As one of the nation's largest private practice radiology organizations, Southwest Diagnostic Imaging (SDI) provides comprehensive diagnostic imaging services to the entire Phoenix metropolitan area. Comprised of three radiology practices – Valley Radiologists, Scottsdale Medical Imaging, and EVDI Medical Imaging – SDI annually interprets more than 2.6 million exams across 35 full-service imaging centers and 12 regional hospitals, including Banner Health, HonorHealth and IASIS Healthcare.
Like many evolving healthcare institutions, SDI struggled to reconcile and exchange patient data and imaging files from multiple systems and locations. For years, radiologists spent much of their day writing addendums into patient records, because information at the point of care was missing or incomplete. At times, radiologists could not access patient studies from hospitals just 150 yards away.
To give their providers a consolidated view of any given individual, and enable greater clinical and operational efficiency, SDI’s leaders partnered with the Monrovia, Calif.-based NextGate, implementing the company’s enterprise master patient index capability to achieve real-time, cross-platform patient identification. The EMPI allows for seamless health information exchange and a longitudinal view of a patient’s medical and imaging history.
Moving ahead with this initiative has led to a number of advances. Among them, SDI leaders have been able to streamline physician workflow and productivity; automate real-time patient matching and duplicate record detection and resolution, thereby reducing the administrative waste involved in having to pursue manual patient lookup and identification; improve practicing radiologists’ confidence in data quality and accuracy. The organization’s leaders estimate that they have averted over 100,000 patient-record duplications since implementation of the solution. Indeed, they report, in the process of implementing the solution they found one individual who was associated with 50 different patient records, with 50 separate account numbers.
Recently, two of SDI’s leaders, Travis Haskins and Brian Frohna, M.D., spoke with Healthcare Informatics Editor-in-Chief Mark Hagland. Haskins is the organization’s CIO, and has been with the organization since 2000, while Dr. Frohna has been a practicing radiologist for 24 years, and is the group’s chief technology officer. Below are excerpts from that interview.
Please share with us a sense of the scope of the challenges you faced, and of this initiative.
Travis Hoskins: We have about 4.5 million patient lives we’re managing in our system, and the streamlining of managing patient demographic and other related patient information, saves us time, as opposed to having six or seven disparate systems to independently manage. As we continue to build the system out, a process that used to involving merging five or six different systems’ information to merge into a patient, has become just one system to merge.
When did you begin this initiative?
Travis Haskins: A little over three years ago, we identified that our systems were aging; this was part of a much broader system overhaul for most of our applications. So we embarked on better managing patient lives, implementing a better RIS [radiology information system] system, which went live just a few weeks ago, and on automating systems that used to be handled manually by individuals. There’s a lot of ingestion of outside forms and images; we’ve bene working on automatic order generation. We’re working on the ability to automatically receive a patient into the system and link an order to a RIS; these are all processes that used to be done manually.
What kind of governance process have you established around this multi-pronged initiative?
Brian Frohna, M.D.: A couple of years ago, three organizations got together to form this umbrella organization, SDI, for several reasons, one of which was to streamline and unify processes under one umbrella organization, even as the two physician practices remained operationally separate. Eventually, we brought a third and a fourth organization in, and we realized we had patients who had interacted with each organization separately, sometimes with demographics that matched, such as the same name, address and phone number, and those records were relatively easy to match; but we also found that there was a large number of patients whose demographics didn’t match identically, so that’s what required manual processes to de-duplicate. So, bringing in [vendor] helped make that easier. On top of that, our organization, Southwest Diagnostic Imaging, does billing for the hospitals as well. We have a number of contracts with hospitals here in the valley.
And we needed to get the patient a common medical record number, the EMPI number, so that everyone could be aware of them across inpatient and outpatient, all the transitions of care. And creating this makes that process more efficient, and also makes us aware of prior outside studies. And as most radiologists know, having awareness of a prior chest x-ray or CT scan makes us that much smarter.
Brian Frohna, M.D.
Do you know the volume of petabytes of data stored in your systems?
Haskins: Currently, we have approximately 500 terabytes of data.
You’re talking about 4.5 million patients across the valley, correct, and stored in a unified database, then?