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
Seamless Workflow and True Interoperability
For over 150 years, Children’s Hospital of Philadelphia (CHOP) has been devoted exclusively to caring for infants, children, teens and young adults. As the nation’s first children’s hospital, CHOP has a history of innovation and excellence. The 535-bed facility in Philadelphia is home to world-renowned programs for cancer, cardiac care, orthopedics, fetal surgery and many others. CHOP treats more than 1.2 million children a year through hospital admission and outpatient visits. More than 2,000 physicians in the CHOP Care Network serve patients at more than 50 locations in Pennsylvania and New Jersey.
Through the years, Children’s Hospital of Philadelphia has been the national leader in pediatric care, and as such has experienced many dramatic firsts in the field. The Hospital has fostered medical discoveries and innovations that have improved pediatric healthcare and saved countless children’s lives.
- CHOP wanted to make high quality pediatric radiology services available to all children, regardless of their location and the size/capability/staffing of their local hospital/medical institution
- The hospital wanted to offer the full CHOP experience to all children, including access to top pediatric radiology specialists to interpret studies and radiology exam protocols to reduce radiology dose to patients
- CHOP needed to move patient data between CHOP and partner institutions seamlessly
- CHOP needed to expand capabilities to reverse the internal downward trend in radiology revenue
To address the problems, CHOP was faced with managing complex interoperability issues. The hospital needed to provide diagnostic imaging that was available across disparate health systems for physician interpretation and reporting. The platform had to be automated, capable of managing differing MPIs, and proven to integrate at both the HIE and departmental system levels.
CHOP sought a company that had the experience and expertise in virtual radiology to handle large networks of images that could be moved to pediatric radiologists, sent back to the originating institution, and stored in its EMR/radiology system. This needed to be accomplished independent of the RIS, PAC and EMR without changing workflow at either institution. The company had to be able to insure record security and understand the needs of the customer (CHOP) as well as the customer’s customers (partner institutions).
ScImage provided the expertise, experience and interoperability required. The ScImage platform allows for configuration of complex business rules and provides automated, secure and bi-directional movement of relevant prior studies, current images and reports between CHOP and the referring medical center. Images and final reports are stored in the information systems of both hospital systems without disruption of workflow at either institution. The end result is increased quality of care, productivity and physician confidence in the reporting due to new access of comprehensive information.
ScImage also has extensive experience with partner-driven relationships and understands the needs and concerns of both.ucture we can focus on improving our workflow instead of learning new software.
- Children throughout the country have the advantage of the CHOP experience
- Reduce radiation dose to the patient
- Studies are read by top pediatric radiologists
- Physicians have full access to prior studies resulting in less test duplication
- Cost of care to patients is reduced
- Studies are passed back and forth with security and maintained at the patient’s hospital of origin
- Seamless radiology is provided, resulting in better quality of service
- Build strong relationships between institutions
- Patient care and revenue is enhanced
- The model is a microcosm for healthcare delivery of the future
PICOM365 technology by ScImage provides a platform for true interoperability between different healthcare organizations with disparate information systems. The result is a seamless workflow to radiologists for reading and reporting between different organizations. This capability allows CHOP to extend its “brand” reach regionally and nationally to promote excellence in pediatric radiology.
Complete Workflow Solutions: Multi-specialty Group Practice Adopts Comprehensive Digital Workflow
When Dr. Walter M. Whitaker brought the first EKG machine to Quincy, Illinois in 1930, little did he know what remarkable advancements in medicine were to come. Seven years later, in 1937, Dr. Whitaker, Dr. Orie F. Shulian and Dr. Kent W. Barber merged their private practices and opened the Quincy Clinic. This early clinic introduced the innovative concept of group practice to the tri-state area. The idea of group medicine has advanced greatly over the last half century but in 1937 the concept was new. In fact, at the time, less than one hundred group practices existed in the entire country, with only two or three in Illinois. The early clinic contained a complete diagnostic and therapeutic unit and was considered to be one of the most modern buildings in Quincy.qmg
In 1945, the Physicians & Surgeons Clinic opened its doors and Quincy, Illinois became one of the Midwest’s primary centers for healthcare. The Physicians & Surgeons Clinic and the Quincy Clinic merged in 1987, combining their vast resources in staff and equipment.
In the spring of 1994, a new state-of-the-art medical facility was opened at 1025 Maine Street and became known as Quincy Medical Group (QMG). April 2003 saw the grand opening of a new facility on Hampshire Street, housing various medical services and offices, with the Surgery Center of Quincy occupying the top floor. In order to provide quality primary care to their patients in rural communities, QMG also maintains affiliate offices in Canton and Lewistown, Missouri; as well as Mount Sterling, Pittsfield, Pleasant Hill, and Barry, Illinois.
