Health Imaging & IT - May 2008 - (Page 49)

steps. This intermittent approach did not allow the seamless flow of information that a facility like the Cleveland Clinic Imaging Institute—with an annual imaging procedure volume of 1.7 million to 2 million—demanded. The Institute spans multiple hospitals and radiology departments and to ensure the flow of data is not interrupted, a number of software applications, including the syngo Workflow (RIS) and a combination of SIENET Magic (legacy) and syngo Imaging for PACS from Siemens Healthcare, are deployed. Cleveland Clinic recognized that the next evolution of an integrated RIS/PACS involved interfacing patient content with EMRs. “Ideally, in an integrated system, you would sign-off on a report and immediately the next case would appear. In an interfaced system, you have to sign-off and tell it to go to the next case in the worklist,” he says. “The granularity of how it works begins to break down as you get to the sub-steps in the workflow and have more ‘open and clicks.’” This workflow granularity is an advantage of an integrated system compared to an interfaced. “In a truly integrated system, everything stays in concert,” he says. “Rather than having a delay between HL7 interfaces, you maintain patient exam context in all applications immediately rather than having a single driver and several things that just respond.” As for any breakdown in communication, Piraino says it mainly occurs between the dictation system and the RIS. For example, there is about a 10 to 15 second delay between the signoff in speech recognition and the time it takes for it to reflect in the RIS. This is when everything is working well, Piraino notes. “When it is not working well, the delay can be minutes, during which it is not uncommon for my colleague to try to pick up the case and try to start dictating a study already completed—which interrupts workflow. In the worst case, you could potentially have two dictations on one exam because we have more than one dictation system in use.” [ Erika krishnek, information system operations coordinator/RIS administrator (left), and Scott berger, network/systems engineer/PACS administrator of The MRI Center of Idaho in boise use the Vision Series RIS/Vision Series PACS from Amicas to improve workflow processes for its stand-alone and mobile MRI business. ] integrated ris-driven workflow An integrated RIS/PACS has helped the MRI Center of Idaho, in Boise, improve workflow processes across its business platform. The center, which performs approximately 10,000 procedures annually, is comprised of a stand-alone MRI facility and a mobile MRI business, serving 35 mobile sites in rural communities. The answer is an integrated Vision Series RIS and Vision Series PACS from Amicas. “Now things are very quick and the scheduling system is completely different than before,” according to Scott Berger, network/ systems engineer/PACS administrator. “What used to take days to get out, can now be done within an hour, if it is needed.” Berger says the two systems, which have two separate dataHealthImaging.com bases, communicate via HL7. Before implementing the RIS/ PACS in 2004, the center was working in a semi-filmless environment with a partner hospital that they used for a hosted PACS. The center wanted a more full-featured RIS than the software in use at the time, but at a cost they could absorb. “Having one vendor eased our cost and implementation pressures, as well as interoperability,” he says. “From an administrative standpoint, we were looking really at functionality and the ability for our technologists to easily come up to speed,” Berger adds. “We did not want the headache of building an interface and need to still integrate with another third-party software vendor.” According to Erika Krishnek, information system operations coordinator/RIS administrator, the RIS is the brainchild of the whole operations, sending information to the PACS through HL7 messages—a workflow that begins when the patient is scheduled. Jim Acevedo, IT supervisor at the MRI Center, says the RIS/ PACS looks and feels like an integrated product, despite understanding that there are some interfaces that happen behind the scenes. “As customers, to us it is integrated,” Acevedo notes. “We work with other companies that have totally separate systems, but we would have to come up with some HL7 gateway to communicate with them.” decentralized operations “Whether we are talking about RIS-driven workflow or integration, it is a system that supports paperless operations which matters to us,” says Andy Strickland, director of imaging informatics, at the University of Washington Medical Center in Seattle. In a paperless environment, specifically within radiology, operaMay 2008 | Health Imaging & IT 9 http://HealthImaging.com

Table of Contents Feed for the Digital Edition of Health Imaging & IT - May 2008

Health Imaging & IT - May 2008 Contents On the Web The Enterprise News Update Convention Spotlight: SIIM 2008 Healthcare IT Salary Survey Survey Findings Inside the Transition to Next-Generation Image Management Blurring the Lines: Interfaced vs. Integrated RIS/PACS The Insider's Primer: Taming the Workflow Beast - Five Facilities Tell How Availability, Applications Drive New Archive Strategies Modality Review Managing Technology Inside Technology Reader's Resource Stat Sheet

Health Imaging & IT - May 2008

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