Enhancing the physician experience and improving patient care.
Founded in 1997, Foothill Cardiology Medical Group focuses on providing high quality, comprehensive cardiovascular care to patients, their families and the community, within a compassionate and service-oriented environment.
Foothill Cardiology Medical Group is Southern California, San Gabriel Valley’s largest cardiovascular practice with 19 board certified cardiologists who specialize in the diagnosis and treatment of cardiovascular disease. Services range from routine cholesterol reduction program to EP studies, invasive coronary procedures, structural heart program, vascular services, nuclear and PET imaging, and clinical research.
Prior to implementing PICOM365.com Cloud in 2015, Foothill Cardiology, a long time NextGen user, utilized a hosted on-premise image management system with limited remote reading and limited report editing. When they began to think “beyond PACS,” the Foothill team redefined their requirements for a successful solution, including image enabling the EHR, flexibility in structured reporting, scalability to accommodate their growing practice, and anytime, anywhere access to images with full reporting capability.
ScImage was able to provide Foothill Cardiology with a comprehensive and robust Cloud solution that fulfilled the vision of minimal onsite service with a completely remote diagnostic venue for reading and reporting all exams, including Echo, Vascular, and Nuclear with integrated post-processing.
According to John Gonzalez, Operations Manager, Foothill Cardiology, ScImage was selected to address these needs due to their innovative software approach, flexible architecture, enterprise web-based offering and the company’s willingness and ability to accommodate Foothill’s specific requirements.
“It was really the functionality of the PICOM365 Cloud solution and the ability to integrate with our NextGen EHR. The way that it integrates with the order management process is something that I’ve never seen from any other PACS.” John Gonzalez, Operations Manager
In addition to serving its own patients at three locations, Foothill Cardiology supports six regional hospitals. Secure Cloud-based image sharing capabilities and interoperability built into the PICOM365 platform, enable Foothill Cardiology to upload and interpret diagnostic cardiovascular studies on patients performed at other facilities, largely eliminating CDs for patients that come from outside referrals.
“In cases where the patients are sent with image CDs, we can upload them to PICOM365. Not only does this give us a permanent record which can be viewed throughout the treatment process, it is much more efficient than having to hunt for CDs every time someone wants to view the images,” said Alex Durairaj, M.D., FACC, President, Foothill Cardiology.
“Anywhere access has been tremendously helpful, both from a viewing and a reporting standpoint. When I’m at a remote site, it’s nice to be able to see the study and not have to call someone to send it manually,” said Dr. Durairaj, who also attributes better workforce management to anywhere access.
“Not only does this free our clinicians from being tied to one location to read, but when one office is busy, clinicians from another office can pick up the slack by reading studies from the centralized worklist to maintain proper report turn-around times. This flexibility improves our efficiency with no interruption to workflow and helps me better manage staff utilization.”
ScImage’s high availability PICOM365 Cloud solution delivers constant security and encryption enhancements to balance the need to safeguard Foothill Cardiology’s data with the need for easy and consistent access. “Web-based is absolutely the way to go,” said Gonzalez. “We had Cloud capabilities before partnering with ScImage; however, the solution design was an afterthought. The onsite server and applications core needed to be managed daily by internal staff as well as a contracted IT company, increasing costs and decreasing efficiency. Leveraging Microsoft Azure technologies, ScImage adds a layer of security and protection that we would not have been able to accomplish in-house. PICOM365 architecture puts the power of the Cloud at the core of its design, and helps ensure that our data is protected, private and HIPAA compliant,”
Beyond image management, integrating PICOM365 Enterprise PACS and the EHR improves clinical collaboration with patients. ScImage’s open SQL database allows access to detailed Business Analytics for practice management, and a robust Clinical Outcomes tool supports physicians’ efforts in qualifying patients for specific programs, such as TAVR, significantly reducing the time spent on accreditation. Most recently, PET imaging and Amyloidosis scanning workflows were seamlessly implemented, and Foothill was able to customize the associated structured reports with PICOM365’s Report Designer module.
Foothill Cardiology and ScImage have continued to collaborate to enhance the physician experience and improve patient care through technology. ScImage has a close working relationship with the both the clinical staff and IT department and maintains an open-door policy for communication. Scaled to address new diagnostic procedures and maintain the highest level of security and support, ScImage has helped Foothill Cardiology Medical Group expand its world-class offering.Download PDF
Workflow and Connectivity Drives Growth
Neighbors taking care of neighbors, with the technology and clinical expertise equal to or surpassing a big city hospital – that’s the approach that Butler Health System Cardiovascular Services takes as it delivers top-quality cardiology services.
