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Pursuing Interoperability in Imaging

March 5, 2012
by Gabriel Perna
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One independent radiology group in Virginia discusses how they have found interoperable imaging success

The various imaging informatics problems in healthcare have been well documented. There is a higher volume of images coming in, less radiologists to receive them, numerous picture archiving and communication systems (PACS) in the market and a dearth of interoperability when it comes to moving through different systems. Furthermore, thanks to the Health Insurance Portability and Accountability Actof 1996 (HIPAA), hospitals are less willing to commingle their data with radiology groups.

Like many others in the radiology industry, Reston Radiology Consultants, an 11-physician outpatient radiology group based in Reston, Va., servicing hospitals in the Washington D.C. area, has dealt with these issues. The group, which conducts 24,000-25,000 MRI scans per year, one of the highest numbers for a private site on the east coast, found a way to get its disparate systems in all the different radiology systems working cohesively.

According to Reston Radiology chief operating officer Jeffrey Atkin, the answer has been Merge Healthcare (Chicago). Reston will use the imaging solutions provider for its radiology imaging system (RIS), MRI-CADStream, its portal, and its financial systems. “We looked at who was the best for each solution, and fortunately we’ve always had Merge as the top 1-2. Having that proverbial one throat to choke makes it easier,” Atkin says.  The Merge systems, he says, will help Reston achieve meaningful use as well.

Jeffrey Atkin

Making Interoperability a Priority

However, of all the systems Reston has used from Merge, iConnect may be the most beneficial, according to Atkin. iConnect is an interoperability software platform which allows Reston’s radiologists to get remote access to the image on any device regardless of the PACS system in place, almost instantaneously.

“What’s remarkable about this remote access tool is the one major product we don’t have is Merge’s PACS solution,” Atkin says. “We have one of the other vendors. They were able to painlessly integrate into that vendor, and this vendor isn’t known to play well with others. It’s really been a spectacular experience for us.”

In addition, it’s cost-effective for Reston Radiology, according to Atkin. Like many outpatient, independently-owned radiology groups with sub-specialty doctors, Reston can’t afford to bring too many radiologists on board. As Atkin puts it, “We try to leverage a tremendous amount of reads with a minimal amount of radiologists.” Because it hooks up to various mobile platforms, iConnect allows Reston’s radiologists to offer an opinion even when they aren’t in the office at the time the opinion is needed. Atkin cites the example of when one of the neurology specialists at Reston was able to offer his opinion through the iConnect app on his iPhone, even while he was at dinner.

Ease of Use, Other Benefits

Thanks to Reston Radiology’s investment in a cache server with a terabyte of available storage, there are no issues with image slowdowns, according to Atkin. The server gives Reston a six-month buffer that allows it to keep that instantaneous access.

For Atkin, the investment came down to several things, most importantly, “It has to work – bar none.” This operational effectiveness, Atkin notes, is critical in emergency situations. In addition, he had to prove a return on investment. Compared to the old way of storing and managing images, CDs, he says iConnect has allowed them to cut that number in half. This has saved them, approximately in a conservative estimate of $70,000, which paid for the hardware and training. In addition, he looked at other things.

“The investment doesn’t do you any good if it’s not easy to use,” Atkin says. “If you look at why the iPhone is so successful, it is very intuitive. With this thing (iConnect), I never received training, I just started poking around. You need something that you don’t need to train a doctor on. Doctors have too many things going on. It needs to be easy to use.”

In terms of security, Atkin says everything is encrypted. The server is protected with the same security that the government requires, he says.

For the future, Atkin foresees the iConnect being a platform that will then be used to distribute other sorts of data. In particular, he would like to see it as be put in place as a shortcut on EMRs, as well as allow patients to easily access their images via a patient portal.