Improving Workflows with McKesson Radiology™ Advanced Visualization: A 3D MR Success Story


Tiron C.M. Pechet, MD

Tiron C.M. Pechet, MD

Radiologists operate in a fast-paced work environment, juggling a combination of tasks that includes interpreting studies, and calls from referring physicians. And as imaging volume rises while reim­bursements decline, individual special­ists are under more pressure than ever.

Reading 3D MR often means that ra­diologists must exit their PACS worksta­tions and use a separate program to view the 3D images; they waste precious min­utes waiting for those programs to load or navigating menus. But when 3D functionality is integrated into a radiologists’ everyday workflow, it can expedite the care process and limit many of those interruptions.

Tiron C.M. Pechet, MD, Assistant Medical Director and CMIO at Shields Health Care Group, is a long time user of McKesson Radiolo­gy’s embedded 3D functionality, called VTRIP (Variable Thickness Re­gional Intensity Projection) . “When you open the case, the prerequi­site tasks for interpretation are done automatically; everything is hung in the correct viewports with the correct angles and slice thickness and synchronized to the routine 2D portions of the examination” he says. “It takes about 12 seconds to get to reading, where using a sepa­rate 3D viewing application would eat up at least two minutes.”

The fact that the toolset to read 3D studies is embedded into the McKesson Radiology™ PACS core functionality with its display protocols and familiar toolset has allowed Shields to dramatically increase the amount of 3D studies they interpret, adding sequenc­es to nearly every exam of the brain, spine, and even about half of their pelvic exams. It’s also entered the workflow for diseases such as multiple sclerosis, offering automatic lesion tracking and assisting with preoperative planning for many musculoskeletal examinations. One of the most notable advantages VTRIP offers is that it allows radiologists to quickly compare 3D studies side-by-side, a tedious process on third-party software.

“If you have two 3D studies to compare, a third-party tool can take four or five minutes just to set up, but with VTRIP and the McK­esson Radiology™ (McKesson Technology Solutions is now Change Healthcare) display protocols, the relevant sequences are loaded and ready to be compared without any mouse clicks,” Pechet says. “You can do it on third-party software, but it’s a nightmare and very inefficient.”

The ability to have a case displayed with minimal user input— even for complex studies—is one thing that makes VTRIP valuable, Pechet explains. While reading examinations with 3D sequences might take longer than a traditional exam, the additional informa­tion engenders a more confident conclusion by the radiologist.

In fact, Pechet doubts that a large center could even use 3D MR without an integrated program like VTRIP, citing his experiences at a partnering imaging practice where Shields provides MR reads.

“They are hamstrung by an archaic PACS,” he says. “I would love to provide them with 3D images, but their PACS can’t handle it. In­stead, they churn out study after study of 2D images because radiol­ogists have to open up another tool to read 3D images.”

“Now that they’ve seen what we can do on our system, they’re including a 3D dataset in every exam because they recognize the value,” Pechet adds.

A Healthy Dialogue

Pechet explains that Shields Health Care has been using VTRIP since the very beginning—they were an early rollout customer.

“We had transitioned to McKesson Radiology,” Pechet says, “and I got involved with the development of VTRIP fairly early on be­cause being on the forefront of 3D MR was important to us.” Even in the mid-2000s, Shields recognized the value of 3D MR to the entire patient care chain, and their long relationship with Change Healthcare has proven to be collaborative and rewarding for both parties.

While day-to-day issues are handled by Change Healthcare’s 24/7 support team, Pechet is in regular contact with members of the product de­velopment team, providing advice and a clinical perspective. He says the Change Healthcare team’s openness to his input helped them concentrate on developing features that are critical to clinicians who use 3D interpretation in their daily workflow. The teamwork be­tween client and vendor has been instrumental in moving Shields forward.

Looking ahead

A radiologist’s toolset will need to evolve to reflect growing empha­sis on proving their value to the greater organization. According to Pechet, “We have to figure out how to broadcast our presence and expertise as radiologists to wherever care is being delivered.” Quantifying time spent on tasks can show how radiologists are a crucial part of care.

As 3D MR continues to progress, Pechet believes that solutions that demonstrate clinical intelligence and depth will remain in­dispensable in the future direction of PACS development. Radiol­ogists need solutions that optimize complex tasks and intelligently present imaging information where and when it’s needed. “There is no substitute for the core functionality of the system,” Pechet says. “It may morph, but the way that radiologists process imaging data will remain the same—their eyes will acquire images just as they always have.

To learn how radiology workflow systems can benefit your organization, read about our solutions or see the solution in action either by requesting a demo online or catching us at Booth 3479 during HIMSS 2017.

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