Mobile medical images challenge PACS administrators

The growing use of tablet devices and mobile phones by doctors for viewing medical images, pose a number of challenges for PACS administrators. Dr. David Hirschorn, is the director of radiology informatics at Staten Island University Hospital, N.Y. and a researcher in radiology informatics at Massachusetts General Hospital, Boston. He is also a member of the American College of Radiology IT and Informatics Committee, serving as a representative to FDA for mobile medical devices. He was a featured speaker at the Sept. 10 NY Medical Imaging Informatics symposium. PARCA E-News spoke to him, by cell phone (of course) to ask about these challenges.

Q. How did you become interested in medical imaging on mobile devices?
A. I’m a radiologist who researches  displays. For years I’ve looked at what we really need in order to read an x-ray or a CT scan. They make medical displays that are a lot more expensive than consumer displays.

PACS News Roundup

Meaningful Use stage two emphasizes encryption

A point of increased emphasis for the meaningful use (MU) Stage 2 final rule is encryption of “data at rest”—the patient-identifiable information stored on servers, hard drivers and portable devices. The increased emphasis most likely is due to the more than 50,000 breaches reported to the Office of Civil Rights since late 2009 when healthcare organizations were first required by the ARRA to notify the government of their breaches. More

iPad equals secondary-class LCD for reading emergency spinal MRIs

A study in the Aug. 2012 Academic Radiology researchers compared the iPad with secondary-class LCD monitors for reading emergency spinal MRIs. They concluded the displays had no statistically significant differences in diagnostic accuracy, showing that mobility doesn’t necessarily have to come at the cost of reader accuracy. More

Study shows how to handle massive increase in outside imaging study requests

Facing a 1,400 percent annual increase in requests for interpretation of outside imaging studies from 2010 to 2011, the Department of Radiology led by Dr. Stephen Reis at Westchester Medical Center in Valhalla, N.Y., analyzed the workflow issues and identified six key problems for handling the requests. As reported by HealthImaging.com, the researchers shared the department’s workflow solution in August issue of the Journal of the American College of Radiology. More

Multi-site hospital system slashes PACS downtime via workflow continuity model

In an analysis of a workflow continuity system implemented by the University of Pittsburgh Medical Center (UPMC), a PACS team led by Brian Kolowitz found that downtime was reduced by 94 percent from 2008 to 2011. The impact of unplanned downtimes was reduced by 72 percent while the impact of planned downtimes was reduced by 99.7 percent over the same period. The study appears in the July 2012 Journal of Digital Imaging. More

Integrating imaging with EHRs through the Cloud

In advance of next month’s Society for Imaging Informatics in Medicine (SIIM) 2012 annual meeting, PARCA talked with K. Thomas Pickard of PACSGEAR. At SIIM, PACSGEAR  is announcing an upgrade to its popular MediaWriter technology to offer cloud-based open image exchange. In just 10 years PACSGEAR technology has been adopted by one in three U.S.hospitals. Thomas currently serves as PACSGEAR’s vice president of Marketing and Business Development. Previously he held roles at Emageon, eMed Technologies, and Thinking Machines. Thomas has an MBA from St. Mary’s College of California and has been working in healthcare IT for over 15 years.

Q. For those who may not be familiar with PACSGEAR, what do you do?

PACSGEAR essentially does two things: connect images to PACS and integrate them with EHRs. A new area of interest to your readers is the open image exchange.

PACS News Roundup

EMR use critical for documenting workflows 

Heart Rhythm Society Scientific Sessions
BOSTON – May 9, 2012 – It is critical to document workflows and develop a feasible adoption timeline when attempting to use EMRs to assist with pain points, stated Fred M. Kusumoto, MD, of the Mayo Clinic Jacksonville Electrophysiology and Pacing Services in Jacksonville, Fla., on May 9 during the 33rd annual scientific sessions of the Heart Rhythm Society. (More)

Medical imaging incident reporting system could boost patient safety

PHILADELPHIA – May 7, 2012 – From doctors who don't follow imaging protocols to hospitals that cut radiology staffing corners to save money, the dangers of radiation overexposure continue to dog healthcare. Researchers writing in the May edition of the Journal of the American College of Radiology said the healthcare system could improve radiation safety with a national incident reporting system for medical imaging. (More)

