Challenges to RIS+PACS Integration

Makori Arnon, Clalit Health Services

Makori Arnon, MD, MHA, Director of Imaging Informatics, Clalit Health Services, Tel Aviv, Israel

The world of radiology sees frequent use of the term “integration,” but this term can easily mean many things to different people. When used in conjunction with describing implementation of a RIS+PACS platform at a hospital, it demands we clearly define our expectations up front to minimize the challenges and disruption that can accompany integrating a new RIS+PACS platform into our workflow.

In the current environment we see that RIS, PACS and capture modalities are separate yet complementary entities that are really more bundled than they are integrated. We all know that RIS is a separate platform that is slowly being absorbed into the PACS or into EMR. PACS joins together both clinical information systems with the organization’s IT network and a successful implementation should have a very positive impact upon workflow.

Radiologists need to read images and dictate their findings, and being able to easily integrate images directly into the report via the RIS will help improve workflow. Integrating images into a RIS means that vendors will need to put more emphasis on developing improved RIS technology to provide higher-end throughput. By improving the RIS interface to better address workflow issues, a single-platform vendor will have a big advantage over another third party.

Carestream Radiology Information System

Integrating images into a RIS means that vendors will need to put more emphasis on developing improved RIS technology to provide higher-end throughput.

In the contemporary radiology department, knowledge is everything. This knowledge goes outside the walls of the healthcare facility with the advent of patient portals that allow patients to electronically access, store and share their medical images. With a well-integrated RIS+PACS platform, radiology professionals expect amplified clinical, business and IT benefits that include:

  • Greater value and insight resulting from the generation of clinically-rich reports
  • Improved workflow
  • Greater cost control and a streamlined data flow
  • Increased patient engagement and satisfaction with an intuitive patient portal; and
  • The ability to foster clinical collaboration without boundaries.

To achieve this, we need to improve upon the current integration process by providing a system or single platform for the reading and distribution workflow. Successful RIS+PACS vendors are making this a key focus of future product development activities.

Another issue to consider is that radiologists continue to change how they work. We are now seeing more “point of care” imaging where you have physicians creating medical images by capturing images with handheld ultrasound or endoscopy units. These physicians (not radiologists) are creating a workflow that is “orderless” or “non-scheduled”—and the organization will need to accommodate this workflow by supporting the input of these images into the PACS. Point-of care imaging is an integration point that we will need to see in future development efforts since it is clearly on the rise.

How is your organization handling the integration of RIS+PACS?

What will your RIS+PACS platform look like in the next 10 years?

Makori Arnon, MD, MHA, is the Director of Imaging Informatics at Clalit Health Services in Tel Aviv, Israel. He is also a member of Carestream’s Advisory Group, a collective of medical professionals that advises the company on healthcare IT trends.

The Top 10 Reasons for Veterinarians to go Digital

Heidi McIntosh, Marketing Manager, X-ray Solutions, Carestream

Heidi McIntosh, Marketing Manager, X-ray Solutions, Carestream

Radiography is a jargon-heavy environment filled with terms and acronyms that can be hard for anyone to follow. The last thing you want to worry about is being confused while taking care of your patients. There is no doubt that technology is changing the way we work and many facilities are upgrading from film-based radiography to digital, but some are still on the fence.

A veterinary practice on the coast of Southern England recently showcased the advanced medical care now available for beloved pets and their owners. Raddenstiles Veterinary Surgery upgraded to digital to deliver access and management of high-quality imaging studies for the 3,500 patients the practice sees each month. Going digital has enabled the practice to engage in remote consultations to better treat their patients.

In a recent case, a Jack Russell Terrier fell off a 150-foot seaside cliff and was rescued by the Coast Guard. The veterinarian at the local practice determined the dog had a broken hip and digitally transmitted the images to the on-call vet at the Raddenstiles practice. There, they were able to devise a treatment plan and successfully repair the injury once the dog was stable and fit for surgery.

An Inside Look: A magazine for veterinarians from Carestream about radiology trends.

V-Inside: A magazine from Carestream about veterinary radiology trends.

There are many benefits that come from making the move to digital from both a business and patient-care perspective. Here are 10 of the best ones:

  1. Speed: Imaging exams are faster and smoother than ever before. X-ray images are displayed almost instantly, enabling veterinarians to accept or retake an image if needed, adding up to faster diagnosis and early treatment.
  2. Quality: Digital imaging provides superb quality, which can mean a higher level of confidence in the diagnoses and potentially, an increased standard of care.
  3. Waste: No more film, storage, toxic chemicals, fumes/odors, or long processing times.
  4. Versatility: Flexible and versatile software enables veterinarians to capture both soft tissue and bone detail in the same image, eliminating the need for multiple exposures with film cassettes.
  5. Sharing: Digital imaging supports increased clinical collaboration because images can be quickly and easily shared electronically.
  6. Application: Digitally captured exam images can be enhanced and manipulated to aid in interpretation.
  7. Space: Save valuable floor space since there is no need for a dedicated darkroom or storage for files because all images can be archived digitally.   
  8. Savings: Advancing technology is making the initial cost of digital systems even more affordable. Over time practices can enjoy a lower cost of ownership and operation.
  9. Transition: The transition is smooth and easy with little to no disruption. Digital imaging fits into existing workflow with an easy-to-use interface, minimizing training time.
  10.  Intuitive: This state-of-the-art technology can differentiate practices from the competition and enhance professional image.

