The transformation of the radiology department at Meadows Regional Medical Center (Vidalia, Ga) from a 1960s-era dinosaur to a state-of-the-art digital department has been like a Cinderella story. The changes made during the past 2 years to the radiology department of this rural, 87-bed hospital have been dramatic-and with dramatic changes have come remarkable results.
From what was once a department that featured older equipment in a dark setting, the strong smell of chemicals in the air, and light boxes on the wall, has arisen a bright, airy imaging center with digital equipment and computer workstations. Now, after functioning for more than a year as an almost fully digital department featuring a PACS solution from Connect Imaging (Honolulu), the rewards are becoming clear.
According to Connie Calvarese, RT(R), CNMT, CRA, director of imaging services at Meadows Regional, numerous benefits are associated with the new digital department and PACS, and financial leads the list. “We have seen tremendous cost savings during the 2-year period since we migrated to digital radiology and PACS,” Calvarese says. “The most significant savings we have identified have been in film and supply costs, which have dropped more than 73%. Two years ago, we spent more than $336,000 for film and supplies. In our last fiscal year, we spent approximately $90,000. And the bulk of those remaining costs were for mammography studies, the one area we haven’t yet addressed for PACS.”
Other benefits include a reduction in lost films and a more efficient workflow that have translated into an increase in procedure volume. “My staff is not running up and down to the file room as much,” she notes. “The volume of procedures has increased almost 8%. That tells me we are able to schedule more patients, because we aren’t wasting time pulling and handling films and filing jackets. We made a significant investment in equipment and now are able to complete more studies and generate income for the hospital.”
The system also has proven to be more efficient for physicians and patients, as they no longer have to wait for films. “Our patients are much happier because it is quicker for them-before they can get dressed, their image is up on the system,” Calvarese explains. “It also is much faster for physicians. The minute an image has been taken, it is available throughout the hospital and for off-site physicians. Physicians can be on the phone 5 minutes after an image is [taken] to discuss the case with the radiologists. This speed provides great advantages for patient care.”
Reworking the Facility
The changes to the radiology department have their roots in hospital-wide renovations that began in 2000 with the commitment to become a more full-service medical center, including the construction of a $7 million, 20,000-sq-ft annex and the addition of several specialties. As part of this ongoing transformation, Calvarese was hired in May 2002 and charged with modernizing the radiology department. She says she faced many obstacles, and change did not occur quickly.
“When I first came here, we used traditional wet processing,” Calvarese says. “Film was everywhere, and we were quickly outgrowing our film storage space. In addition, much of the core imaging equipment was outdated and not DICOM-ready. We had to assess every piece of equipment and determine if it was worth keeping and upgrading, or if we needed to buy something new.”
Once the film storage issue was addressed by completing a massive purge of outdated film, and the survey of imaging equipment was completed, the department made an investment of more than $4 million in equipment, staff, and facilities. Equipment purchases included a new dual-head nuclear camera, three new ultrasound machines, two MRI scanners, and a second CT scanner, the latter of which was placed in a room previously used for film storage. The department also added CR to ready the radiology room for PACS. (The fluoroscopy room had recently been upgraded to digital fluoroscopy.)
The Power of PACS
The next critical step toward becoming fully digital was the acquisition and installation of a simple, easy-to-use, and affordable PACS solution, which would allow staff members and off-site referring physicians to share images, information, and expertise. Calvarese and 11 other staff members from a variety of departments served on a steering committee to find the most appropriate PACS partner for its needs. The committee began by reviewing proposals and product demonstrations from 10 large, midrange, and small PACS providers. After narrowing the field to four providers and further rigorous review, two finalists were chosen. In the end, based on an affordable price and the full range of capabilities offered, the hospital selected Connect PACS from Connect Imaging. The turnkey PACS gave radiologists, clinical users, and referring physicians the advanced tools neccessary to perform their jobs as well as helped carry the imaging department into the 21st century.
