Imaging centers are known for providing convenient locations with extended hours and easy access. Some foster a cozy ambiance by providing snacks and sodas in the waiting area—and perhaps some children’s toys.

What goes on behind the scenes is much more complicated. Imaging centers are striving to satisfy and gain loyalty from three audiences with vastly different needs—referring physicians, radiologists, and patients.

Referring physicians want rapid access to imaging studies and reports from any location or device—without the inconvenience of requirements that call for specific operating systems and frequent image viewer software upgrades. Zero-footprint viewers adeptly address this need by allowing physicians to review radiology reports and imaging studies from workstations, laptops, and mobile devices anywhere, anytime.

Radiologists need advanced reading features for all modalities available from any workstation at their homes or offices. This greatly improves productivity for on-site reading while simultaneously allowing efficient off-site reading for specialty or after-hours exams. Other highly desirable capabilities are embedded voice dictation, the ability to automatically populate patient and exam information into the report, and other automated tasks that improve efficiency while maintaining quality.

And last but certainly not least, imaging centers seek to win loyalty from patients. In the past, that often meant convenient locations with good parking and friendly staff. Now patients are eager to be more involved in their own care, so imaging centers are adding portals that allow patients to download, store, and share their imaging studies. This allows patients to better manage their care and communicate directly with physicians and specialists.  

Learn more about how two imaging centers are using technology to meet business objectives while improving patient care.    

Reno Diagnostic Centers

By Ron Milbank

Reno Diagnostic Centers is a privately owned radiology group that operates two imaging centers in Reno, Nev. In addition to these imaging centers, the group provides reading services for Northeastern Nevada Regional Hospital and four physicians’ offices and clinics. The radiology group reads more than 56,000 imaging studies a year.

We recently replaced outdated technology with a next-generation, integrated RIS/PACS platform to improve our business model and allow us to offer better service at a lower cost. In addition to fully integrated RIS/PACS, we also wanted RIS and PACS platforms that each delivered advanced functionality that could help boost productivity and efficiency. Another essential capability was an image viewer that would enable convenient remote access for referring physicians, whether they are using workstations or mobile devices such as iPads.  

We carefully evaluated RIS and PACS capabilities from over a dozen suppliers before making the decision to implement Carestream’s Vue RIS and Vue PACS.

Key Advantages of Next Generation PACS

Embedded advanced reading tools boost productivity. Our radiologists were very involved in evaluating and selecting the PACS system. One of our top priorities was for the PACS to deliver advanced reading features for all modalities to help eliminate the need for radiologists to move to dedicated workstations. Each dedicated workstation has a different user interface and tools—and moving between systems hampers productivity, while also tying our radiologists to a specific location.

It also can be a tremendous advantage to have these advanced tools embedded—or native—to the PACS platform. We did not want the headaches of integrating third-party systems onto our PACS. Our radiologists now have real-time 3D vessel analysis; automatic registration of volumetric comparison of different modality types; cardiac exam review; orthopedic surgical planning; virtual colonoscopy reading; and mammography-specific reading tools—all from a single workstation platform. This delivers exceptional convenience and productivity along with possible cost savings from eliminating three dedicated workstations.  

Radiologists can read and report from any location, including homes for after-hours cases. Some of our imaging centers are open evenings and weekends, and we provide immediate reads for these extended service hours. In order to maintain both efficiency and convenience, our radiologists now have access to their specific hanging protocols and all advanced reading features from any location. And because our PACS is web-based and uses advanced streaming technology, even complex 3D imaging studies are available quickly from any location.  

A zero-footprint mobile image viewer builds greater satisfaction for referring physicians. Our Vue Motion image viewer is a tremendous asset because referring physicians can quickly and easily access patient images and reports from any workstation or remote devices such as an iPad. No major software downloads or upgrades are required, which saves time for our staff and our referring physicians. This represents a significant improvement over our previous viewer, which required a specific Windows operating system and browser.

We have more than 850 external accounts using Vue Motion to access our Vue PACS, representing several hundred physicians’ offices. Most of these accounts were activated within the first 30 days our viewer was available.

We contacted referring physicians via e-mail and had each office submit a request for an online account that would allow use of the image viewer. The viewer is so easy to use that most physicians are proficient in about 5 minutes, so we have had very few questions or support requests. Physicians are very satisfied with the viewer’s performance and report that it greatly improves their access to images and their ability to rapidly determine appropriate treatment for patients.  

