Interoperability Imperative

I’m sure you can understand how critical that is for us. We used to have a contract form that would basically hold my IT department hostage, if a physician had a problem, and they would call us to come back and fix it. And even when a vendor upgrades their software, they usually require a new version of these applets, and often, the new versions of the applets conflict with older versions of the applets.

HCI: So how has it all worked out?

Roy: It’s working fine; we have a number of doctors using it. Right now, we’re in the beginning stages of this; there are about 50 outside referring physicians using the system; we do have some of our own physicians using it, though it has a more limited tool set than the full Merge. And the other thing is, I didn’t have to build any results interface or interface of a dictated report from a radiologist, to the iConnect server, because the iConnect server pulls directly from my PACS server.

In other words, because we had built this directly in our PACS infrastructure, we didn’t have to build it again. And if a referring physician wants to look at prior data or images, they can do so. It’s not like this is a separate system sitting out there with limited storage and after a certain period of time, cases fall off. Because this accesses our archive, it’s pretty unlimited.

HCI: What is the current quantity of storage in your system?

Roy: Altogether, we’re approaching about 100 terabytes, with about 70 of those terabytes being imaging-related. And the next big area of growth will be from cone-beam CTs in radiation oncology; the image acquisition, in comparison to diagnostic imaging, is a lot larger.

HCI: What strategic lessons have been learned so far?

Roy: Let me put it in terms of challenges. One of the challenges that we face as a group is ensuring that vendors pay as close attention to the folks who are in maintenance mode, as possible. We’re paying huge maintenance fees every month, and that’s a steady revenue stream for most vendors; and they kind of lose sight of you when you’re trying to move to an upgrade, or whatever, because they’re kind of focused on the next large group to land. And that’s not any vendor in particular, it’s just true of IT in general.

The other challenge is meeting specific IT needs that might not be of a standard cut. For example, we’re branching out into teleradiology. And we already have contracts with some groups that have freestanding imaging centers and a couple of hospitals, and so forth; and that business model is tweaked a little bit from our normal business model.

Meanwhile, it can be a bit challenging when we need to tweak the IT model; it is hard for our vendors to keep up with our pace. The other thing is, if you’re doing business outside the four walls of your group, you can run into the challenge of disparate systems, medical record numbers, and so on; all that kind of plays havoc with us. And so the more integration you can get, the better off you are.

HCI: Do you see other CIOs of other groups like yours following the same types of paths forward?

Roy: I think we’re all faced with similar problems, with regard to reimbursement and such. But every group like ours has a little bit of a different relationship with hospitals. Here, we don’t have our PACS systems in the local hospitals. I know of medical groups that actually provide the PACS systems for the hospitals. I’d love to have that scenario, not just to build a kingdom, but it would become 100 times easier to build business not only with the hospital, but with the referring physicians.

With one of the hospitals here, where there are prior cases done at the hospital or one of our outpatient imaging centers, we have a collaborative archive to share cases for prior relevancy, and we also allow referring physicians to access that archive, with an agnostic viewer. But with the other hospitals in the area, we have all different types of arrangements.

HCI: Are you optimistic about the future?

Roy: Yes, I’m very optimistic going forward.