Has your facility undertaken a Hospital Information System (HIS)/Radiology Information System (RIS) conversion project in the past? If so, you understand the complexities of this type of project and the interdependencies that exist between the HIS/RIS and the other downstream radiology systems. So what is the best course of action to ensure a successful project? Many facilities set themselves up for success by starting the planning and testing process early. This article will help guide you through the HIS/RIS conversion project as it specifically relates to the downstream enterprise medical imaging system. This will help you plan for the required changes and allow you to focus on the new HIS/RIS, not the other downstream systems.
1. Understand How the Change Will Impact Radiology Data Flow and Workflow Documents
Once the decision to replace an existing HIS and/or RIS has been made, it is important to understand how the change will impact the radiology data flow and how the data elements will change. The logical starting point is to review your existing data flow and workflow documents. You’ll need to fully understand the current workflow and how the data flows in the radiology environment before you can start planning for the changes. At a minimum this should include the HIS/RIS, any upstream system(s), EMR system(s), PACS, dictation system, and other radiology information systems. If the workflow and data flow documents are out of date, or do not exist, it is imperative to update or create them. Not only will this help you plan for the upcoming changes, they will also provide you with the current state snapshot that will need to be documented as a part of your change management procedures.
2. Document Intended New Workflow and Data Flow
Now that you have the updated workflow and data flow documents, you should have a clear picture of the end users’ workflow and how this impacts the data flow within each system and between the systems. Talk with the new HIS/RIS vendor and have them explain how their system will impact your current workflow and data flow. Will any of the data elements currently in use need to be retired or updated in the other radiology information systems? Some examples of these data elements are MRN schemes, EMPI data, procedure tables, facility codes, physician identifiers, room identifiers, patient demographic identifiers, etc. It is important to understand if these changes will impact the other radiology systems that directly or indirectly connect to the HIS/RIS. Once you understand how the new HIS/RIS will change the workflow, data flow, and data elements, you should document the intended new workflow and data flow.
3. Engage Radiology Vendors to Address System Impacts
Once the expected future state has been documented, you should engage each of the other radiology vendors to let them know how the HIS/RIS change will impact their system. Vendors may need to update the HL7 inbound interface, HL7 outbound interface, backend configurations, or even database tables. The amount of work required in each of the radiology information systems will vary, depending on the level of change being implemented. In most cases these changes will be billable events as they fall outside of normal support. It is important to plan for these charges early in order to prevent any last minute project costs that were unplanned. Work with each of the vendors to plan for, test, and validate the changes well in advance of the actual go-live. This will allow for as smooth of a transition as possible from the legacy HIS/RIS to the new HIS/RIS.
4. Review and Update Expected Future State Workflow and Data Flow Documents
After the implementation, review and update your expected future state workflow and data flow documents. The updated document will now become your current state workflow and data flow manuscript. The new current state workflow and data flow documents should be made available to the end users, support staff, and also filed with your change management documentation.
With careful execution and budget planning, thorough testing, and proper documentation, the HIS/RIS conversion process can be executed with minimal disruption and downtime.