In our configuration, the image viewer accesses a stand-alone VMWare server that connects to the PACS to access imaging exams and radiology reports. We have a contact with each office that enables them to access data on their patients through the Vue Motion interface in order to maintain HIPAA compliance.

We created a method to send reports back to independent facilities that ensures the data are associated with the right patient. Dealing with differences in patient accession numbers has been a challenge faced by imaging centers for many years. We have solved this problem by having the PACS assign a four character prefix to the accession numbers. This ensures that the study is read and reported back to the correct provider, using their original accession number.    

RIS Features Further Streamline Workflow   

The RIS further streamlines our workflow due to embedded voice dictation, which eliminated another discrete server software solution. The scheduling module is customized to address the needs of our business workflow.
In addition, we mine data from different resources to insert into our report. This allows us to automatically populate information including: referring physician, modality name, patient name, patient date of birth, exam code and name, sedation protocol and drug amounts, contrast protocol and drug amounts, and other fields. Our radiologists can now dictate reports with up to a third less words—saving an average of 20 seconds to 1 minute per study and improving productivity while maintaining quality.

When we were building this system, we were determined to achieve the highest level of disaster recovery available. We have redundant RIS and PACS servers in our main office that store data on an EMC storage area network (SAN). We also have an off-site PACS server with an EMC SAN stored at an Integra Data Center for real-time backup and recovery of RIS and PACS data. Because both sites are connected via high-speed metropolitan network, we are able to recover data in minutes instead of hours or days.

Investment Promises a Rapid Return  

Usually high-level performance comes with a higher price, but our new system is actually saving us money. We are supporting a fully featured RIS/PACS along with fully redundant archiving at a per study cost that is almost 40% lower than our previous systems. As a result, we are projecting a 2½ year payback on our investment.

Much of the projected cost savings is due to the intelligent design of the RIS/PACS that includes embedded capabilities to help eliminate the need to integrate and support multiple independent solutions and workstations.

We consider this implementation a success because it met all our objectives: better service for our referring physicians; greater convenience and productivity for radiologists; and reduced expenses for our company. 

Houston Medical Imaging

By Randall Stenoien, MD

Houston Medical Imaging (HMI) conducts more than 40,000 imaging exams each year at our three sites. Since we are always looking for innovative ways to grow our business, offering patients rapid electronic access to their radiology reports and imaging studies seemed like a great way to build patient satisfaction and loyalty. We found what we were looking for in a web-based patient portal that was cost-effective and easy for us to implement—and also easy for our patients to use.    

We have used Carestream’s MyVue patient portal for about a year and it’s been a great success. Half of our patients sign up to use the portal, and half of those patients have activated their accounts. Patients can access the portal through our website, and we have security measures in place to protect the privacy of patient records.

We expect even higher activation rates in the future as more patients begin to play an active role in managing their healthcare, which often includes e-mailing reports and imaging studies directly to physicians and specialists.

While this portal was designed to serve patient needs, it also benefits our company because it’s a market differentiator. The Houston area is a very competitive market for imaging services. In order to be successful, we need to attract more patients every year—and that requires finding new and better ways to serve both patients and referring physicians.

Our imaging volume is up by 10% over last year—and we believe some of that growth is driven by the capabilities of our patient portal. The portal also has helped us develop a reputation as an innovative and progressive provider of imaging services—which we hope will foster additional growth in referrals by physicians and by our current patient base.

Imaging Centers Use New Features to Drive User Satisfaction  

Imaging centers have carved out a valuable niche in healthcare by providing cost-effective imaging services in an informal setting. In order to improve service and boost study volumes, imaging centers are investing in advanced image management and distribution technologies that address the needs of physicians, radiologists, and patients. A common trend among all these constituencies is the desire for convenient electronic access to radiology reports and imaging studies. In the past, radiologists and referring physicians were limited to specific sites and workstations. Today’s mobile environment requires much more flexible access for referring physicians. That flexibility is also being extended to patients who are now equipped to participate in directing the course of their care.        


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Ron Milbank is Director of Information Technology at Reno Diagnostic Centers in Reno, NV. Randall Stenoien, MD, is CEO of Houston Medical Imaging.