As the real-world examples in this issue indicate, the right information technology can be applied successfully to projects of any size, from the radiology department too small to attract even one radiologist to the electronic medical record initiative of an entire nation. One-size-fits-all solutions do not exist, but the size, scope, integration, and installation pace of radiology information system (RIS), speech-recognition system, picture archiving and communications system (PACS), and electronic medical record (EMR) projects can be tailored to solve (or prevent) problems in any setting.
Beginning with “Backward Success..”, the massive task of providing clinicians with access to images on and beyond the huge Baltimore campus of Johns Hopkins Hospital is described. The unusual approach taken here was the reverse of the usual progression, yet has been successful in a setting where 400,000 imaging studies are handled each year by more than 120 radiologists, residents, and fellows. Rather than install expensive, dedicated workstations to provide clinicians access to the images archived in a multiple-PACS configuration for nuclear, ultrasound, MRI, CT, and general radiography images, Johns Hopkins installed a web-based PACS system to integrate all images into the EMR, where clinicians gain access to images and reports.
Another institution that has an enterprise PACS integrated with its EMR is profiled with “Enterprise PACS..” – but this facility is an 100-bed community hospital in Exeter, NH. Although Exeter Hospital is not large, its leaders found its need to avoid the medicolegal consequences of film loss, to cope with a near doubling of imaging volume in recent years, to compete with other institutions, and to reduce the expense of housing patient records to be compelling reasons for desktop integration of the PACS and EMR. This implementation was spearheaded by the hospital’s CIO and managed by its information systems and diagnostic imaging departments.
A PACS deployment linking five small hospitals and two larger facilities that cover the entire Canadian province of Prince Edward Island, described in “Province-wide PACS..”, allows radiologists at the two main hospitals to interpret images from the five smaller radiology departments (which are staffed by technologists) and permits images to be forwarded outside the province for subspecialty readings. Paid for by private donations, provincial grants, and matching Canadian federal funds, this system has produced an estimated 25% increase in staff productivity. It is also the foundation for an EMR system on Prince Edward Island that will eventually link Canada’s four Atlantic provinces; it may serve, in time, as the model for Canada’s national EMR, which is now being developed.
Hospitals of any size can benefit from the use of speech-recognition technology to generate radiology reports, but the degree to which its adoption will be successful depends heavily on the percentage of reports for which it is used. The 300-bed Children’s Hospital Boston, following an early speech-recognition project that was not accepted by its potential users, used planning, teamwork, extensive training, and integration with PACS and RIS to achieve a remarkable use rate of 97% for speech recognition. This project, described in “Implementing Speech Recognition..”, is responsible for an expected savings of $250,000 per year in transcription costs and an 83.3% reduction in average turnaround time for reports made by staff radiologists.
As always, Agfa is pleased to sponsor the publication of this Intelligence Report. Agfa stands ready to help imaging facilities of all sizes find the best solutions to their problems, and to assist them in the constant attempt to do more with less, by applying information technology on the correct scale in the most effective way.
Ray Russell is Executive Director of Marketing, HealthCare – Radiology Solutions, Agfa Healthcare, Greenville, SC.