Source: Siemens Medical Solutions
Radiology information technology (IT) such as PACS, RIS, clinical applications and digital dictation/speech recognition is creating new opportunities for radiology services, both inpatient and outpatient. Radiologists tout efficiency, administrators praise productivity and patient throughput, while referring physicians utilize Web-based services to access their patient’s information in a timely manner.
Yet, the growth in radiology IT also presents new challenges, in particular, the management and coordination of integrating complex IT solutions. These challenges are not isolated to just radiology, rather they represent a burgeoning complexity met by healthcare facilities of all sizes.
It is no secret in healthcare that IT solutions and imaging modalities from competing companies do not always work well together. However, with vendors’ adherence to standards such as DICOM, HL7 and CCOW, and with more companies following the lead of the Integrating the Healthcare Enterprise (IHE) profiles, implementing IT solutions and new modalities at the clinical level and sharing information between IT systems is no longer a Herculean task.
The healthcare industry’s initiative toward greater compatibility within hospitals and among physicians and patients in and out of hospitals has led to the rise of IT-specific professional services provided by radiology vendors. To succeed in today’s radiology IT marketplace, vendors must possess the ability to integrate their system with other vendor’s system(s) to create a streamlined and seamless sharing of patient data and images. Patient information no longer resides at the department level, rather it exists at the health system level with enterprise-wide IT strategies becoming the preferred method for organizing, managing and storing clinical data. Digital radiographs are no longer considered the domain of radiology, and, as a result of the digitization of medicine, images are becoming an important tool in other specialties such as cardiology, radiation oncology, nuclear medicine and more.
Therefore, the vision and associated value of professional services in the radiology domain has adapted by taking on a more enterprise-wide view that better serves the needs of an IT department and CIO. Companies that offer a broad portfolio of professional services, such as Kodak Health Group, may provide project management; network design and implementation; RIS/PACS integration with third party applications; workflow; information lifecycle management; and document security services.
Defining Professional Services
Unlike IT solutions such as PACS or RIS, there is no one concise definition of professional services that fits all the vendors’ offerings. Generally, professional services assist a facility in maximizing its investment in IT solutions. This includes providing the appropriate planning and implementation prior to purchase, training and integration subsequent to purchase and workflow re-engineering and optimization that further increase the value of the IT solution after successful completion of implementation and integration activities.
Successful outcomes of business models are quickly becoming the litmus test by which IT solutions and corresponding professional services are gauged. While it is IT that promises increased efficiency and reduced costs, it is the successful management of those solutions, often accomplished through the utilization of professional services, that makes a promise become reality.
While there is no doubt that professional services vary widely among vendors, it is possible to divide the broad offerings of professional services for the radiology IT marketplace into four general categories.
Strategic Planning and Design
Strategic planning and design services guide healthcare facilities in making the most appropriate business decisions, whether it is regarding the acquisition of a new healthcare facility building, services, capital equipment or IT solution.
Services will include some type of needs or market assessment and may also include application for a Certificate of Need in the states that require one. In some cases, an analysis of the organization in terms of workflow and culture is necessary, particularly if the facility is embarking on its first of many IT installations. As the radiology community has noted with PACS purchases, physician and other healthcare provider “buy-in” must be attained prior to purchase for any chance of efficient system use after implementation.
The development of policies governing use, accessibility and security are all crucial aspects of any IT implementation and not just because it is required by the Healthcare Insurance Portability and Accountability Act (HIPAA) of 1996. Sites that do not already have IT solutions in place may require additional consulting services to better understand the business impact of IT on existing operations.
Procurement services can be bundled under this category and are not limited to traditional “consulting” companies. Many modality vendors have found a niche by creating a separate arm of their organization to consult on building construction and capital equipment considerations.
Product Support Services
Usually defined as services that accompany the successful implementation of a product (i.e., PACS or RIS), product support services typically include project management, product integration and workflow engineering. Vendors may also include applications training, system administration (such as PACS administration services) and network assessment.
In many cases, product or service support for a purchase is bundled with the product. The facility should carefully review these types of services to determine if support is already part of the product purchase. In some cases, the quality and type of service provided makes or breaks a deal. When McKesson recently won a $1.3 billion contract with Triad Hospitals Inc. for a clinical and business IT transformation, the company claimed Triad weighed its decision more heavily on McKesson’s high level of service than on its IT products.
The inherent goal for many product-focused services is to enable the healthcare facility to maximize its technology investment across the enterprise and realize some level of a return-on-investment (ROI). ROI may be the result of increasing physician referrals, additional patient throughput on a particular modality, reducing costs by eliminating waste (reprocessing “lost” films), full-time employees (FTEs) or capturing accurate charges. Services generally include network evaluation, re-engineering workflow, migrating data from systems or archive/storage solutions or services, integration of department-specific data into the EMR or EHR and disaster recovery and business continuity planning. Depending upon the vendor, operational assessments and asset planning may also be available.
Most unfamiliar to the radiology department is product-independent services, which typically remain the domain of the facility’s IT department, yet significantly impact workflow in radiology and across all specialties. Services include business continuity and disaster recovery planning, network/infrastructure evaluation and implementation and storage/archive consolidation. Vendors can also provide security, system monitoring, business outcome and benchmarking under this umbrella of professional services.
Tips for Selecting Professional Services
Facilities should engage their IT department at every level of professional services, recommends John Koller, president of KAI Consulting and a leading IT healthcare consultant. Koller cautions that in many instances, some level of product support or product-focused services may be included in the product purchase.
“Know exactly what you are buying from the vendor and what that cost is – particularly in service contracts bundled with the product,” said Koller, who also suggests conducting an evaluation of the IT department to determine what services can be reasonably provided with internal staff. By ensuring interaction between clinical and IT departments at a very early stage, clinicians can focus on their expertise, functionality and advanced applications of the IT solution, while IT can focus on what it knows best, proper utilization of infrastructure, security issues such as HIPAA and disaster recovery and business continuance.
The single most important consideration facilities must include in the evaluation and selection of professional services is “ensuring that the person or company delivering these professional services has the qualifications to deliver the service you are about to purchase,” according to Stuart Gardner, president of SG&A Consulting. Gardner suggests the buyer obtain and check references to determine if the vendor is knowledgeable and experienced in implementing healthcare information systems. Once the buyer is satisfied with the vendor’s qualifications, the contract should clearly define the expectations and deliverables.
Professional services are designed to ensure that healthcare providers achieve the full productivity and efficiency gains offered by digital image capture and management solutions. What distinguishes one solution from another may not be the product and its technology as much as the professional services to back it up.