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| Tosaporn Krasaeath, MD, views images on the Connect PACS, which has dramatically improved workflow at the Meadows Regional Medical Center. |
Calvarese says Connect PACS was the best fit for the hospital on many fronts. The system is Windows based and uses Dell computers-an important feature for Meadows Regional, which uses Dell computers throughout the hospital and has a corporate account. The system also uses standard digital language, which provides the hospital with valuable flexibility. “With Connect Imaging, you acquire a native DICOM image, store a native DICOM, and are not locked into one type of system,” Calvarese says.
In addition, Connect Imaging uses Citrix technology for its ConnectShare remote access product-another plus. “We felt comfortable that Connect uses Citrix, providing users with view-only access,” she says. “Referring physicians can’t download our images to their computers. Being Citrix based rather than Web based also was important when looking at HIPAA compliance; we wanted to ensure that there were multiple levels of security.”
Affordable pricing was a key selling point of the Connect Imaging PACS. Other important considerations were the use of a standard network storage device, such as RAID, and comprehensive product support. “Connect Imaging hired a local engineer,” she says. “He was an IT professional in [our] community. Connect Imaging trained him, and he is right here with us. I was very impressed with that act.”
Installation began in spring 2003, and the system went live in June 2003, supported by a separate subnet added by a local company to handle the PACS traffic. Six workstations are placed throughout the hospital, and all personnel who work with patients are trained to use the system, including the 42 members of the radiology department. Approximately 40 referring physicians also use the system through remote log on to view studies for their patients.
Eighteen months later, Calvarese says the simple, easy-to-use system has proven to be a cornerstone in the department’s day-to-day operation, with its user-friendly software and integrated access. Its design allowed most radiologists to learn the system in less than an hour, and live support from Connect Imaging was available to users while at a workstation.
“The Connect PACS System has been very reliable,” she says. “We have had occasional issues with our network provider, which is separate from the PACS, and we had one failure of Dell equipment. But otherwise, things have performed exceptionally well. Connect Imaging is diligent about monitoring the system remotely via its PACSWatch, and the company notifies us immediately of a network problem. Our local engineer handles preventive maintenance and any upgrades or troubleshooting that need to be done on site.”
The department also has been able to customize the system based on its ongoing experience. “Any time we have made a suggestion about a change in a system function, Connect has changed it for us,” Calvarese notes. “The company adds functions for us and works closely with us. Connect isn’t a big corporate entity that sells one product that everyone must use just one way. If a radiologist says he doesn’t like a particular feature, the company changes the program so he can turn off whatever he doesn’t like or add whatever he wants.”
Reaping the Rewards
Converting to PACS helped to decrease the total number of employees needed, even as the department added such services as a new MRI center that had to be staffed. “We needed fewer ancillary staff who handle films and other administrative work,” Calvarese notes. “I also migrated some staff and retrained them in other areas so they would not lose their jobs.”
As for the future, Calvarese says she is trying to decide how the department can move even further into the digital environment. Plans call for the department to switch its three general diagnostic radiology rooms from CR to DR over the next 3 years. In addition, digital mammography remains a goal for down the road, when the center’s current equipment becomes outdated and all-digital equipment becomes more affordable.
“Our migration to PACS and a digital environment has been a big plus for us,” she says. “It used to be that only large university hospitals could afford to make a move like this and risk trying PACS. Companies like Connect Imaging provide a very solid, affordable product with excellent service that allow small facilities, like Meadows Regional, to jump into PACS without any concerns. Our move to PACS has allowed us to be on the forefront, to market ourselves to patients and prospective employees as the first hospital in southern Georgia to become fully digital. Who would have thought you’d hear that from a hospital with less than 100 beds in a community of 12,000?”
Jill Freeman-Stack is a senior program director at Sullivan & Associates (Huntington Beach, Calif), a strategic healthcare communications organization.