Opinion

RIS/PACS integration issues when performing multi-modality studies

When using a RIS, PACS and a voice recognition or traditional transcription reporting system from different vendors, many institutions are having integration issues with mapping the orders to the performed studies and resulting reports. These scenarios are well documented as part of the IHE scheduled workflow profiles; however, not every system is fully compliant with the information model, which covers the relationship between the orders, studies and reports.  (From time to time individually written articles that have been reviewed by the Advisory board of PARCA that are relevant to improving patient outcomes, workflow and productivity will be included in the PARCA Newsletter.) (More)

AHA blasted for 'Hail Mary pass' on meaningful use

WASHINGTON – May 03, 2012 – No sooner had the American Hospital Association submitted its comments on the proposed rule for Stage 2 meaningful use than they came under fire for "spurious" arguments on patient access to online information. “We know from the last two years of public debate on meaningful use that the association has really pushed back hard on the requirement around giving patients access to their health information electronically,” Christine Bechtel, vice president of the National Partnership for Women & Families, and a member of the federal Health IT Policy Committee, told Healthcare IT News. (More)

Hospital CIO survey shows connecting independents is priority

NEW JERSEY – April 25, 2012 – While a majority of hospital CIOs responding to a recent survey conducted by healthsystemCIO.com say they are participating in regional health or system-to-system information exchange efforts, they expressed disappointment with the slow and inconsistent progress.Twenty percent of respondents said that adoption rates have been disappointing, citing limited interest by providers and resource constraints as key factors, while just 17 percent noted that they’ve had a high degree of success. (More)

Leading Views

Larger Role for Informatics and IT Pushing PACS Administrators

The evolution of healthcare technology in the U.S. is pushing PACS administrators to rapidly adapt to the growing role of information technology in healthcare, as data from specialists need to be integrated with hospital systems and beyond. In a RSNA 2011 session titled "Radiology Informatics: Fundamentals for the Future," Keith Dreyer, DO, vice chairman of radiology computing and information sciences at Massachusetts General Hospital, discussed quality mandates surrounding image interpretation, reporting and access and how informatics and IT will play an ever larger role in the future of radiology. Dr. Dreyer elaborated on his vision of that future in a Q&A for the PARCA e-newsletter.

Q. In your RSNA session you talked about a “new age for radiology,” can you briefly describe that new world?

As patient centric initiatives such as the CMS Meaningful Use program take hold in radiology our services (and subsequently our IT systems) will need to expand beyond the wall of the department or imaging center.  Even beyond our provider enterprise to integrate to other care providers and patients themselves.  Currently, PACS systems are silos providing merely an electronic version of film with limited communication capabilities.  RIS systems are also inward facing and do little to provide meaningful interactive communication beyond the department to our ordering clinicians and our patients.  In a patient centric world, our systems provide very little other than to serve as limited edge devices for EHRs and PHRs.

PACS News Roundup

Bill would smooth medical licensing for telehealth
Feb. 7, 2012 – A bill expected to be introduced in Congress this year aims to make it easier to use medical licenses across state lines. As reported by Auntminnie.com the bill will create a comprehensive and interoperable database of verified physician credentials that would provide a tandem state/national license that would allow physicians to provide telehealth services in states accepting the tandem license. Currently each state requires its own license to practice medicine within its borders. The system complicates and hinders use of technology to deliver health care more efficiently in some cases via telehealth technology. (Read more)

Case study documents benefits of implementing PACS
Feb. 2, 2012 – Double-digit gains in productivity and efficiency were the results of a system-wide implementation of a PACS for the University Hospitals Case Medical Center (UHCMC) in Cleveland, according to a case study published in the February issue of Academic Radiology (requires subscription).  As reported by HealthImaging.com, the study showed that following the full implementation in 2009, radiology exam volume doubled from 269,750 in 2003 to 722,661 in 2010. The reduction in film use saved $3.2 million, and turnaround times were cut from 80 hours in 2002 to 20 hours in 2010. (Read more)

Is DICOM a non-standard standard?
Jan. 31, 2012 – Dr. John D. Halamka, set off a spirited debate with a blogpost stating that DICOM is a non-standard standard. As chief information officer of Beth Israel Deaconess Medical Center and Harvard Medical School and chairman of the New England Healthcare Exchange Network his opinion is highly regarded, and his opinion opened up a lively discussion of the DICOM standard. Members may want to weigh in on the discussion. (Read more)