A health provider network in rural Montana has found that cloud technology brings interoperability and simplicity to the task of sharing radiology images, while saving considerable time and expense in the process.
When Great Falls Clinic radiology manager Gayle Knudson was asked at a leadership retreat in the fall of 2008 to come up with a Big Hairy Audacious Goal (the term coined by James Collins and Jerry Porras in their 1996 article entitled “Building Your Company's Vision” for the Harvard Business Review) for her organization, she came up with something much bigger. Her idea was for the hospitals and radiology facilities in Montana to have a completely interoperable system to share radiology images. The idea was the genesis of the Image Movement of Montana (IMOM), which has moved Montana clinicians forward in terms of health information exchange in a way that few other statewide collaboratives have done so far.
“What we were trying to do was resolve all of the interstate moving of images without [aggravating] the disparities from different PACS [picture archiving and communications system],” Knudson explains. “We wanted to be able to do it with very little cost, less than CDs, and make it seamless with no one facility having to take ownership, and keep politics out of it.”
The model at the time for sharing radiology images at Great Falls Clinic, a 57-physician outpatient clinic in Great Falls, Mont., as well as much of the state, was when a patient's images were needed at another facility, the originating facility burned the images onto a CD and shipped them via FedEx for about $12. The images were then downloaded from the disc to the facility's PACS.
SEEKING AN ALTERNATIVE
Following the retreat, in February 2009, Knudson and her colleague Bill O'Leary, regional outreach and PACS administrator at the 290-bed Kalispell Regional Medical Center, convened a statewide radiology manager/PACS administrator roundtable meeting to refine the plan of attack and develop the guiding principles for IMOM. To try to stay free of politics so the project could move forward more stealthily, Knudson and O'Leary took a backdoor approach and invited PACS administrators rather than CEOs and CFOs.
THE PROBLEM WILL BE IF YOU USE TOO MUCH TECHNOLOGY AND GET TOO COMPLEX, YOU'RE GOING TO KILL THE PROCESS.-ERIC MAKI
According to Great Falls Clinic IT manager Eric Maki, who was brought into IMOM to offer IT guidance, early talks went in many directions that included building out an interoperable electronic medical record. “The technology is out there and won't be the issue,” Maki says. “The problem will be if you use too much technology and get too complex; you're going to kill the process.”
So with a lean goal in sight of solely exchanging images, and with their guiding principles in focus, the next issue facing the leaders of IMOM was funding. After realizing that applying for federal funding would involve much more money than they needed, the group decided to vet vendors by taking their show on the road to Missoula, Billings, Kalispell, and other Montana cities to talk to IMOM members to see what kind of PACS those facilities used. The trip yielded a pool of about eight vendors, which led to a request for proposal (RFP) process.
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