Founded in 1898, BHS has numerous locations throughout Butler, Pennsylvania and surrounding counties. With more than 20 highly educated specialists, BHS provides care for everything from routine cardiac care, interventional cardiology, electrophysiology, open heart surgery, TAVR, and rehabilitation. The 296 bed hospital system has been recognized for receiving a 5-star rating from Health Grades for its cardiovascular surgery program and earning the Apex Award from VHA for Acute Myocardial Infarction and Heart Failure.
“The only way for a small, community hospital to survive in today’s changing environment is by continuing to provide quality care, to expand into new regions, and by adding cardiovascular service lines. You have to build partnerships and demonstrate their value, and you can only do that with image management technology that drives workflow and connectivity well beyond the physical walls of the hospital,” said Thomas W. Raraigh, BS, RT (R) (CT), Director, Cardiology & Imaging Services.
In 1998, in search of an image archive for Cath lab and echo studies, BHS found a cardiovascular information systems (CVIS) provider that approaches partnerships in much the same way. Starting with an archive for Cath lab images in the early years of digital archiving communication systems, the BHS and ScImage partnership quickly expanded to consolidate multiple cardiology data silos within a single database with a single log-in, including Echo, Peripheral Vascular, ECG and Nuclear Medicine.
“The major Cardiology PACS upgrade we completed with ScImage in 2013 has been pivotal in our success over the past three years. For the first time, ScImage gave us the ability to launch cardiac PACS within our EMR, providing full diagnostic viewing and reporting capability for seamless workflow during patient imaging communication. This has resulted in faster clinical decisions and improved our workflow, reducing the length of stay for inpatients by enabling cardiac diagnostic testing interpretations 24/7,” said John R. Falen, PACS Administrator.
ScImage upgrades have also featured structured reporting, providing BHS a fully order-driven imaging solution for all cardiology services and capabilities.“ Previously, cardiology reports were not uniform and turn-around ranged from 24 to 72 hours. Referring physician satisfaction scores have significantly improved now that reports are consistent across all interpreting physicians. Importantly, the structured reporting and seamless access to a unified SQL database offers clinical and operational analytics that play a key role in meeting the stringent requirements of the ICAVL and ICANL accreditation bodies,” added Falen.
In addition to serving its own patients, Butler Hospital supports several small, rural facilities that perform echo exams and contract with Butler to interpret the studies. Previously, this required cardiologists to physically drive to the other facilities to read the exams. Additionally, STAT studies would often have to be deferred to another cardiologist group if the assigned physician was completing office visits off site.
“Our group is extended well beyond the front doors of the hospital, in some cases, 30 miles. The ScImage platform has provided us ability to provide services in these remote locations and still provide quality and timely reporting for studies performed at any one of our outpatient or in-patient facilities,” said the cardiology group administrator.
Secure Cloud-based image sharing capabilities and interoperability built into the ScImage platform enable BHS to upload and interpret diagnostic cardiovascular studies on patients performed at other facilities. Cardiologists have the ability to launch the PACs from anywhere and complete interpretations at anytime, including STAT studies. This allows BHS to provide services to remote sites without the expense and difficulty of setting up multiple cardiology PACS systems at each location.
“With the ScImage system, I can read from anywhere, in my office or at home, making it very efficient, timely and paperless,” said Dr. Prem Kumar, BHS Cardiologist.
According to Dr. Phillip Painley, BHS Cardiologist. “It’s serviceable and cost effective, I utilize the mobile platform frequently while on call and the report tools make delivery of studies more efficient.” “By providing the diagnostic cardiology services at these smaller rural facilities, we help ensure that all patients have access to timely, high quality cardiac care,” added Raraigh. “In turn, we continue to strengthen our relationships and receive referrals for high end cardiology services at our main campus. This investment has helped build our surgical and cath business and resulted in a strong downstream revenue for high end cardiovascular procedures.”
Raraigh attributes some of the success of Butler Health System Cardiovascular Services over the past several years to its partnership with ScImage. “We have been able to improve workflow and efficiency, not just for our cardiologists, but for our entire staff and for our patients. With the ability to get diagnostic testing done faster and generate reports more efficiently, we can treat and discharge patients faster and more cost-effectively. Based on ScImage’s ability to help us reduce report turnaround times, increase access and reduce costs for our cardiovascular services, Butler is now reviewing ScImage’s Enterprise Imaging solution to integrate radiology and other imaging services.”
