DICOM, zero-footprint

The ability for physicians to access DICOM and non-DICOM images from any location or device using the new zero-footprint viewer will enable better all-around care for imaging center patients.

 


Imaging Associates is the imaging center of choice for many Alaska physicians and patients, providing a unique mix of innovative technologies and services, exam protocols and subspecialty reads in under two hours. The company works to provide physicians with seamless access to a wide range of services unique to the state, including prostate magnetic resonance imaging (MRI), migraine relief, vascular services, 3-D modeling for assessment of brain injuries and neurological conditions, and Alaska’s first and only high-field open MRI.  

Challenge: Embedded PACS/RIS Viewer Lacks Desired Functionality 

Imaging Associates implemented a new picture archiving and communication system/radiology information system (PACS/RIS) solution in April 2014 to serve as the company’s core information system for managing medical images, reports and other outpatient data. Radiologists found the image viewer that came with this system to be less-than-comprehensive in its feature set. They also felt the viewer was not intuitive to use. The primary reason for the viewer’s unpopularity, however, was due to lengthy wait times experienced by referring physicians while downloading images. The delays were frustrating, resulting in a loss of physician productivity and responsiveness to patients.

“We evaluated a number of different viewers in our search for an enterprise solution,” said Ward Hinger, CEO, Imaging Associates. “Many products on the market claim to be ‘zero-footprint.’ Most, however, have difficulty working with various browser versions and require downloads and add-ons to work properly.” Viewers that require these extra steps can cost a busy physician precious time. 

Solution: Zero-footprint Viewer Provides Versatility, Improved Collaboration

Physicians need flexibility and a variety of options, including mobile devices, when accessing patient information. Hinger and his team determined their selected viewer should be able to identify and ingest images from virtually any departmental archiving solution, displaying a wide variety of image types, both DICOM and non-DICOM. “The ability for physicians to access images quickly is critical for us,” said Hinger. 

“We implemented the Lexmark NilRead Enterprise Viewer because it is a true zero-footprint clinical and diagnostic viewer that can be accessed from any physical location, from any platform, including smartphones, tablets and PCs,” continued Hinger. “It provides a rich view of a patient’s medical history, including reports and images. There is no need to download any add-ons, plug-ins or other objects to the desktop.”

One of the viewing features Imaging Associates found to be valuable is the Web-based collaboration tool. Online collaboration, including the ability to analyze and share measurements, helps radiologists communicate and work together more effectively with referring physicians. “Enhanced collaboration aids in the development of cleaner, more accurate treatment plans for our patients,” said Jason Roach, director of IT, Imaging Associates. Physicians also now have access to a comprehensive timeline of a patient’s reports and images. Additionally, once the patient exam is completed, all images are available in one convenient location. 

Viewer Flexibility and Configurability Keys to Smooth Implementation and User Acceptance 

According to Roach, whenever a new physician contacts Imaging Associates for access to a patient image, issuance of login credentials typically happens within minutes. “Regarding user acceptance, the new viewer’s interface is so intuitive that doctors are able to begin using it immediately with little or no instruction,” he added. 

After viewer rollout, Roach’s team began to receive suggestions from users about tailoring it to support specific workflows and interaction use cases. “We had a number of requests for report viewing changes,” said Roach. “Some of our physicians wanted to view PACS reports in specific formats.” One request involved matching the Imaging Associates report with the referring physician’s report format, eliminating the need to dictate information into the patient record. Revisions were typically delivered within a matter of hours, enabling reports and workflow to quickly support clinician preferences. 

 

SIDEBAR:

How to Identify a “True” Zero-footprint Viewer

Jason Roach, director of IT, Imaging Associates, cautions clinical and IT leaders to be careful when evaluating enterprise viewing solutions, pointing out that prospective vendors should be completely transparent in demonstrating “zero-footprint” performance. Listed below are key questions to ask when shopping for a true zero-footprint solution:

  • What plug-ins will we need?
  • Which Web browsers does the software work with?
    • Are there any other plug-ins needed on those Web browsers?
    • How many versions back does compatibility go?
  • Will my user base be able to use the software they already have installed?

 

Results: Improved Viewing Experience Enhances Clinical Workflow and Patient Care

According to Ward Hinger, CEO, Imaging Associates, and Roach, physicians that have begun to use the new enterprise viewer appreciate the application’s ease of use and the ability to access patient reports within two hours. “We’ve also incorporated the viewer into one of our software applications used for EHR integration,” said Roach. This solution gives referring physicians a quick link back to images related to reports received via an HL7 interface, saving time that in the past would have been spent searching through various systems.

When working with Imaging Associates radiologists, physicians in other parts of the U.S. can now log onto the Lexmark NilRead viewer via the Imaging Associates website using smartphones, tablets and other devices to see patient images and associated reports. “The ability to access the viewer from anywhere will help us expand market reach while providing better all-around care for patients,” said Hinger. “We can also use it for teleradiology reads whenever we bring on new sites outside our local service area.” Imaging Associates is working to sign up as many practitioners as possible on the new service.


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