Flexible cloud-based PACS platform for fast and accurate reporting.
Synergy Radiology Associates is Houston’s premier radiology team, comprised of more than 75 Board Certified Radiologists and one of the fastest growing radiology groups in the county. We sat down with J. Armando Saenz, M.D. to discuss how the flexibility of PICOM365.com, ScImage’s cloud-based PACS has supported Synergy’s vision for growth and patient care.
Why did you select ScImage’s PICOM365 cloud-based PACS?
With more than 75 radiologists, Synergy provides radiology reading capabilities for more than 100 sites. We serve different facilities with varying needs, some have no PACS of their own, others have systems already in place but they need a quality radiology group to be plugged into their workflow. The robust capabilities of the PICOM365.com architecture give us the flexibility to have arrangements that meet the technology and workflow needs for clients of varying sizes.
Most of our clients are cloud-based, but one of our major clients requires a physical server at each facility. Ultimately, our vision is to have workflow in which radiologists can use a single platform with one window, or at least one monitor – a way to easily look at the worklist and manage the list without necessitating too many monitors or steps, and allows control in terms of how and where the studies are routed.
How does the flexibility of ScImage’s cloud-based PACS help you serve your clients’ needs?
ScImage worked with us to create a master worklist that tied our workflow with other clients and facilities. This included revamping the radiology reading dashboard to create a second worklist for the on-premise exams, giving radiologists two windows on the same screen to watch the different server environments. On our end, our radiologists log into one worklist and are able to see everything they need. We have tags that allow us to know where the studies are coming from but they all show up on one work list, and one system. It has been working well.
The flexibility to use both cloud and physical servers is further enhanced by custom filters to manage which studies go to which rads. As a result, when a radiologist logs in, they only see the studies they need to read, giving us the ability to handle various facilities with different credentialing makeups.
How does ScImage’s PicomSentry Help Support Growth?
Overall, ScImage has supported our growth because it is a very robust system, it is easy to implement, and helps us keep up with, and accommodate client demands. Because we serve so many different facilities with varying system needs, a quick and easy implementation is critical to get plugged into their workflow.
As we bring on new sites, we’ve started deploying ScImage’s PicomSentry, a preconfigured security appliance that enables users to utilize ScImage’s PICOM365 Enterprise PACS with plug and play convenience. Whether a facility has an existing solution or no imaging system place, PicomSentry provides immediate back-end interoperability and they’re up and running with a robust system. It provides our customer with options to leverage the PACS they have already invested or start a sophisticated image management solution. It’s quick and easy, and we can get a site up and running in weeks, not months – it’s one of the fastest implementations in the industry.
Why is the speed of report turn-around time important?
In addition to patient experience, speed and accuracy are critical to the delivery of high quality medicine in the ER setting. Accuracy is a given, we have a process to maintain accuracy and our error rate is well below the national standard. So, why does speed matter? It matters because when the report takes longer, the clinician is waiting – and even, more importantly, the patient is waiting.
We’re very proud that Synergy is able to consistently deliver some of the fastest report turn-around times in the country. That is one of the most important reasons we’ve implemented PICOM365 by ScImage. We did not want exams being sent from server to server or from server to cloud which is going to add time, and therefore, impact the final turn-around time. Speed, accuracy and quality are not only the keys to good patient care, but they are critical to our ongoing success and growth.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.
Single Database Solution Unifies Group’s Approach to Reading In Rural Oklahoma
Founded in 1969, Diagnostic Imaging Associates (DIA) initially provided Oklahoma’s rural hospitals and clinics with “circuit-riding” radiologists that would read cases once per week for a few hours before moving on to the next facility on their list. While these circuit riders provided a valuable service to the rural communities, as technology advanced, it became clear that there was more that could be done for these communities. Today, DIA has grown from a two-man operation into a radiology physician group with more than a dozen radiologists that specialize in MRI, CT, X-ray and all interventional radiology procedures. The group relies heavily on a robust telecommunication network that is run by the state of Oklahoma to provide radiological testing for patients and diagnostic image interpretation. DIA’s focus is on treating patients with the least invasive means at the highest success rate. Among their customers are Tulsa Regional Medical Center and its affiliates, Cancer Treatment Centers of America and several small community hospitals throughout the state. DIA also provides fellowship opportunities in interventional radiology and a residency program for radiologists in training.