“As we have grown, ScImage has grown with us. For more than 17 years, they have been more than a vendor, they have been our partner – small enough to be responsive yet big enough to get it done,” concluded Raraigh.Download PDF
Enterprise-Wide Solution Integrates Cardiac and Radiographic Studies, Enabling Facility to Practice Collaborative Medicine
Founded in 1937, the 222-bed Alton Memorial Hospital located in Alton, IL, served more than 90,000 patients in 2003. The local leader in cardiology services and a member of BJC HealthCare based in St. Louis, Alton Memorial Hospital opened the region’s first diagnostic cardiac catheterization lab in 1988 and the first balloon angioplasty program in 2000. The hospital provides numerous other heart care services, including enhanced external counterpulsation and a complete cardiac rehabilitation program that features state-of- the-art exercise and monitoring equipment.
Alton Memorial Hospital performs approximately 900 diagnostic cardiac cath cases per year and also performs more than 70,000 radiology exams annually. Recently, Alton Memorial Hospital announced an enterprise-wide digital imaging initiative. The hospital intends to implement the project in multiple phases, with the initial phase beginning with cath, echo and EKG capture, information analysis, integrated reporting and system management for the Cardiac Services Group.
Assisting Alton with their digital initiative is Los Altos-based ScImage. The enterprise PACS provider will serve both radiology and cardiology to provide a single point of access for patient studies and information generated in both the cardiology and radiology departments. Once all phases of the project are completed, ScImage’s enterprise-wide PACS, PICOMEnterprise, will give caregivers at Alton Memorial — and eventually at other institutions in BJC — an overall centralized integrated solution with the means for accessing data collected in multiple departments. As part of the digital initiative, ScImage will also integrate the capture of reports from legacy reporting systems and use PICOMEnterprise’s Web-enabled Electronic Patient Folder to store those reports alongside patient images to provide a more complete record of patient exams for both attending and referring physicians. Once in place, physicians will be able to access all available patient images and the associated information from a single login.
About the Hospital:
Founded in 1936, Alton Memorial Hospital is a JCAHO-accredited, full-service hospital serving the River Bend area of southwestern Illinois. Recognized for its heart services, orthopedic surgery, oncology services, women’s health services, outpatient surgery and testing, gastroenterology, pain management, pulmonary medicine, rehabilitation and sports medicine, the hospital also provides numerous health education and wellness programs to the people of Alton, IL and the surrounding communities.In addition to boasting the area’s only balloon angioplasty program, Alton Memorial Hospital offers open MRI through Twin Rivers MRI Center,CT services, PET imaging, nuclear medicine and cardiac and pulmonary rehabilitation. The hospital operates a 24-hour emergency center and the area’s only hospital-based ambulance service. 225 medical staff members and 596 FTEs provide these services.
Phase two will connect all of the DICOM compatible modalities in the Radiology Services Group so that digital images can be captured, stored and distributed throughout the enterprise. Integration with the hospital’s radiology information system (RIS) was critical to Alton’s digital imaging initiative. In addition to storage for the hospital’s images, ScImage will also provide a means for managing workflow and patient scheduling via an HL7 interface to the hospital’s Siemens Novius RIS. The integration will provide the hospital a way to reduce data entry errors by utilizing patient demographics that were entered at the time of admission. This second phase of the project will begin in the fall of 2004 and will also include conflict resolution and DICOM modality worklist functionality.
Phase three will bring the remainder of the modalities in the Radiology Services Group up to the DICOM standard and also add computed radiography modalities to enable standard films to be read digitally. During this phase, the hospital will also add high-powered radiology review stations for use by the reading radiologists. Once phase three is complete, the hospital’s vision includes connecting the system to BJC HealthCare’s multiple campuses for image and information access.
“We took a lot of time to evaluate different vendors including extensive site visits to narrow the search that brought us to choose ScImage,” stated Al Hibbett, manager of Cardiopulmonary Services. “In the end, it was an easy decision because they were able to meet our requirements of cost effectiveness, use of non-proprietary hardware and satisfy multiple service lines all under just one roof.”
In addition to the web-enabled Electronic Patient Folder, PICOMEnterprise also employs ScImage’s ForeverOnline architecture. ForeverOnline is a low-cost, high- availability solution that employs intelligent image routing to serve high-volume, centralized reading environments. This configuration of PICOMEnterprise combines a powerful multi-processor server with a highly scale-able storage solution that eliminates the wait for image and information retrieval by keeping everything online. Alton Memorial Hospital will also coordinate its digital initiative using ScImage PicomOnline Web-based disaster recovery hot site for both secondary secure storage and backup application delivery for teleradiology and remote access.
“We selected ScImage because this project will be critical to the ongoing success of the hospital and we knew that they could meet our aggressive requirements for integration,” stated Jack Wepler, manager of Medical Imaging Services at Alton Memorial Hospital.