The latest edition of An Inside Look magazine further discusses how Raddenstiles Veterinary Surgery benefits from going digital, along with “RAD 101: Know Your Modalities,” and a closer look at the TDR Detector. You can read the latest edition of the magazine here and subscribe to never miss a new version here.

How can going digital help your veterinary clinic be at its very best?

A Mobile Imaging Efficiency Showdown: CR vs. DR

When it comes to medical imaging it is no secret that every second counts. The modern healthcare environment can be incredibly fast-paced and medical imaging professionals demand, and deserve, the best when it comes to time-saving technologies.

We wanted to compare the efficiency of DR compared to CR using the DRX-1, and with the support of Queen Elizabeth Hospital in Birmingham, UK we were able to record a speed test. In the video, wireless DR is almost twice as fast as standard CR mobile imaging–an impressive performance that could make a big difference in terms of productivity and patient care.

The Top 5 Everything Rad Posts From the First Half of 2014

top 5The first six months of 2014 have proven to be quite eventful for all of us in the world of medical imaging and healthcare IT. As we look forward to the second half of the year, we wanted to take a look back at the five most popular posts of the first half of 2014.

1) Five Ideas the Medical Imaging World will be Implementing in 2014

This post gives a preview of the five big trends that we thought would affect the medical imaging world in 2014.

2) Preparation and Support is Key to Safe Imaging with Pediatric Patients

There are many components of medical imaging that can intimidate or scare children. Learn about how hospitals employ child life specialists to support children and their families before, during, and after their radiology appointment.

3) ACR on CNBSS Mammography Study: “Deeply Flawed and Widely Discredited”

This post highlights the American College of Radiology’s (ACR) response to a study which claimed that mammograms offered no advantage in detecting breast cancers that were too small to feel. The ACR found many serious design flaws in the study, and found no reason to dismiss the importance of mammograms.

4) Q&A: Digital Breast Tomosynthesys

Ron Muscosky, Worldwide Product Line Manager, HCIS provides answers to some of the common questions health care organizations are asking about Digital Breast Tomosynthesys.

5) [Whitepaper] How can Bone Suppression Improve Chest Radiographic Images?

This whitepaper takes an in depth look at Carestream’s bone suppression software, which helps radiologists interpret chest images by removing the ribs and clavicle from x-rays.

Improvements in Treating Sports Injuries Can Benefit Everyone…From Professional Athletes to Recreational Enthusiasts

Diana Nole, Carestream Health

Diana L. Nole, President, Digital Medical Solutions

Sports medicine is a branch of medicine that deals with the broad scope of overall physical fitness as well as the prevention, diagnosis, treatment and recovery of injuries related to sports and exercise. Beyond professional sports where teams have employed their own physicians for years, sports medicine has emerged as a healthcare specialty focusing on a large patient population that includes youth sports, casual athletes and adults dedicated to active lifestyles. Many challenges exist in sports medicine today but two that are top of mind in the area of radiology are:

  • Earlier detection and monitoring protocols for traumatic brain injuries (TBI);  and
  • Accurate diagnosis, treatment planning and recovery follow-up for extremity injuries common to knees, ankles, feet, elbows and hands.

While the topic of TBI has received much press recently in the world of sports, it is also a major public health problem. The Centers for Disease Control and Prevention (CDC) estimate that every year at least 1.7 million TBI occur either as an isolated injury or along with other injuries. TBI is a contributing factor to almost a third (30.5%) of all injury-related deaths in the United States. The cost of diagnosing and treating TBI in the U.S. alone is $30 billion annually. The dangers posed by concussions apply to recreational and professional sports enthusiasts of all ages. The CDC estimates nearly 3.8 million sports-related concussions occur every year. Most athletes will recover from concussions in a week or two, but complications can occur if a concussion is not properly recognized or treated. Athletes with multiple concussions or athletes who continue playing before they are fully recovered are at increased risk for long-lasting problems that can include severe headaches, bouts of anxiety and depression, and balance problems. Medical studies on professional athletes have linked concussions to chronic traumatic encephalopathy, a brain disease that causes dementia and depression.

Based on study from UPMC.

