Health Imaging & IT - May 2008 - (Page 66)

options and flexibility Halifax Medical Center in Daytona Beach, Fla., implemented Unity PACS from DR Systems in 2003. The operating rooms went live with PACS about 60 days later. The biggest challenge, says System Administrator Bill Kazee, is that the surgeons all look at the films differently. Neurosurgeons, for example, prefer to hang up 8 to 12 films and scan all of them. Orthopedic surgeons generally look at one sheet of film. The solution, he says, was to provide a mix and match of options. During phase one of implementation, dual monitors were wallmounted in the ORs to allow for as much real estate as possible. The team addressed each physician group’s needs: Neurosurgeons got a quad bank of monitors on a mobile cart while orthopedists and other surgeons got dual-monitor carts. Some surgeons like the carts because they can be rolled to either side of the operating table or wherever is easiest for the surgeon to see them. The goal was for the surgeon to never have to leave the table. Most of the rooms have multiple 20-inch monitors which allows for more “ability to divide and conquer that exam” by providing, for example, axial images on one screen and post-processed images on another. Initially, Kazee installed wall-mounted monitors in the rooms. However, he learned that the surgeons preferred the ability to move their viewing station to various locations. During surgery, the physician will either manipulate the station before scrubbing in or have a circulator drive the cart for him, Kazee says. If the surgeon wants to zoom in on a certain image, the circulator can drive the software. Every OR already had a circulating nurse not involved in the table field. Once a case is brought up on a monitor, they don’t need very advanced skills to alter images. The involvement of the circulator during a procedure was provided to the surgeon as a result of the workflows demanded of the surgeons at other facilities where they have to leave the sterile field to manipulate the image data. “It really made sense to us to implement the product like this, as why force the surgeon to leave the table field in a 66 Health Imaging & IT | May 2008 demanding procedure and spend costly time manipulating the images himself. Plus, the surgeon can preplan image views most likely to be needed during the case.” When installing the equipment, Kazee says the team had to ensure power and networking drops in locations where the carts would be used. Some network drops were a problem but new ORs are being built now and all will be wireless. Kazee took advantage of the lessons learned from OR implementations at other hospitals in the area. Beyond the involvement of the circulators, he also had large multi-display station’s installed in the OR physician lounge and on each of the patient floors—something that was not made so readily available to the physicians at other institutions. That lets surgeons preplan procedures and take last-minute looks. He says the feedback has been fantastic. overall functionality Wilson Memorial Hospital in Sidney, Ohio, also is in the process of renovating its operating rooms and installing image displays on booms. Wilson implemented Vision Series PACS from AMICAS a year ago, says Tony Linkmeyer, director of imaging. The facility had been an early adopter of PACS in the late 1990s, but the system needed to be replaced. The previous, thick-client PACS was very heavily server-based, which made it difficult to distribute images. “We knew we had to shift gears and move to a model that would let us distribute images more easily.” Linkmeyer says his surgeons wanted speed, flexibility and accessibility. “They didn’t need too many bells and whistles as much as good functionality of the system overall.” AMICAS offers a “forever priors” concept, he says. Since the physicians had asked for a guarantee of available images, the facility chose to migrate five years of the prior eight years of images into the PACS. “If support staff didn’t push images before a procedure, the doctor was screaming at me,” he says. Now, surgeons can call up priors themselves. Wilson used to have two imaging carts with the thick-client PACS loaded on and HealthImaging.com http://www.erad.com http://www.erad.com 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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