The Oklahoma Telemedicine Network and OneNet
Circuit riders supplied by DIA and other subspecialty groups served a valuable purpose to the residents of rural Oklahoma. In an effort to provide better service using the technology available, the Oklahoma State Legislature signed a bill in the early 1990s to create the Telemedicine Advisory Council. This council set about leveraging advancements in Internet technologies which led to the creation and initial development of the Oklahoma Telemedicine Network (OTN) in 1993. OTN placed new high-bandwidth connections or used existing high-bandwidth connections between 45 hospitals throughout rural Oklahoma to better serve these communities. The communications lines were used for telemedicine, video conferencing and other types of point- to-point communication between hospitals, physicians and their patients. Toward the end of the 1990s, OTN was turned over to OneNet, which is run by the Oklahoma State Regents for Higher Education and is operated in coopera- tion with the Oklahoma Office of State Finance.
A native of rural Oklahoma himself, DIA’s president and a long-time proponent of telemedicine, Dean Fullingim, D.O., understood that the state’s rural population required access to radiology services. However, because fewer and fewer physicians were being trained as radiologists, access to those services was limited. Dr. Fullingim saw potential in the network being run by the state and set about making use of this valuable resource. Working at Oklahoma State University at the time, he devised a way to put the medical school’s telecommunications infrastructure to work in order to provide teleradiology services to rural Oklahoma. Leveraging OneNet’s infrastructure Dr. Fullingim made it possible for patients in rural communities to receive diagnosis and treatment without traveling long distances or waiting for a circuit-riding radiologist’s weekly visit.
“I no longer have to maintain three solutions and the data being stored is seamlessly delivered to our physicians..”
Allen Noland – DIA Director of Systems Technology
DIA has grown considerably since inception. Today DIA comprises a dozen radiologists reading for 41 facilities from eight central locations around the state. This growth and the advancement of technology by way of advanced visualization applications for CT and MR has meant using solutions from multiple vendors to get the work done. Dr. Fullingim and DIA’s director, systems technology, Allen Noland, knew it could be done more efficiently.
From Multiple Vendors to One Solution
In late 2004, DIA set out to consolidate their efforts. The group practice was using systems from three different vendors to provide interpretive radiology services to their customers. DIA’s homespun radiology information system, DIA RIS, tied the three solutions together so any solution they selected needed to be standards base d and must interface to the RIS seamlessly. This is because DIA RIS currently handles patient scheduling, film requisitions and reporting for the group’s busy reading environments. In an effort to end the frustration associated with using several solutions to complete their work, Dr. Fullingim and Noland needed a single solution to provide cross-sectional imaging tools, efficient telemedicine and standard radiology imaging — all features that their current three vendors provided.
After considerable research and evaluation of several solutions at the annual Radiological Society of North America (RSNA) exhibition in Chicago, DIA launched a pilot project to evaluate ScImage’s Enterprise PACS, PicomEnterprise. What attracted the two telemedicine veterans to the PicomEnterprise solution was its Web-based design, combined functionality for key components of their workflow and consistent user experience. The solution was also cost competitive. Shortly after the evaluation began, a decision was made to move the entire group off the existing combined product approach and onto ScImage’s PicomEnterprise solution. The impetus for the decision was that DIA could begin reading all exams from their 40-plus institutions using a unified platform.
According to Noland, “Because of ScImage’s single database approach, the solution is easy to manage and administer. I no longer have to maintain three solutions and the data being stored on our PicomEnterprise server is seamlessly delivered to our physicians through our DIA RIS front-end. In addition, the built-in visualization tools for MPR and Oblique Slicing make image interpretation and manipulation much easier because our radiologists don’t have to move to a separate workstation.”
In fact, DIA currently reads an average of 900 radiology exams per day from outlying facilities that are interconnected via the OneNet network. Using the Web-based PicomEnterprise solution, a dozen reading radiologists provide primary interpretations for CR, CT, MR and ultrasound from eight facilities around the state. By eliminating the circuit-riding radiologists, physicians can now stay in one place and provide more efficient service to more patients, more rapidly.
“DIA has been providing world class teleradiology services to the residents of rural Oklahoma for the last 17 years,” stated Dr. Fullingim. “We have worked with multiple vendors during this time. We interpret more than 200,000 exams annually that come from 41 facilities around the state. ScImage helped us unify our approach to reading and now we all use the same system, the same tools and the same interface. We couldn’t do that without ScImage.”