Workflow Intelligence Optimizes Priority of Reads


Evan KaminerEditors Note: This article by Evan Kaminer, MD, Chairman of Radiology, Montefiore Nyack, was originally published by Dotmed Healthcare Business Daily News and is reprinted here with permission.

While productivity certainly is important in today’s healthcare environment, I measure success by the exceptions.

It only takes one delayed reading with a bad outcome to lead to a disaster. Our workflow intelligence system makes sure that the most urgent cases get read first and on time, so it is highly unlikely that a stroke protocol report CT brain or other critical study will be delayed.

Montefiore Nyack, formerly Nyack Hospital, is a 375-bed community acute care medical and surgical hospital which was founded in 1895 and is located in Rockland County, NY. An affiliate of Montefiore Health System, its mission is to provide competent, innovative and accessible emergency and acute care services.

In radiology, we take that mission seriously, diligently striving to improve quality processes, workflows and reporting. Some examples include reading stroke cases within 30 minutes, improving report turnaround time for not only emergency cases but for everyone to speed diagnosis and decrease lengths of stay.

McKesson’s solution for workflow intelligence has helped in these efforts by moving study prioritization to the administrative level. We were facing two issues that slowed our work. One was the tendency for the ED to mark every case STAT, even if the case was read by the ER physician. The technologists had a manual process for identifying high priority cases but the process was time-consuming and prone to error. The other was letting radiologists decide how they would set up their individual worklists, which caused problems in making sure urgent cases were consistently read in a timely manner.

Now, using the flexible rules engine provided in our workflow intelligence solution, I (as the chairman) decide how cases are prioritized and, thus, the order in which the cases are read. This helps us stay compliant with our service agreements with the hospital and benefits radiologists who do not frequently work in the hospital because the system organizes their reading priority.

The solution enabled us to design an escalation model and a de-escalation model, which allows for change as new data is received. Studies can increase in priority if not read in preprogrammed times. They can decrease in priority if a preliminary report is generated.

With workflow intelligence we can help discharge ICU patients faster. By putting the ICU studies at the top of the worklist, the radiologists can read the studies sooner and free up the ICU beds faster. The system also allows manual prioritization if a patient is waiting to be discharged and needs a priority reading.

From the radiologist’s perspective, we moved away from filtered and sorted lists to an intelligent, dynamic list based on defined priorities. If we miss a case, the system will send escalating notifications via pop-up, text message or e-mail so we can ensure the study is read before it becomes flagged as an exception. We are required to measure performance on key measures, it is nice to have a tool that prospectively makes sure we meet our benchmarks.

The workflow intelligence system allows us to improve the quality of the service we provide to both the hospital and our patients.

In short, workflow intelligence has greatly benefited department productivity and the lives of the patients we serve.


To learn more, hear Dr. Kaminer and McKesson’s Tomer Levy, General Manager, Workflow and Infrastructure, speak on Aligning the Enterprise and Medical Imaging: A Collaborative Approach, March 2 at HIMSS ’16. And, be sure to visit McKesson booth 4002 to learn more about Conserus Workflow Intelligence™.

If you’re going to RSNA this year, book a demo or meeting in advance to discuss how we can help you address your security workflow and interoperability needs, then visit McKesson booth 7313 in the North Hall.

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