Health Imaging & IT – Integrating RIS/PACS for the Enterprise - (Page 15)

The PACS team also had to plan for different modalities to become DICOM compatible. “Every time we made a purchase or made an update, we had to make sure that we had everything we needed to be compatible with DICOM,” Headrick says. Toward the end of 2000, the hospital created a kind of “mini PACS” to view the digital modalities using GE Radworks dictation stations, compatible for initial modalities such as CT and MRI, then eventually expanded compatibility to include PET, CR, digital mammography and ultrasound. While the makeshift “mini-PACS” was used for image viewing, the IT department set up the infrastructure for the PACS network. This required the installation of gigabyte switches in all hospital network closets to enable all hospital computers to move the PACS images throughout the network at the appropriate speed, according to Director of Information Systems Jason Mashburn. Headrick met with Adams and Mashburn to propose the PACS project to a team of key hospital department heads who sorted out all the budget issues, and presented their results to the Executive Group for final budget approval. The project was given the green light by the hospital’s board of directors in 2003, with permission to start looking at vendors and products in 2004. They started by sending out requests for proposals to different vendors, invited vendors onsite for demos and even had team members conduct site visits as part of the vendor vetting process. After narrowing down the selection in 2005 to two vendors, the team decided to hire an external consultant, Innovative Health Solutions, to assist with the final vendor selection and purchase, specifically with contractual recommendations and details. “These contracts can be pretty extensive,” Hanks says. “The biggest reason we looked to a consultant was because this was a huge investment for the organization, and it was something we had little or no experience in. But they didn’t actually assist us much in making the selection, we did that internally.” The firm reviewed the final two contracts to determine the best pricing and vendor to suit the hospital’s needs. “They assisted us with the contract effort and I think it has paid off in the long run for their attention to detail in the contract,” Hanks says. GE Healthcare won the PACS contract with the hospital at the end of 2005, based on product functionality and features. Once a GE installation team was onsite in May 2006, the RIS/PACS deployment, including staff training, took 18 months. The hospital went live, system-wide on Sept. 10, 2007. “We flipped a switch and there it was,” says Clinical Analyst Charles Price, RN. Hospital staff can now access radiology results, lab results and patients’ electronic medical records via 52 physician stations throughout the hospital. According to the PACS implementation team, the transition has been smooth. “We have had to go back and look at some workflow and re-do processes, but as far as major overhaul goes, everything has been fine,” Price says. “We did have stumbling blocks, but for the scope of the project, this has probably been the best I have been involved in.” The “stumbling blocks” included concurrently running the current mini-PACS while building the new one, and interfacing the new system with the hospital’s other systems such as the hospital information system, the emergency department information system and the radiology dictation system, he says. The PACS team provided extensive training for staff during the entire implementation process, not just for the radiologists, but for general hospital staff as well, so that the user base was ready and “they were ready to jump on this when it was turned on,” says Hanks. “I think one of the biggest reasons for our success with our training was that we had a GE data workflow specialist help us design a workflow and after the workflow was developed, we used that to train everyone,” says RIS/PACS Manager John Cadieux. “After go-live, we still went with the expectation that we were going to use that workflow designed by GE, but then we had to adjust on the fly because some of the steps didn’t work out.” Post go-live, the PACS team has monitored film costs, which have dropped significantly, and report turnaround, which is faster, to see how patient care has improved. The PACS project team attributes the majority of the successful implementation to the cross-disciplinary team and the extensive training provided to the medical staff. “This was a team effort—if we got pushback from anyone, it could have turned into a nightmare. But we didn’t,” Hanks says. “We have increased workflow efficiency, not just for radiologists, but the surgery department as well. It is really just amazing how much faster they are getting to their reports and to their images now for more efficient care for patients.” n Keys to Successful PACS Implementation Here are some words from the wise for RIS/PACS deployment. ✓ Create a multi-disciplinary team. Start the planning process with a team of people that the deployment will directly affect, including radiologists and the IT department, to adequately assess the organization and know its strengths and weaknesses. ✓ Consult with the It department. It is key to get input from the information systems team early on because they can look beyond the surface of the software demo to tell you if the product will interface with department and hospital information systems. ✓ understand the contract. Pay attention to contract details because regardless of what you see or hear, what is in the contract (such as features, timeframes for implementation and milestones to determine success) is what rules. This can prevent huge cost overruns. ✓ don’t scrimp on hardware. Make sure there are enough PCs and PACS workstations for staff to view images so patients and clinicians are not kept waiting, especially on the day of the go-live. ✓ train everyone, well. If users can’t use the system, it doesn’t matter how sophisticated the software is—the implementation will fail. Providing extensive training for staff before the system ever goes live helps make for a smoother transition. ✓ have enough staff on-hand. You need a dedicated team to focus on the project. Pick an appropriate amount of welltrained “super-users,” ideally one per modality, in preparation for problems during go-live. HealthImaging.com Integrating RIS/PACS for the Enterprise http://HealthImaging.com

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Health Imaging & IT – Integrating RIS/PACS for the Enterprise Table of Contents Integrated RIS/PACS: Making Work Flow Singular Benefits: Integrated RIS/PACS Delivers Imaging Center Battle Strategies: Combating DRA Spurring Reading Efficiency in a Large Imaging Center Group Creating the Global Imaging Record RIS/PACS for the Community Hospital What’s the Best? Single Vendor vs. Best of Breed

Health Imaging & IT – Integrating RIS/PACS for the Enterprise

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