There are many variables involved in improving patient care and outcomes. However, the process starts with information. Clinicians need to have as much accurate patient data at their fingertips as possible to make the best diagnoses, prescribe the best treatment plans, and initiate effective care coordination. Unfortunately, gaining a holistic view of a patient’s medical history is not easy. Healthcare is a highly segmented industry, and care is delivered by many providers in several different locations. Even in today’s evolving digital healthcare landscape, too much patient data is trapped in silos and often overlooked by caregivers.
By implementing an enterprise-wide medical imaging platform that integrates with its EHR, Georgia Regents Medical Center now has a more holistic view of patient health across the care continuum.
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There are many variables involved in improving patient care and outcomes. However, the process starts with information. Clinicians need to have as much accurate patient data at their fingertips as possible to make the best diagnoses, prescribe the best treatment plans, and initiate effective care coordination. Unfortunately, gaining a holistic view of a patient’s medical history is not easy. Healthcare is a highly segmented industry, and care is delivered by many providers in several different locations. Even in today’s evolving digital healthcare landscape, too much patient data is trapped in silos and often overlooked by caregivers.
Diagnostic images, for example, are a crucial component of a patient’s medical history that are often stored in a location other than the health record itself. Clinicians often have to go to great lengths to track down older images to review as part of a patient’s medical assessment. This disjointed process can have a detrimental impact on clinical workflow and patient care.
Luckily, technology solutions are emerging that are truly starting to break down these silos. A prime example is the enterprise-wide clinical imaging platform recently deployed at Georgia Regents Medical Center (GRMC).
Building A Universal Imaging Database
Like most healthcare providers, the medical imaging landscape at GRMC was very departmentalized prior to adopting its new clinical imaging platform. For example, GRMC had standalone radiology, cardiology, and OB ultrasound PACS systems. None of these solutions interfaced with the others, nor did they integrate with GRMC’s Cerner EHR or the hospital’s dictation system.
“In the past, if I were reading a cardiac MRI and wanted to compare that image to an echocardiogram (which was the reason the cardiac MRI was ordered in the first place), I would have to walk up six flights of stairs to a separate viewing station to look at those images,” says Dr. James Rawson, Chief of Radiologic Services at GRMC. “Needless to say, this process was inconvenient and time consuming and interrupted my clinical workflow.”
In early 2013, GRMC embarked on an initiative to implement a single, enterprisewide imaging database that would interface with its EHR. The hope was that this universal database would not only allow imaging results to be uploaded in a more timely manner, but also that it would also allow radiologists to access this information quickly for their interpretations. Finally, GRMC didn’t want the imaging database to benefit just radiologists and cardiologists — the health system wanted medical images and data on its patients to be accessible to all the clinicians providing care to these individuals.
GRMC quickly realized it wouldn’t be able to accomplish this objective by simply building interfaces between its existing imaging systems. “We had three separate imaging databases and each had evolved independent of the other,” says Dr. Rawson. “Integrating these disparate systems and our EHR would have required several complex DICOM [Digital Imaging and Communications in Medicine] outputs and HL7 [Health Level Seven International] feeds. This simply wasn’t practical.”
As a result, GRMC began to investigate new vendor-built solutions in this category. The provider ultimately selected Philips IntelliSpace PACS version 4.4 because of the product’s ability to integrate with existing systems at GRMC as well as its image post-processing capabilities.
Philips IntelliSpace PACS consolidates and stores clinical images from multiple departments (e.g., radiology, cardiology, endoscopy, etc.) across several systems and modalities (e.g., x-rays, PET, CT, MRI, ultrasound, etc.). The solution also integrates with GRMC’s Cerner EHR to provide clinicians throughout the health system with advanced viewing capabilities for any of these medical images directly from the patient record in the EHR interface.
Treating PACS As A Workflow
The pilot installation at GRMC started with radiology in January 2014 and expanded to cardiology in March. Other departments, such as obstetrics, will be added in the coming months. Eighteen months of historic radiology and cardiology images and data were migrated over to the new IntelliSpace PACS solution prior to go-live. If patient images prior to this timeframe are needed for clinical care, they are migrated over to the new system manually.
From the outset, GRMC viewed this initiative not as a simple technology installation but as an exercise in process reengineering. “To many folks, PACS is viewing software, and to others it is a piece of hardware that archives medical images,” says Dr. Rawson. “To us, PACS is a workflow. Moreover, it is a workflow that doesn’t just impact radiologists and cardiologists, but referring physicians and other clinicians in our care continuum as well.”
With this in mind, GRMC trained more than a dozen staff members on lean principles and process redesign. “We didn’t simply want to automate our existing processes,” says Dr. Rawson. “We wanted to tear apart the workflow and figure out better ways to do everything — all with the focus on improving patient care.”
As a result of this exercise, the enterprise imaging initiative turned out to be more involved than GRMC initially bargained for. For example, the provider didn’t just implement the IntelliSpace PACS system. To realize the best outcomes from this new investment, GRMC also realized it needed to replace every piece of viewing hardware and software in the reading room. Moreover, the provider invested in new ergonomically designed furniture for comfort and optimal clinical workflow. The result is a standard viewing environment throughout the enterprise that can be customized based on specific preferences of individual clinicians.
Streamlined Image Access Improves Patient Care
Prior to implementing its new clinical imaging platform, radiologists had to go to several different viewing stations in multiple locations at GRMC to interpret medical images of ![]()
various modalities. Now they can access all images from a single station that is interfaced with the EHR. Dr. Rawson describes his new workflow since implementing the IntelliSpace PACS system.
“There are three monitors located at every viewing station,” he says. “When I log on using my authentication credentials, my customized layout preferences appear on these monitors. I start with the monitor on my left that displays my work list and prior studies. The images I need to interpret appear on the monitor in the middle. Finally, clinical information, contacts for referring physicians, and our voice recognition software (for dictation) appears on the monitor on the right.”
According to Dr. Rawson, he is now able to provide a more complete report because he has easier access to all images, the medical record, and other relevant pieces of information about each patient. Plus, his work is not bound by geography because he can essentially access and interpret information using any workstation on campus or remotely via a home computer, laptop, or tablet device.
Similar workflow benefits are experienced by other physicians in the GRMC network as well. Referring physicians now have immediate access to imaging studies via the new image-enabled EHR. They no longer have to track down this data from other providers in the health system.
“The best metric to illustrate the success of this initiative is having physicians throughout our health system stop to thank me for making it easier for them to take care of their patients because of our new enterprise-wide imaging solution.”
There are many variables involved in improving patient care and outcomes. However, the process starts with information. Clinicians need to have as much accurate patient data at their fingertips as possible to make the best diagnoses, prescribe the best treatment plans, and initiate effective care coordination. Unfortunately, gaining a holistic view of a patient’s medical history is not easy. Healthcare is a highly segmented industry, and care is delivered by many providers in several different locations. Even in today’s evolving digital healthcare landscape, too much patient data is trapped in silos and often overlooked by caregivers.
various modalities. Now they can access all images from a single station that is interfaced with the EHR. Dr. Rawson describes his new workflow since implementing the IntelliSpace PACS system.
