Greg Freiherr, Industry Consultant

Greg Freiherr has reported on developments in radiology since 1983. He runs the consulting service, The Freiherr Group.

Sponsored Content | Blog | Greg Freiherr, Industry Consultant | Electronic Medical Records (EMR) | February 02, 2020

BLOG: How Sharing Patient Images Electronically Extends Providers’ Reach

Graphic courtesy of Pixabay

The electronic transmission of patient images, when done cost effectively, efficiently and instantaneously, can help expand services of the provider; it can even change the culture of patient care, according to imaging administrators who described their daily experiences in an ITN webinar.

Administrators from three major U.S. providers — HCA Healthcare’s Continental Division, the Duke University Health System and Seattle Children’s Hospital and its WWAMI (Wyoming, Washington, Alaska, Montana and Idaho) affiliates – described during the webinar how their use of PowerShare to send patient images through the cloud changed patient management and provided growth opportunities.

The PowerShare Network provided the means by which HCA Healthcare’s Continental Division expanded its stroke treatment program; created channels through which images could be transmitted; and laid the groundwork for the future use of artificial intelligence. Using this network “changed the culture” underlying the Duke University Health System, said the imaging administrator there. And it provided the framework for the Seattle Children’s Hospital and WWAMI affiliates to transfer not only radiology but cardiology images.


To Cardiology – And Beyond

Cindy Price, the Seattle Children’s Hospital radiology informatics manager, said radiology’s use of the PowerShare Network whetted the interest of cardiologists in electronic image transfer. Price credited “the success we were having in radiology with cloud transfers,” for cardiology’s interest in using the Network.

She and colleagues set up an “umbrella” account in the PowerShare Network to add cardiology to the radiology-grounded network.  In the ITN webinar, she noted that structuring the account this way allowed cardiology “to capitalize on our existing network to expand their own.”

The Duke University Health System took the opposite tack.  Instead of relying on radiology to lay the groundwork for the expansion of image sharing, the Health System first reached out to oncologists at a single facility, the Duke Cancer Center.

The Health System rolled out the PowerShare Network by specialty until it was widely available to its 3000 physicians and their staffs, according to Hope Holiday Harten, radiology administrative manager. Today physicians throughout the Duke system use PowerShare to transfer images, radically changing their practice of medicine, Harten said.

“In the past if you could get the images in a couple of hours that was considered really great time,” she said.  “Now the expectation is (that) you will have (them) in a matter of minutes. It really has changed the culture.”


The Need for Reliability And Speed

Administrators representing the three different health systems agreed that the use of compact disks is not a viable alternative to the use of PowerShare to transmit images.  The reasons relate to the physical nature of storing patient images on CDs.

This use of physical media to store images raises the issue of image reliability. The CDs may not be compatible with equipment used at the transfer site. The biggest shortcoming of disks, however, involves the speed of transmission. Routinely sending trauma images over the PowerShare Network, for example, can dramatically accelerate treatment.

During the webinar, Harten described how surgical planning was accomplished for a rural gunshot victim because the images were received by the tertiary care center “before the patient left (the rural hospital).” Instant image transfer “is pretty standard now,” she said, not just for trauma patients but for all treated in the Duke system.

For stroke cases, reducing the time to treatment “is what it was all about,” said Brian Phillips, the imaging systems administrator of HCA Healthcare’s Continental Division.


Growth Beyond Radiology

Previously the Division had relied on business-to-business VPNs (virtual private networks) to send images electronically among sites.  But, over the years, VPNs “became a significant bottleneck for the growth of our outreach and telemedicine service lines,” Phillips said during the webinar.

Improving the treatment of stroke victims was what spurred the Division to implement PowerShare.  This was the first step in a continuing journey.

PowerShare initially connected Colorado sites in the Division’s stroke program.  After establishing a dedicated stroke channel, the Division branched out and today has more than 300 connected facilities on the PowerShare Network, Phillips said during the ITN webinar. More could be on the way.

The transformation at HCA Healthcare’s Continental Division began about seven years ago, he said, when the Division began evaluating cloud-based services for the electronic transmission of images. Ultimately PowerShare from Nuance Communications was chosen “to be the hub of the trauma transfer and stroke transfer environment,” Phillips said during the webinar.

PowerShare is now routinely used to transfer images involving cardiology, radiation oncology and even general diagnostics.  Each has its own “channel,” he said. Transmitting images through these individual channels “has allowed us to grow the stroke network into our newly formed artificial intelligence environment for stroke.”

Illustrating the impact of PowerShare, Phillips described how images transmitted from remote locations in Wyoming, for example, can be analyzed using smart AI models trained to spot stroke. Ones suggestive of the brain trauma may be routed hundreds of miles for human interpretation.

“Users can get a quick remote look through the PowerShare app while they are sitting at their kids’ soccer games,” he said during the webinar, noting that providers set up PowerShare (on their mobile devices) “so they can just pop in and pop out.”

Growth of the Division’s PowerShare Network to hundreds of connected facilities throughout the Rockies and Great Plains took “a lot of meetings in and around Colorado, Kansas, Wyoming and Montana,” he said. More growth is expected through the inclusion of private physician practices and “large-volume feeders for our environment,” particularly ones in Denver and the rural areas in Western Kansas.


Editor’s Note: This is the third in a four-part series about image sharing. The final installment will look at how the PowerShare Network helps providers prepare for the future. The first BLOG: How To Deploy Electronic Image Sharing, can be found here. The second BLOG: How PowerShare Drives Adoption of Electronic Image Sharing, can be found here.

Related content:

BLOG: How PowerShare Drives Adoption of Electronic Image Sharing

BLOG: How To Deploy Electronic Image Sharing 

Webinar: Practical Strategies to Solve the Challenge of Image Sharing


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