PICOMEnterprise will allow multiple departments to store and distribute patient information both inside and outside the hospital. This will allow attending and referring physicians at Alton Memorial Hospital to practice collaborative medicine, which will ultimately lead to better patient care.
Data Migration Key to Leading Heart Hospital’s Image and Information Management System Selection
Missouri Baptist Medical Center, a 489-bed hospital in St. Louis, Missouri and a member of BJC HealthCare, has been providing world-class services to its patients since its founding in 1884.
Long recognized as a leader in cardiac services, Missouri Baptist Medical Center received the inaugural American Hospital Quest for Quality Prize in 2002 from the American Hospital Association for its leadership and innovation in patient care quality, safety and commitment. This commitment to excellence is prevalent throughout the entire organization.
Recently, Missouri Baptist began a large construction project to expand and upgrade its heart hospital within the existing medical center structure. The plan includes 40,000 square feet of new construction/renovation, including the following:
- two additional cath lab rooms;
- a 14-bed cath lab prep and hold unit;
- a second EP lab;
- a 10-bed post-surgical cardiovascular recovery unit;
- a 6,000-square-foot cardiovascular diagnostics suite;
- an endovascular OR suite;
- and new office space within the center for the hospital’s four cardiothoracic surgeons — Nicholas Kouchoukos,MD; Peter Murphy, MD; Michael Murphy, MD; and Michael Mauney, MD.
As part of the project, the hospital has upgraded its existing AngioCOMM image and information management and distribution solution. The system,designed by ScImage of Los Altos, Calif., has served the hospital well since it was first installed in 1998. However, the demands of modern medicine and significant advances in technology led the hospital to modernize the system using ScImage’s latest image and information archive and distribution solution, PICOMEnterprise.
PICOMEnterprise gives Missouri Baptist Cardiac & Vascular Center the ability to review, distribute and archive patient studies, including reports and procedure data along with patient demographic information using ScImage’s web-enabled Electronic Patient Folder (EPF). The EPF allows authorized users to securely access patient data stored in uniquely identified individual electronic patient folders on the PICOMEnterprise server, which is the backbone of the PICOM Solution.
Data migration was a key concern and one of the reasons why the Missouri Baptist Cardiac & Vascular Center elected to upgrade to PICOMEnterprise. Because they provided a seamless upgrade path for previously archived studies,
the decision to choose ScImage again was an easy one. More than 18,000 exams currently stored on magneto optical disk will be migrated and converted, storing them on a large storage device using ForeverOnline.
ForeverOnline is a low-cost, high-availability solution that employs intelligent image routing to serve high-volume, centralized reading environments. This configuration of PICOMEnterprise combines a powerful multi-processor server with a highly scalable storage solution. It eliminates the wait for image retrieval by keeping everything online,thereby increasing productivity in heavy workload environments and eliminating the need for a mechanical jukebox. PICOMEnterprise will house the hospital’s archived and future studies and make the data available to physicians both inside and outside the facility using the latest security protocols.
Once the upgrade is complete, cardiologists and referring physicians will have immediate access to a variety of data, images and reports generated by the Missouri Baptist Cardiac & Vascular Center. This includes hemodynamic information from the physiological monitoring systems as well as echocardiogram images/reports and cardiac stress test reports. This data will be linked to the patient medical record number and made available to authorized attending and referring physicians from the lab, their private offices or even their homes.
“We are excited to see the first steps of our heart hospital upgrade,” said Douglas Sohn, director of the Missouri Baptist Cardiac & Vascular Center. “The new facilities are designed with the needs of the patient and efficiencies for our physicians as the top priorities. The jukebox storage system we have used for years is overflowing and cannot keep up with current demand, including the need for immediate access to study information. Eliminating the mechanical storage device is going to reduce wait times for both physicians and patients.
“In addition, migrating our data to ScImage’s ForeverOnline storage architecture will also support our disaster recovery plan,” Sohn continued. “We will no longer be responsible for hundreds of MODs. Instead, we will have a single archive, which will make backup for disaster recovery and business continuity a much more straightforward process.”
Simultaneous to the data migration, a new echocardiography reporting solution will be put in place. The goal is to reduce the turnaround time from the completion of a study to availability of the final report. This translates into higher throughput for the department and shorter wait times for study results — two very important factors for this award-winning facility.
Overall, upgrading to PICOMEnterprise is giving physicians at Missouri Baptist Medical Center the tools they need to practice collaborative medicine and the hospital a means for eliminating its reliance on outdated technology. The result is improved efficiency, a more patient-centered environment and a heart hospital within a hospital that positions the Missouri Baptist Cardiac & Vascular Center for the future.