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Interoperability Imperative

March 23, 2011
by Mark Hagland
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How one multispecialty medical group got strategic around diagnostic image-sharing

Craig Roy, who has been with Radiology Associates of Sacramento (RAS) for more than 14 years, first as director of IS and then as CIO, has been focused intensely on improving and optimizing the informatics landscape for his 60-plus-physician medical group, Radiology Associates of Sacramento. The group, which continues to expand through acquisition and development, currently includes about 45 radiologists, about 15 radiation oncology physicians, and four nuclear medicine specialists, and provides services in a broad range of areas, from radiology to nuclear medicine, to radiation oncology, gynecologic surgery, vascular surgery, urology, and medical oncology.

As Radiology Associates of Sacramento, already the largest private radiology group in Northern California, has continued to grow and expand, the need for its physicians to make use of interoperability solutions has become more and more pronounced. Early this year, RAS announced that it had successfully implemented two of the five components of the iConnect suite of interoperability solutions from the Chicago-based Merge Healthcare (the suite’s zero-footprint viewer, and its vendor-neutral archive), in order to successfully share diagnostic images and other clinical content across disparate clinical systems. Roy spoke recently with HCI Editor-in-Chief Mark Hagland about his experiences in driving interoperability forward in a multispecialty physician group environment. Below are excerpts from that interview.

Healthcare Informatics: Is the growing diversity of your medical organization part of what moved you towards an interoperability strategy?

Craig Roy: That’s right. We had acquired these businesses and simply took over whatever information systems they had and converted them over to our core system; so we added a module for medical oncology, for example. Our urology group uses NextGen [the Horsham, Pa.-based NextGen Healthcare] as its EMR. Meanwhile, our radiation oncology solution is from [the Stockholm-based] Elekta.

Craig Roy

HCI: What has the timeframe been for your IT development?

Roy: About two-and-a-half years ago, we started to talk about the strategy of bringing newer businesses into our practice in order to make our group stronger, since we saw the radiology specialty becoming somewhat commoditized. So we looked at clinically relevant practices that we could integrate into our practice. And the non-radiologists have come in within the past two-and-a-half years. We first brought in the vascular surgeons; then the medical oncology and urology specialists thereafter, within about a year. We’ve since incorporated one oncology group and two urology groups.

HCI: So you needed to create a vendor-neutral archive to support image management across the archive?

Roy: We actually had had Emageon, now part of Merge, as a vendor-neutral archive, for over five years. And we chose Merge as our PACS [picture archiving and communications system], partly because of their adherence to DICOM standards; Merge was our first PACS system. And one of the driving factors behind choosing a PACS system was that Merge’s archive was set up according to DICOM standards, and we could use that in the future if we wanted to change out PACS vendors. Since that time, you know, everyone has a little bit of proprietary aspect built in, but it’s still possible to use any viewer with their archive.

HCI: When did you go live with Merge’s vendor-neutral archive?

Roy: We went live right around the spring of 2004.

HCI: And you went live with iConnect at the beginning of the year, right?


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