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Architecting an Imaging Informatics Interoperability Strategy in Southern California

December 11, 2012
by Mark Hagland
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Pasadena’s Huntington Hospital implements an imaging informatics interoperability strategy

Rebecca Grant, director of imaging services at the 625-bed Huntington Hospital in Pasadena, Calif., has been particularly busy of late. Grant, whose original background was as a radiology tech and then radiology department manager, now supervises operations for a radiology department staff of 70, including 19 radiologists. In October, she and her colleagues signed an agreement for a new PACS (picture archiving and communications system) for Huntington Hospital with the Chicago-based Merge Healthcare. The new Merge system will replace a current system from another vendor. Meanwhile, the Merge system will be able to interoperate with the cardiology PACS system from GE Healthcare that has been running in the cardiac catheterization area.

Grant sat down with HCI Editor-in-Chief Mark Hagland on Nov. 27 while both were participating in the RSNA Annual Conference being held at Chicago’s McCormick Place Convention Center. Below are excerpts from that interview.

What made you and your colleagues decide to leave your existing PACS vendor and move over to Merge’s solution instead?

It came out of our existing PACS vendor’s inability to be flexible and to provide us with the type of information we need to work with our partner, Hill Radiology Group—they’re adopting Merge, too, and are leave the same existing vendor. We have two joint ventures with Hill Radiology Group: they own and run an imaging center, and we’re silent part-owners in that. We also own a breast care center, but they run it for us. So, there are two joint ventures involved, though our businesses are separate. We’ve been trying to be able to pull up images and priors from separate companies. And no one’s been able to do that before Merge. They help us pull up priors and have a unified worklist, with a VNA [vendor-neutral archive]; that’s what they offer us.  So, to summarize, they’re very flexible, their product is extremely flexible, and they work with their partners. We needed all of that.

Rebecca Grant

Issues around flexibility were top of mind during your selection process, correct?

Yes. We did several site visits with Merge current customers during our selection process, and they told us that if we didn’t like particular elements, those elements could be changed. We also asked all four vendors we were considering, to respond to us regarding 32 elements we were looking for, and Merge outperformed the competition. The main requirement, though, was the ability to pull from two servers, and to provide a unified worklist; and the others either didn’t have the technology or hadn’t implemented it yet. The impact obviously is better patient care. You gain important efficiencies with your doctors not having to work from two different work stations and systems.

What is your situation with regard to your RIS [radiology information system]?

We’ve had the same vendor for our core EHR [electronic health record] and our RIS. But we’re switching from our existing system to both the EHR and RIS from Cerner [the Kansas City-based Cerner Corporation]. Our existing EHR and RIS vendor hasn’t evolved into a modern system.

What do you hope to accomplish in the next few years?

We’re developing something called the Huntington Health eConnect System. It would allow any physician in our area to access patient medical records, images, history and physicals, surgical reports; and allow them to put their own records on this cloud. So our goal is to have an integrated, web-based product that would allow physicians to have access to data in our community.

That sounds like something between a cloud and an HIE [health information exchange]?

Yes, that’s right. Rebecca Armato, our director of physician IT, and I, have discussed the strategy for this. We would like to create a robust platform available to maybe go into an ACO [accountable care organization], which would include our own hospital and the 800 physicians in our area. We do have some employed physicians, as well as affiliated physicians.

What kinds of pieces  of an IT foundation does an organization need in order to become an accountable care organization?

Huntington Hospital is right at the forefront of that expectation of having all those pieces in place. We have a comprehensive cancer center; and a comprehensive radiation oncology department. We have built relations with our radiology groups. We have other types of relations with other physician groups that we work with, such as, we’re a comprehensive stroke center, and we’ve just contracted with other local hospitals that can’t get stroke-certified, to take care of their patients.

How many diagnostic imaging procedures does your organization perform every year?

About 120,000 studies at the hospital itself; the outpatient studies are within the medical groups.

What should CIOs and CMIOs know about your experiences so far with imaging informatics development?

Now that everybody’s digital, it’s absolutely essential that patient care organizations give access to patient records to the physicians in their community, and to their patients as well. They have to have access to those images and that information, for continuity of care. Without that, you end up repeating tests, and so on, because of all the problems everyone has had trying to work with [saving diagnostic images on] CDs. This makes it easier for physicians to have access to their care; that’s the bottom line.

So it’s all about interoperability?

Exactly. It doesn’t matter what systems you have, what types of servers you have, what technology you have in your house. You have to be able to pull from all those systems. That’s what’s so key and so exciting about this. More broadly, Huntington Hospital is so embedded in the community; there are so many things we do in the community. We give good care, and if we give good care, it seems clear that the reimbursement will come in at the end.

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