s telecardiology services will have the ability to data mine patient records and electronically transfer them to their own EMR systems, which include patient administrative systems, electronic practice management, and laboratory information.
The CompuBRIDGE EMR is currently undergoing beta customer testing. Upon completion, CompuMed will make the system available to the general marketplace.