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Climb Every Mountain

November 1, 2007
by root
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Getting the right PACS may feel like climbing a mountain, exhausting and never-ending at the same time

When it comes to identifying an organization with a clear need for information and imaging technology, it's hard to imagine a more worthy one than the Interior Health Authority of British Columbia (IHABC).

This regional health authority, which is responsible for managing the healthcare services of the southern interior region of British Columbia, is in charge of a vast geographic area the size of the state of Oregon that stretches from the Rocky Mountains on the east to the Pacific coast on the west, in Canada's westernmost province. Yet it is also a vast area with an extremely sparse population, and no large metropolitan areas. The IHABC's headquarters city, and the region's largest community, Kamloops, has a modest metro area population of 150,000, surrounded by mountains and valleys. And the patient population of the region already travels significant distances to access its hospitals and medical clinics.

Not surprisingly, says Anne Baldwin, R.N., regional diagnostic imaging manager for the IHABC, the prospect of creating a region-wide PACS and unified EMR made intuitive sense as soon as the region was created several years ago. And in fact, the region-wide PACS/EMR began to emerge early in 2001, at the same time that the regional authority was being created (British Columbia was going through a health authority reorganization process at the time). By mid-2006, the initiative had gone live in its entirety, with a unified PACS system from San Francisco-based McKesson Corporation, and a core EMR (which had already gone live in stages and was fully live by 2003) from the Westwood, Mass.-based Meditech. In terms of volume, there are 1.8 million unique patients on the unified master patient index, and about 500,000 images in the system.

The result? Turnaround time for availability of diagnostic images to radiologists in the region has gone from an average of 68 hours to a guaranteed 24, Baldwin reports. And, she adds, “It used to take three days to find out the results of the tests; now, three minutes is too long” for the ordering physicians. The doctors love the system, she says, and it's clear that not only has patient safety been enhanced; the complicated transportation dilemmas (for patients, doctors, and healthcare facilities) of the past have been solved. In fact, she says, in U.S. terms, what has been created (entirely with government funding) is equivalent to a statewide regional health information organization (RHIO). The difference, she concedes, is that the regional health authorities within the Canadian provinces have centralized governance and management, and full public funding, elements lacking in the United States. Still, says Baldwin, the success of the IHABC initiative demonstrates that PACS diffusion across even the most diffuse corners of a defined geographic area is possible.

The IHABC's initiative has an echo in the efforts of the Ochsner Health System to diffuse image management capability out to a wide swath of the greater New Orleans region. Through concerted effort, CIO Lynn Witherspoon, M.D., and his colleagues (see main story) have integrated their EMR and PACS systems, even as they went through organizational change with the acquisition of some former Tenet Health hospitals, following Hurricane Katrina in 2005. In the post-Katrina world of the New Orleans metro area, says Witherspoon, community-wide image diffusion has become a necessity.

What's more, he adds, “This is also a huge ‘wow’ with the patients, when the physician can show the patient on the PC monitor their chest X-ray and lab results on the same screen, for example. They love it and appreciate that the physician caring for them has access to every piece of data about them.”


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