The outpatient-imaging sector has been consolidating as a result of the Deficit Reduction Act of 2005, which decreased reimbursement for several types of imaging exams. Now, hospitals are absorbing struggling outpatient centers, and as the entities merge, a unified interface is required between the outpatient centers and their affiliate hospitals.
The question this situation poses is how to effectively integrate a solution for radiology information systems and picture archiving and communication systems (RIS/PACS) into a streamlined advanced clinical information system, addressing both outpatient and inpatient electronic medical record (EMR) challenges.
Whether you are selecting a RIS/PACS solution or trying to integrate a RIS/PACS solution into a healthcare information system (HIS) or EMR, there are a few of the questions that need to be asked and answered prior to selecting a solution. These include: “What is the desired outcome of the solution? What does it take to achieve a streamlined workflow optimization and seamless integration? How do I select a vendor with a product that will fit my unique workflow needs and supply the resources and time in which it takes to plan and execute a successful implementation?” According to Teddi Jo Samano-Cordova, PACS/RIS consultant at Beacon Partners, “There are a number of efficiencies a RIS/PACS solution can provide for workflow optimization. You should target solutions that offer a user-friendly interface, a single integrated database, a Web-enabled architecture to support off-site users and advanced radiology applications for paperless workflow.”
RIS/PACS solutions eliminate the need to toggle between screens with multiple workstations and multiple logins. It also allows you unified patient information with one login and one view that provides all patients’ priors and patient information.
These solutions will streamline your workflow and provide valuable metric tools. These tools help managers facilitate budgetary planning, cost analysis, revenue generation, productivity reporting and resource and facility utilization. RIS/PACS metric tools can document every aspect of your study with real-time statistics. You can utilize these tools in order to calculate the progress of a study, from the time a patient walks into the department and arrives at the front desk, to the time it takes to room a patient, begin and end a study, transcribe a study, radiologists sign off and send automated faxing of reports back to the referring provider.
Utilizing worklists is another valuable tool that a RIS/PACS solution can provide. A radiologist can remain in control of their reading status with personal, location-independent work lists, accessible from any workstation that instantly displays only the cases they need to read and assists them in prioritizing tasks. A technologist can work directly from his or her worklists in order to expedite and improve patient care and accuracy of studies.
Implementing a Plan
Implementation planning must be developed and managed proactively. Prior to selecting a vendor, it is crucial to complete a comprehensive analysis of existing workflow. If there are changes needed to existing workflow they must be identified and agreed upon by leadership in this discovery phase. The new solution should assist in working out the existing problems instead of creating new ones. Focus on how you will achieve adhering to new workflows and best practices. What type of change leadership is needed to inspire the change? How will your team lead people through a transition and what type of effective communication will you use in order to convey these changes? Be realistic when selecting the necessary changes. Prioritize them so you and the implementation team understand the precedence. Solidify leadership commitment to pre- and post- benchmarks that include measures for patient safety, physician satisfaction (referring and radiologists) and efficiency and cost savings measures.
These dashboard reports can be shared as:
• Project success stories for quality improvement in an area vital to the success of the entire organization.
• Statistics that can be utilized to support the discussions related to the significant cost associated with implementing a RIS/PACS solution.
• Physician adoption metrics utilized to encourage systems compliance to review results and studies, which will allow the reduction of film, media (CDs) and the burden on the patient to bring their “MRI” from their emergency visit or to their specialist or primary care physician.
• Metrics that provide quality indicators for patient safety reporting, reduction in repeat studies, lost studies, physician utilization, peer review, etc.
Further integration with the EMR solutions will improve physician utilization and patient satisfaction.
Key Differences Among RIS/PACS
When selecting a vendor you must understand the differences in their product versus other software solutions. Look at long-term outcome if you are selecting a RIS/PACS solution and you know in the very near future you will need to integrate it with a HIS. Select a vendor with upcoming changes in mind. With all of the great solutions that are being offered, you must not try to fit your workflow into their software, but analyze what software best fits your desired workflow optimization.
Some of the solutions offer various options to their suite and you may pick and choose according to your budget. There are a wide array of options including: order entry, scheduling, patient workflow, mammography/MQSA, transcription/radiologist reporting, nurse navigator/case management, new cancer screening, preventive care, insurance and referrals, document management, Web-enabled distribution, billing and practice analytics capabilities, embedded dictation, patient reconciliation, alerts and notifications, record location, store and retrieve for clinical data, privacy and security with tracking and auditing, authentication, viewing studies and reports remotely on multiple Web browsers, just to mention a few.
There are teams of healthcare management professionals in the consulting business that are focused exclusively on organization performance and are there to help you maximize your organizations enterprise yield for optimization performance. Often it is better to have an unbiased opinion that is not caught up in the day-to-day process to examine your workflow needs.
Successful implementation planning will guarantee a smooth transition that will help your organization reach workflow optimization. Organizations that have embraced a RIS/PACS solution are finding unique benefits that lay a solid foundation for quality improvement.
Sharron Finlay is regional manager for healthcare management consulting firm Beacon Partners Inc.