Tidbits from RSNA that Are Worth Repeating


Medical Imaging Tools Discussed at RSNAIt was great to see so many people during the RSNA 2014 Conference in Chicago. In case you missed it, we made several presentations in the McKesson booth that were noteworthy.

Below you will find highlights of five of those presentations.

Freddie Adorno, administrator of Enterprise Imaging Informatics for Nyack Hospital, a 375-bed facility 20 miles north of New York City. Adorno spoke about his hospital’s experience with McKesson Enterprise Image™ Clinical Reference Viewer (CRV). He said the CRV’s public URL streamlined access for everyone, especially those making the referral. This eliminated the frustration of multiple logins that that were required for Virtual Private Network and Terminal Services methods.

Making CRV the default viewer for the EMR integration was a win for the referring clinicians as well because they now have the tools they had been asking for with e-jacket, Adorno said. Mac users can save time by using their iPads inside and outside the hospital in the same way.

Physicians appreciate the intuitive design of Clinical Reference Viewer, Adorno said. When Adorno presented an overview of CRV to a newly affiliated neurosurgeons’ group, each physician gained access to images and reports immediately with little training.

Jack Wong, Radiology/Cardiology/PACS administrator, The Queen’s Health System, a four-hospital system that serves the state of Hawaii and other Pacific islands. Wong presented on the health system’s experience with peerVue QICS™.

PeerVue QICS is highly flexible and works within departmental workflows – not the other way around, Wong said. Workflow changes within QICS are simple to make. The system works for radiology, cardiology and other hospital departments, requiring a single server for the entire enterprise. It uses a small software client to deploy the functionality on any PC in any facility. As a result, Wong said peerVue QICS is running standalone on hospital PCs and has been integrated with PACS and CPACS systems.

While the American College of Radiology doesn’t specify how many reviews to perform, 80% of imaging sites within the system do about 300 a year, which is easy to do with the QICS system, Wong said.

Cindy Hardin, MSRS, RTR, MR, executive director of Product Management at McKesson. Hardin traced the history of diagnostic imaging as it informs the present and the future.

As organizations prepare for the future of enterprise imaging, there are several considerations to be made:

  • Images must be easily accessible from the EHR or through healthcare portals to all users – physicians and patients alike.
  • Images must reside in systems that are built to be highly available, even in the event of disasters.
  • Hospitals need to meet regulatory requirements, such as HIPAA and Meaningful Use.
  • Hospitals must lower overall operational costs through many avenues, including data consolidation.

Enterprise solutions, such as those from McKesson, can help organizations simplify their IT infrastructure, provide interoperability based on industry standards, intelligently aggregate a relevant view of patient data through a single integration point and complete an organization’s EHR.

Laurie Bergeron, product analyst, McKesson. Bergeron explained how to bring intelligence into imaging workflow.

Lack of a unified, rules-driven workflow solution creates bottlenecks in imaging workflow, wastes radiologist time and talent and requires constant manual monitoring and intervention. Work is poorly prioritized and does not meet business objectives such as turnaround times and service level agreement thresholds. Likewise, studies are not being assigned to the most qualified professional; users are pulling from a filtered list that is not sub-specialty aware. Overall, the work is static and does not respond dynamically to escalate and re-assign work.

Bergeron suggested the solution is to embrace workflow intelligence and automate and streamline workflow across the enterprise. Such intelligence would give an organization:

  • A consolidated list of interpretation, quality and communication tasks for their users; removing the silos of information
  • The ability to meet SLA’s (Service Level Agreement) and turn-around times
  • Assignment based on sub-specialty
  • Advanced configurable prioritization capabilities
  • Eligibility and rotation flexibility
  • The potential to escalate cases and dynamically move tasks
  • Communication tools such as notifications, emails, SMS

Overall this will give your enterprise the assurance that the correct study is read by the most appropriate healthcare professional in the most efficient timeframe.

Matt Bishop, Enterprise Solutions architect, UnityPoint Health. Bishop discussed a unified PACS architecture for UnityPoint Health, which encompasses 32 hospitals, more than 200 radiologists and 1,200 workstations in nine geographic locations in Iowa, Illinois and Wisconsin.

Overworked application servers were causing unpredictable system and workstation performance that was affecting system stability. Bishop and his team were charged with creating a PACS architecture that satisfied the health system’s current needs and anticipated tomorrow’s requirements.

The plan was four-fold: to centralize, standardize, measure and virtualize operations in ways that reduced errors while increasing capacity and flexibility. The current system has a single virtual IP address, with a single centralized database instance and centralized storage that’s been replicated for disaster recovery.

The system was standardized to a single server platform and single workstation build that helped minimized workstation hardware platforms. Clinical Reference Viewer is used across the enterprise.

Performance is benchmarked with a standard set of studies that examine First Image Display time, retrieval time from the archive as well as monitor-based performance. Finally, VMware virtualization helps make scalability and disaster recovery easier.

Keep up-to-date on discussions about the latest medical imaging tools and more by following McKesson Enterprise Medical Imaging on LinkedIn.

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