A Unified Multi-Specialty Workflow Solution
After careful consideration, the committee and Ms. Williamson selected ScImage for RIS, PACS, ECG Management, Orthopedic workflow, long-term storage, archiving and telemedicine. “The decision was easy. Our experience with ScImage, who was already providing image management, long-term archive and telemedicine for our CT and MRI exams, had been positive. When we learned of their complete workflow management solution for multiple departments and that they could provide the right kinds of clinical productivity tools for our health care providers, we knew we had found our vendor,” stated Ms. Williamson.
The solution that ScImage created for QMG enables a comprehensive digital workflow. ScImage’s radiology information system, PicomRIS, will allow each of the affiliate locations to schedule imaging exams for their patients. Worklist integration with the variety of modalities used in the practice will speed the turnaround between patient registration and exam completion. The technologists performing the exams will also benefit from ScImage’s web-based conflict resolution and post-acquisition order resolution-making it easier than ever to make corrections to exam data from anywhere within the clinic. The RIS will also provide digital dictation for the reading physicians, as well as web- based transcription tools. Automated billing services will enable faster turnaround for reimbursements and the administrators will be able to track and manage the overall workflow using the sophisticated management reporting tools included with PicomRIS.
“ScImage’s complete workflow management solution for multiple departments provides the right kinds of clinical productivity tools for our health care providers.”
Robyn Williamson – Senior Director, Imaging Services, Quincy Medical Group, Quincy, IL
Today, QMG, as it is commonly known, is one of the leading multi-specialty group practices in the United States. After nearly 70 years of service to the tri-state area, the clinic provides the highest quality healthcare services available to more than 300,000 people within a 75-mile radius.
With nearly 100 physicians, physician’s assistants and nurse practitioners, this physician owned group covers 24 medical and surgical specialties. Among these specialties are cardiology, radiology, general surgery, vascular procedures, orthopedics, neurosurgery, ear, nose & throat and obstetrics/gynecology.
The Need for a Digital Workflow
Because of QMG’s dedication to quality patient care, the group has always looked to the future. The group felt that in order to continue their success, they needed a long-term plan for a complete digital workflow. Adopting an entirely digital workflow would be a multi-faceted project that would tie together several systems. This included their practice management system (PMS) and electronic medical record software (EMR). The group agreed that making the imaging exams performed at the clinic available through the EMR would enable a more efficient workflow. QMG also needed a radiology information system to manage the imaging workflow and began evaluating several vendors —some large, some small.
Based on previous experience with a digital workflow, Ms. Williamson knew QMG needed a complete solution that would address their unique and complex workflow, help attract and retain a strong referring physician base and assist QMG administrators in making sound future business decisions. She and the committee also knew that none of this mattered if the solution they selected would not allow them to stay true to the group’s mission of providing the highest quality health services by people who care.
Any solution they chose needed to make all of the patient’s information available to the physicians when and where they needed it as seamlessly as possible. This solution also needed to be responsive, flexible and customizable so there would be little or no disruption to the clinic’s busy workflow.
QMG_labOn the backend, ScImage’s multi-departmental PACS solution, PicomEnterprise, will launch exam images, data and reports within QMG’s existing electronic medical record software. This includes all of the traditional imaging modalities, as well as ECG. Physicians will be able to access information stored in PicomEnterprise’s Electronic Patient Folders (EPF). The EPF concept allows ScImage to gather all relevant clinical and non-clinical objects (images, reports, wave files, waveforms, scanned documents, etc.) under a unique patient identification number. This number will be tied to the existing EMR giving QMG providers access to the data when and where they need it.
Ms. Williamson and the IT Steering Committee also wanted to ensure that any solution they chose would address the needs of their referring physicians. They understood that the needs of these very important customers required that they be able to schedule patient exams and review exam data with patients during their follow-up visits. Since QMG had been using ScImage’s offsite disaster recovery and telemedicine solution, PicomOnline, for more than two years, it was clear that this active data center could improve information exchange with their referring physicians. “In speaking with several physicians in Quincy and our affiliate locations, we knew that these folks needed to be able to access their patient’s information from not only the office, but from home and the hospital too. We also knew that administering this kind of access could prove to be challenging and time consuming. ScImage’s solution makes that very easy for us. Having a disaster recovery solution that satisfied our business continuity goals while giving our referring doctors secure access to their data just made sense,” stated Ms. Williamson.
One of QMG’s internal medicine practitioners and the IT Steering Committee’s physician champion, Dr. Greg Andrews agrees, “ScImage’s overall workflow solution is going to assist us in growing our business and will enable a more efficient workflow for the group. We have been using the PicomEnterprise solution since 2004 with great results and look forward to adopting the elements that complement and complete our digital workflow.”
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