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.