Collaborative Medicine Wins Through Multi-Department Use of Enterprise PACS
Situated near the shores of Lake of the Ozarks in Osage Beach, Missouri, Lake of the Ozarks General Hospital (as it was known in 1978 when it first opened its doors) has grown over the past 25 years to become a state-of-the-art medical facility. Known now as Lake Regional Health System, the facility supports a full range of medical and surgical services, including complete cardiovascular care. Additionally, because of the increased summer population, Lake Regional also has one of the state’s busiest emergency departments. In keeping with the tradition of the community-minded visionaries who founded the hospital, Lake Regional continues to innovate and adopt new technologies. Today, Lake Regional is one of only a handful of medical centers in the country that is collecting,storing and distributing data from multiple departments (primarily cardiology and radiology) in electronic format.
Early this year, Lake Regional purchased ScImage’s PICOM Solution. The product gives the cardiac and radiology services at Lake Regional the ability to review, distribute and archive patient studies, including reports and procedure data along with patient demographic data using ScImage’s Web- enabled Electronic Patient Folder (EPF). The EPF allows authorized users to securely access patient data stored in uniquely identified individual EPFs on the PICOMEnterprise server.
Overall, the PICOM Solution has given physicians at Lake Regional the tools they need to practice collaborative medicine and the hospital a means for reducing capital expenditures, improving workflow efficiency and providing the flexibility to integrate data from imaging studies with data from patient procedures from multiple departments in the hospital.
Cardiologists and referring physicians can now access a variety of data generated in the cardiac services department and stored on ScImage’s PICOMEnterprise server from the lab, their office and even from home. This includes cardiac stress tests and hemodynamic information from the cath lab’s hemodynamic monitoring system,as well as reporting for the cardiac cath and echo labs. Soon, the physicians will be able to view EKG waveforms and reporting from vascular procedures. All of this data is or will be linked to the patient’s medical record number and made available to authorized attending and referring physicians.
Cath lab manager Connie Rugen sees the benefits everyday. “Our cardiology department is logically integrated to enhance workflow for surgeons and cathing physicians. They have been anticipating an easy way to access patient information from any location, and are pleased with ScImage’s solution. Physicians can now review imaging and non-imaging studies alongside hemo data and stress results. Efficiency will improve further when viewing EKG reports and vascular reporting become available.”
The PICOM Solution is also fully integrated into the radiology department. Images pertaining to all digital radiology modalities are being captured and stored in the EPFs of the PICOMEnterprise server and made available enterprise-wide. Robust 2-D and 3-D viewing tools allow physicians to read cases at the hospital and by using PICOMEnterprise’s built-in telemedicine functionality,they are also accessing studies remotely. “Being able to roll out of bed and quickly review an ED case gives me the opportunity to determine whether I need to get to [the] hospital immediately or if I can get [a] few more hours of sleep,” stated one of Lake Regional’s on-call radiologists. To supplement on-call reading, PICOMEnterprise’s intelligent scheduled routing services are automatically routing images to a remote teleradiology group for nighttime reading.
Integration was a key element in the decision to adopt the PICOM Solution. In addition to serving the needs of the imaging intensive departments, ScImage also provided a means for managing workflow and patient scheduling via an HL7 interface to the hospital’s Meditech patient registration and order messaging system. The integration gives the hospital a way to reduce data entry errors by capturing patient demographics that have previously been entered. In addition, procedure ordering and patient information are pushed to ScImage’s scheduling product PICOMScheduler. The scheduling software gives both departments a means for tracking patient procedures and also sends “order completed” messages back to the Meditech system. Integrating with the existing solution gives the hospital the opportunity to reduce capital expenditure costs and increase workflow efficiency at the same time.
“ScImage seamlessly interfaced their PICOMEnterprise solution to our different point-of-care clinical systems and imaging modalities including CT, ultrasound, MRI, nuclear medicine, cardiac cath and echo,” according to Steve Grotewiel, Director of Medical Imaging. “Now, physicians at Lake Regional have near real- time remote access to procedural images, reports and other clinical information. Getting clinical information into the hands of every caregiver at Lake Regional Health System is a top priority for the facility and for me personally.The result is that physicians have the right tools to make the best decisions when treating patients. We evaluated many systems but went with ScImage because they were able to provide us with a cost effective, integrated solution.”
About Lake Regional Health System:
Lake Regional Health System supports medical and surgical services in orthopedics, complete cardiovascular care reconstructive surgery, obstetrics and gynecology, outpatient services, community health education and prevention. Credentialed by the Joint Commission on Accreditation of Healthcare Organizations, Lake Regional offers high-tech medical diagnostics and treatment, coupled with high-touch patient care. Nearly 1,000 employees support the medical expertise of 70-plus full-time medical staff. With a 100,000 square foot expansion in 1999 — larger than the facility’s original structure — the 140-bed facility now includes a 12-bed observation unit, an 18-bed intensive care unit, rehab therapies, cardiac rehabilitation, an additional cardiac catheterization lab, an oncology suite, physician offices, an expanded outpatient surgery area and a chapel. Lake Regional also features a network of clinics, pharmacies and rehabilitation services located throughout the region. The organization’s vision is to transition from a primary/secondary hospital into a regional, tertiary care medical center and related clinical services.
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.