Health Imaging & IT - October 2007 - (Page 50) e n t e r p r i s e pA c s : W h e r e d o t h e o p p o r t u n i t i e s a n d c h a l l e n g e s l i e? At University Medical Center in Tucson, Ariz., PACS images are now stored via an application service provider. To address this situation, UMC has elected to transfer its archive management to an application service provider (ASP) model. According to Schaefer, this frees the facility from having to construct and deploy an archive disaster management solution, provide archive maintenance, or hire personnel to manage and service the system. “With an ASP-based archive, we’re better able to focus on providing service at the point of clinical care, which is our primary goal as a healthcare system,” he noted. For those facilities seeking to expand their current PACS beyond radiology, or an institution looking to bring an enterprise PACS on board, Schaefer recommends that they pay close attention to security and access beyond the walls of the hospital. “One of the challenges we faced is that we wanted to be as secure as possible, but we didn’t want to hinder patient care,” he says. “You have to walk a fine line between securing your PACS network and providing as much access as possible to physicians. You should plan on spending a fair amount of time documenting and testing your strategy to achieve this goal.” community hospital maximizes resources Greene Memorial Hospital in Xenia, Ohio, is a mid-size community hospital, licensed for 210 beds but typically staffed for 80 beds. They are targeting 78,000 imaging procedures performed in their hospital this year, plus an outpatient imaging cen50 O C T O B E R 2 0 07 | Health Imaging & IT ter and four satellite facilities in medical office buildings. The hospital provides a broad mix of imaging services, including digital x-ray, CT, MRI, SPECT/CT, breast-specific gamma imaging, ultrasound, mammography, fluoroscopy, DXA, and is considering bringing mobile PET/CT on board. Mary Ann Hargrove, director of radiology at the facility, is justly proud of the imaging service lines Greene Memorial is able to offer residents of Xenia and its surrounding area. “When we set out to bring an enterprise PACS into our facility, we first realized that we would have to upgrade our modalities in order to utilize the benefits of PACS,” she says. According to Roxanne Quinlan, imaging services coordinator at Greene Memorial, this meant replacing a variety of systems. “We replaced our film-based x-ray units with CR, upgraded to three new ultrasound units, replaced our C-arms and portable x-ray, purchased a new CT, and acquired a SPECT/CT system,” she says. The equipment acquisitions took place over a two-year period while Hargrove and her colleagues planned Greene Memorial’s PACS installation. Due to budget constraints, the facility’s administration asked her team to handle all aspects of the PACS project. “Our facility has limited resources and we planned, implemented, and deployed the PACS on our own,” she says. “We did not hire a PACS consultant. We did it from the ground up by ourselves.” Hargrove accomplished this task by educating herself on best practices, as well as pitfalls and potholes, for PACS implementation via extensive research, informational interviews with professional colleagues at other institutions, and attendance at educational sessions such as those provided at the American Healthcare Radiology Administrators (AHRA) annual conference. They went live with their enterprise PACS in October last year. Hargrove says that the radiologists began reading from the system at 8 a.m. and by noon that same day her staff had stopped printing film. She prepared the facility’s referring physicians for the all-digital roll-out by enabling them to work with a web-based system starting in Spring 2006. “We got them interested and excited about digital, but kept printing film for a window of time,” she says. The web system is available to referring clinicians who create an account with Greene Memorial, Quinlan says. Patients who request copies of x-rays or other test result images are now given a copy of the report and images on a CD that is provided at no cost. Greene Memorial has its PACS interfaced with an EMR from a smaller vendor with a radiology module that Hargrove’s staff uses, replacing its use of a RIS and allowing enterprise-wide access to diagnostic images and information. Hargrove reports that not only did they work through this project on their own, but they’ve had no major problems and have saved money with the new system. Although the team planned for contingencies in its PACS budget, they did not have to use the funds, so they are currently under budget projections for the implementation. In addition, the efficiencies created by the deployment have allowed Hargrove to downsize the staffing levels in her department when HealthImaging.com http://HealthImaging.com
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