According to a study from UPMC, 1 in 10 high school athletes will suffer a concussion this year.

Extremity injuries are also a major health issue. In the U.S., musculoskeletal disorders are reported more than any other health condition and 9% are related to sports activities. These injuries can cause pain, limit activities and require surgical repair and/or physical therapy.

Early detection and effective treatment planning are essential to minimizing the immediate and long term effects of both TBI and extremity injuries. One potential solution is a next generation, cost-effective 3D imaging system designed for use at the point of care/point of potential injury at practice and sports venues, as well as for use by healthcare specialists in their offices or in hospitals. This could enable physicians to more quickly treat the patient while reducing the number of office visits, thus improving the quality of care from the patient’s point of view.

Carestream is working with research partners to develop such a solution using cone beam CT based technology that can detect both initial damage—and monitor recovery—from a brain injury. This could enable physicians to design appropriate treatment regimens for each patient to help reduce the effects of the injury. This technology also could deliver advantages for extremity imaging including images of anatomy under true weight-bearing conditions (i.e. standing), which could provide valuable diagnostic information that is not currently available.

What type of imaging systems are you currently using for TBI and extremity exams? What do you see as the improvements needed to deliver better image quality and diagnostic confidence for these exams?

The Future of Mobile Technology in Healthcare

Andy Lim,HCIS Business Manager ASEAN, Carestream Health Singapore

Andy Lim, HCIS Business Manager ASEAN,
Carestream Health Singapore

Technology is constantly evolving. It seems like every day there is a better, smaller device that replaces the new one you bought yesterday and still don’t know how to use yet. In the past (present for some hospitals), image sharing was done solely via film distribution and multiple copies needed to be printed for multiple physicians to view the study.

As technology advances, hospitals begin looking to store their digital images in a centralized archive for distribution within and outside the hospital. This enhances the workflow of the hospital and brings clinical benefits not only to radiologists and clinicians, but also to patients.

While different technology may support certain mobile devices, your archive is the source where data is fed to your device. Your archive is also the foundation of data sharing.

Having a Vendor Neutral Archive (VNA) in place today ensures all clinical data belonging to the patient is securely stored and ready to be connected to a validated mobile technology/device. The other advantage of VNA is that data is stored in a non-proprietary format with the ability to ingest and store DICOM and NON-DICOM files so it gives the clinical users a complete patient portfolio, hence enhancing better patient care.

This mobile technology is extremely beneficial to three key groups of mobile users in the radiology space:

  1. Radiologists want access to view emergency cases and provide preliminary reports without traveling back to the hospital when they’re on call.
  2. Clinicians want access to images and reports in the clinic without complex installation or the need for a high end workstation.
  3. Patients want access to images and medical reports without the need to carry film or DVDs, and to be able to share their studies with other doctors for second opinions.

At Carestream, we’ve come a long way in the design of our software for use with mobile technologies and platforms to ensure they evolve in accordance with the needs of our customers and are easily integrated with the wide array of healthcare technologies. We realize that nothing lasts forever but rather than just accepting the fact, we responded by creating affordable solutions for our customers to stay one step ahead of technology.

Health IT Timeline

We recognize that not every IT solution can provide enterprise distribution – and yet that is what you need. For this reason we developed Vue Motion, a lightweight, vendor neutral viewer that can enables radiologists and clinicians to access patient data regardless of whether it is embedded in an EMR or it is serving as a standalone imaging viewer.  It has an intuitive interface, so it requires no dedicated resources or training. Yet it can handle virtually any task from calling up basic patient information to accessing full studies, as well as distributing reports and images.

Patients are becoming more involved than ever in their healthcare. As image distribution in radiology evolves, hospitals are constantly looking at innovative and cost effective methods to distribute images and results to the patient. Spire Healthcare, the UK’s second largest provider of private healthcare, has implemented Carestream’s Vue Motion zero-footprint viewer to enable its clinicians to view patient images on Apple, Android and other validated devices.

As this independent viewer is PACS-agnostic, clinicians across Spire can securely view PACS images from all of Spire’s 37 locations, where 27 sites have CARESTREAM Vue RIS/PACS and 10 sites use other systems. This ability to access images across multiple platforms is bringing increased flexibility to Spire consultants and timely results to patients.

“Vue Motion has made a vast difference to my image reporting,” said Dr Qaiser Malik, Consultant Radiologist at Spire Healthcare. “I no longer have to physically go to the hospital to log in at one of the workstations to view images and previous reports. I can log in at weekends wherever I am which is of great advantage. It is an absolutely fabulous tool and advances patient care by providing clinicians with timely reports and a head-start on treatment options.”

Read the full case study on Spire Healthcare and see what more Vue Motion provided the facility with here:

 

What is the biggest obstacle for your facility to overcome when trying to keep up with the variety of healthcare technologies?