Post on 16-Jul-2015
transcript
BEAMING IMAGES
RADIOLOGY PACS IMPLEMENTATION- THE ROAD TO A
FILMLESS ENVIRONMENT
MembersRobert E. Henkin, MD, Mary Olson, MD, Robert H. Wagner, MD, Denise Punka, James Halama, PhD, John Tu,
MD, Art Krumrey, Tess McCoo, James Ryva, Mario Ayala, Gary Stevens,
Renee Abelarde, Ron Price
Opportunity for Improvement
Radiology operation has shifted from a primarily hospital based operation to a combination of hospital, out-patient and multi-satellite. Hard-copy films were no longer serving the demand for viewing the study in various locations at the same time. Due to manual distribution of films, there was a significant risk for losing or misplacing them making it unavailable for review, reading or copying.
Most Likely CausesMulti-disciplinary physician practice
requires the films to be reviewed by multiple physicians in various locations on the same day
Transport of films from site to site was a manual process which takes time and sometimes contributes to the loss of films
Lost film sometimes cannot be reconstructed and this causes non-read of films, repeat procedures and bad service to clinicians
The network served by the department is dispersed into a large geographical area such that manual distribution of films no longer serves the needs of the operation
Solutions implementedReplaced old X-Ray equipment with DR and
CRsPurchased & implement a PACS systemPurchased CR plates for small satellites Integrated modalities and the PACSIT arranged access to images via web-browser &
worked with Dr. Tu’s group to post images & results in the EMR
Deployed PACS viewing workstations in strategic areas
Designed QA processes to monitor key steps
Radiology PACS
PACS ? What is PACS?PACS stands for Picture Archival and
Communication System. It is a technology that allows images from procedures (CT Scan, Nuclear Medicine, Diagnostic X-Rays etc) to be stored in digital form in a computer (central archive). The images can then be accessed by various users such as a Radiologist to interpret the study or an attending physician to look at the pictures and to view the report. Images can be viewed using a special workstation or on a regular PC via a web-browser.
PACS Deployment-LUMC
PACs Workstations are in
Main Reading RoomCT Reading RoomNeuro Reading RoomNuclear MedicineUltrasoundSpecial Procedures
Reading RoomEROR-Physician Lounge
PACS Deployment-LOC, Cancer Center, Satellites
Outside of the hospital we installed workstations in;
LOC-RadiologyWomen’s Health RadiologyLOC-Ortho ClinicLOC-Ambulatory SurgeryCancer CenterOrland Park Primary CareOak Brook Imaging Center
ResultsPACS implementation facilitated
interpretation of studies by making the images readily available. The number of cases in “complete” but not read status declined significantly.
Studies in "Complete" Status
0.00
0.50
1.00
1.50
2.00
2.50
3.00
US NM MRI Specials(Neuro/Vasc.)
Specials-Neuro Diag CT
Pe
rce
nta
ge
of
Sp
ec
ific
Mo
da
lity
V
olu
me
% ofStudiesJune2003% ofStudies(Nov2003)
Tu
rna
rou
nd
Tim
e (
Ho
urs
)
Completed Test to Final Report
Jun 0
2
Jul 0
2
Aug 02
Sep 0
2
Oct 0
2
Nov 02
Dec 0
2
Jan 0
3
Feb 0
3
Mar
03
Apr 03
May
03
Jun 0
3
Jul 0
3
Aug 03
Sep 0
3
Oct 0
3
Nov 03
Dec 0
3
Jan 0
4
Feb 0
4
Mar
04
0
20
40
60
80
100
120
Mean = 73
Mean = 36
Mean = 20
Implemented Voice
Recognition
technology
Implemented PACs
Average Report TAT is less than 1 day
Radiology PACS
PACS workstations were deployed in all major sites of operation in addition CR plates were purchased for smaller satellites so that images taken from those areas can still be “read” and archived on PACS
Due to technology restrictions Mammography is not yet on PACS
Conclusion
Images can now be viewed concurrently in multi-locations
Achieved goal of being “filmless”. Note the new LOC is built with this in mind
Addressed problem of unavailability of films
Increased patient & physician satisfaction
Increased availability of images- web , EMR
Film security- prevent loss & mirror archive
Positive impact on report turnaround time
Implemented QA process on workstation performance
Radiology embarked on a collaborative effort to implement PACS, a new technology to store and distribute images across the health system. This project resulted in tremendous improvement:
Next StepsExpand QA processes to cover Computerized Radiography and Digital Radiography operations to ensure optimum quality of images sent to PACS.