For the first time, Imaging Technology News invited readers to nominate U.S.-based outpatient imaging centers that have built up their IT infrastructures and qualify them as a “Most Wired Outpatient Imaging Center.”

This article appeared in Imaging Technology News, May 2010 Issue

Most Wired Outpatient Imaging Centers

Totally digital, vendor-neutral environments secure the future of imaging centers.
Only the strong and most wired will survive.

This never rang so true for outpatient imaging centers as it does today. With drastic cuts in medical imaging reimbursements, imaging centers must be more nimble than ever. The centers that implement information technology (IT) to leverage interoperability, track business trends, protect data, and enhance patient safety are securing their future.

For the first time, Imaging Technology News invited readers to nominate U.S.-based outpatient imaging centers that have built up their IT infrastructures and qualify them as a “Most Wired Outpatient Imaging Center.”

The four centers featured in this article best met the challenging “Most Wired” criteria....

The “Most Wired” Criteria:

1. Interoperability: The center interfaces with disparate IT systems.

2. Reading tools: The center provides radiologists with IT solutions to manage and read images.

3. Business tools: IT solutions that track trends and support marketing efforts.

4. IT for equipment (safety): IT solutions for safer patient care when using equipment.

RadNet Inc., Calif., N.Y., N.J., Del., Md., Fla. and Kan.

Interoperability: With 175 imaging centers in seven states, RadNet uses several different picture archiving and communication systems (PACS). These PACS include GE Centricity PACS-IW, Philips iSite, Merge Fusion PACS, Chili PACS, and RamSoft PACS. These are all interfaced with two separate radiology information systems (RIS), GE Centricity RIS-IC and Merge Fusion RIS. Their specialty PACS include Thinking Systems PACS for nuclear medicine, Hologic PACS for digital mammography, CadStream, DynaCad, and GE Seno Advantage Workstations for mammography, R2 and iCAD for mammography computer-aided detection (CAD), BABE for obstetric ultrasound, and other specialty systems.

There are more than 450 radiologists that both work for RadNet and practice at hospitals. The hospitals RadNet works with interface with different PACS installed at RadNet, including: Centricity PACS-IW, McKesson, Amicas, Carestream, Cerner, and others.

Numerous electronic medical record (EMR) systems are used, including: AllScripts, McKesson Practice Partners, Alteer, RedWood MedNet, GE Centricity, Doc Assistant, OncoEMR, ARIA, Synergy, NextGen, SpringCharts, Practice Fusion, AllMeds, Epic, Aprima, SoapWare, Logician, ALN, Medical Office Online, Go Partners Healthcare Solutions, and eClinicalWorks.

RadNet interfaces its data with several regional networks, including: regional health information organizations (RHIOs), healthcare information exchanges (HIEs) and portals. RadNet plans to allow patient information, with appropriate consent, to be published in Microsoft HealthVault and Google Health personal health records.

PACS are all Web-based, providing referring physicians and off-site radiologists with complete and secure access to images and reports. The center supports Web-based access to fused PET/CT images the iPhone. Plus, Web-based order entry is interfaced to the appropriate outpatient center’s RIS.

Reading tools: To facilitate report turnaround, centers use digital dictation systems from Dictaphone and WinScribe, speech recognition using PowerScribe and structured mammography report generation using RIS. Structured obstetric ultrasound reporting uses the BABE system.

Appropriate image ordering is controlled with a Web-based e-ordering solution. RadNet is developing a critical findings notification solution, whereby a radiologist dictates a critical finding and annotates key images. The system hunts the physician down on his or her preferred device: iPhone, BlackBerry or SmartPhone. If acknowledgement is not received in a timely manner, it hunts down the designated backup person.

Business tools: RadNet uses call centers to schedule patient appointments and track the number of calls each scheduler makes.

A workflow assignment engine distributes the workload amongst radiologists. The centers measure diagnostic equipment efficiency in the context of declining reimbursements for each modality.

Over a dozen billing interfaces extract billing information from the RIS. This information is then scrubbed for appropriate reimbursement coding using CodeRyte coding software, and then passed to the McKesson MD-IV Reimbursement Operations system. The McKesson MD-IV system also tracks analytics.

In addition to off-site replication, RadNet also uses diverse routing for facility wide-area network (WAN) connections and diesel generators.

IT for equipment (safety): RadNet is spearheading a new initiative to aggregate lifetime radiation exposure data for patients, and participating in regional repositories to track patient radiation exposure.

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