Founded in 2010 by Helen Mrose, M.D., Bay Radiology provides advanced screening and diagnostic digital mammography, screening and diagnostic breast ultrasound, ultrasound-guided cyst aspiration, ultrasound-guided core biopsy and stereotactic core biopsy.

Bay Radiology is located in Severna Park, Md., and its mission is to provide the most outstanding breast imaging service in the Greater Annapolis region, with a focus on compassion and personalized care. In 2010, Bay Radiology implemented digital mammography and ultrasound for breast imaging in a state-of-the-art facility. Referring physicians and breast surgeons depend on the practice to provide high-quality images and critical information they need to develop comprehensive treatment plans for their patients. Bay Radiology is experiencing significant growth in volume, given that Mrose is able to provide same-day reports to referring physicians, surgeons and patients.

The Challenge
With the significant costs associated with opening a new imaging facility, Bay Radiology looked at a number of picture archiving and communications systems (PACS) solutions and was deterred by their high costs and complexities. Off-site archiving solutions were also considered, but deemed inappropriate in light of the large size for each study and the need for easy access to priors. In addition, Bay Radiology wanted a fully integrated mammography radiology information system (RIS), PACS, mammography tracking and billing solution, as opposed to piecing a solution from various vendors and having to contend with costly and potentially complex integration projects between different systems.

“Starting a new imaging facility amidst an uncertain economy, changing healthcare landscape and evolving legislation, as well as falling reimbursements is a high-risk proposition. I knew that ultimately the success and viability of the practice would be predicated on implementing the latest technologies in the most cost-effective and efficient manner,” said Mrose, medical director of Bay Radiology. “More importantly, it was essential that the technologies we implemented would enable us to streamline workflow in a manner that provided patients with superior care and referring physicians and surgeons with timely reports and results. Furthermore, we needed to make sure that our ongoing operating costs would be minimized, so that the practice’s economic viability would not be jeopardized.”

Bay Radiology needed a very cost-effective and yet feature-rich, reliable, scalable RIS, PACS with mammography viewing and reporting, mammography tracking solution.

The Solution
Bay Radiology deployed the Candelis ImageGrid RIS/PACS Appliance as well as Candelis’ cloud-hosted image transfer and report distribution solution, called ASTRA. The ImageGrid RIS/PACS is at the core of the practice’s operations. The ImageGrid RIS is a comprehensive Web-enabled solution capturing the entire workflow from scheduling, patient registration, modality worklist (MWL), radiologist reporting using voice recognition and customizable reporting templates. The ImageGrid mammography tracking module captures and tracks all necessary data in the mammography workflow, such as exam results, pathology results, followup and statistical reports/audits.  The mammography tracking module is also certified with the National Mammography Database (NMD). The mammography viewer is a Web-enabled FDA 510(k)-cleared solution tightly integrated with the RIS/PACS and features highly customizable mammography hanging protocols. With its fully integrated and scalable RAID archive, the 2 TB raw capacity ImageGrid PACS can accommodate approximately 10,000 studies.

Candelis’ ASTRA solution is a cloud-hosted study and radiologist report-sharing and distribution solution, and allows for the seamless, secure and HIPAA-compliant transfer of results to referring physicians.The service is priced on a per-use basis at 99 cents per transfer (up to 1 GB). In addition, ASTRA can also be used to archive studies on the cloud for user-defined time periods. Archiving on ASTRA can be used to back up data on the ImageGrid PACS for disaster recovery and HIPAA compliance purposes. Alternatively, ASTRA can be used as an off-site vendor neutral archive (VNA), with the ability to provide cost-effective archiving capacity on demand.  

“ImageGrid and ASTRA have completely streamlined and optimized our entire workflow, helping us achieve our mission of providing our community with the best breast imaging services. The fully integrated nature of the solution has given us operating efficiencies which flow directly to our bottom line,” says Mrose. “ASTRA’s cloud-hosted study and report transfer capability is a clinically valuable tool, in that it provides my referring physicians and surgeons easy access to their patients’ studies when and where they need them.”

The Results
Bay Radiology has been able to achieve physician and staff productivity through immediate and always-online access to its entire image library, as well as the routing of images and reports to referring physicians and surgeons. ImageGrid’s ability to handle multiple modalities and its full compatibility with any DICOM-compliant modality means that Bay Radiology can easily add modalities in the future without concern about handling additional studies. ASTRA, the cloud-hosted image and report transfer component of the solution, has enabled Bay Radiology to save money by minimizing and eventually eliminating labor-intensive and costly CD burning.

“By providing referring physicians and breast surgeons with the ability to view their patients’ studies and reports, we have been able to vastly improve communication with them, which helps all of us to provide superior patient care,” added Mrose.

ImageGrid has been implemented at a fraction of the cost of competing PACS solutions and has been instrumental in helping Bay Radiology to achieve operational efficiencies and low operating costs.

ImageGrid’s appliance architecture enables the integration of the PACS server and archive in a single rack-mountable hardware. Its proactive self-monitoring capability has allowed the practice to avoid additional IT administrative costs, which are typical of many PACS implementations.

This case study was supplied by Candelis Inc.

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