2011 Top 25 Connected Healthcare Facilities: The Science of Practice Management

Health Imaging & IT’s Top Connected class of 2011 is an illustrious group. Several previous winners have re-appeared and demonstrated their continued commitment to imaging connectivity across the enterprise, reporting ongoing gains in various metrics, such as turn-around time and operating costs. One common theme across our repeat winners? They are leveraging data to inform strategic decisions and monitor results.

It’s a business model to be replicated.

Reading between the lines, there are hints of positive developments. Yes, hospitals, health systems and radiology practices are squeezing every ounce of productivity and innovation from their investments in imaging modalities, informatics systems and staff. Compared with last year, volume is steadier, with most sites showing slight gains.

We considered Health Information Management Systems Society (HIMSS) EMR adoption stages, according to the HIMSS Analytics EMR Adoption Model. Our winners are conglomerated at the top of the scale, with most reporting at stage 6 or 7. That means they fall in the top 4.5 percent of U.S. facilities.   

Read on for short profiles of recent imaging connectivity projects at this year’s Top Connected organizations.

Advanced Radiology Consultants Trumbull, Conn. | www.adrad.com
	In winter 2009, the Trumbull, Conn., practice contracted to provide imaging services to a local teaching hospital. It spun out its IT department into a freestanding business, and negotiated a more favorable PACS contract. Advanced Radiology Consultants estimates that it gained a one-time hardware savings of $90,000 and software discount of $190,000. The practice reaped 25 percent in maintenance savings by implementing server virtualization.
Aria Health Philadelphia | www.ariahealth.org
	The Philadelphia-based community hospital integrated all clinical imaging and patient data into an acute electronic health record that provides radiologists, cardiologists and clinicians access to medical images and patient data at the point of care. The system automates workflow and eliminates communication barriers, enabling radiologists and clinicians to collaborate and simultaneously accelerate decision-making and patient care.
Banner Health Phoenix | www.bannerhealth.com
	Banner Health streamlined the image transfer process for trauma patients referred from rural hospitals by employing a cloud-based image transfer system. The system allows physicians at both the rural facility and Phoenix-based hospital to view and share images. Since launching of the system, transfer patients have not required re-scanning and the system shortens image discovery time for trauma surgeons.
Brigham & Women’s Hospital Boston | www.brighamandwomens.org
	The academic medical center integrated Alert Notification of Critical Results (ANCR) into its physician authentication database, PACS, email and paging system. When providers receive and acknowledge a critical results alert, they can view images and reports and order follow-up studies without logging into multiple systems. Since implementing ANCR, the hospital reduced critical results acknowledgment time from 12 hours, 17 minutes to one hour, 56 minutes.
Carolinas HealthCare System Charlotte, N.C. | www.carolinashealthcare.org
	This health system achieved a 75 percent reduction in mammography report turn-around time during the pilot phase of an electronic mechanism to pass ACR BI-RADS codes via voice recognition to the RIS. The model eliminates manual technologist coding review and data entry, and enabled Carolinas HealthCare System to eliminate one FTE. Its average mammography turn-around time is three hours, 50 minutes.
Detroit Medical Center Detroit | www.dmc.org
	In 2010, the multi-hospital organization improved the continuum of care by eliminating disparate image viewers across the enterprise. The project combines the viewer functionality of GE and Cerner image viewing software by use of Vital Images technology. The project improves access and enables image viewing on PC devices such as workstations on wheels, laptops and iPads on the clinical floors, in patient rooms or in remote locations.
Ephraim McDowell Health Danville, Ky. | www.emhealth.org
	The 222-bed hospital in Danville, Ky. deployed cardiology PACS and structured reporting in October 2009, decreasing average report turn-around time from 80 hours to 30 hours and allowed the hospital to eliminate a part-time transcriptionist. Ephraim credits the system with improved patient satisfaction and claims it was instrumental in attracting two cardiologists to the area.
Imaging Healthcare Specialists San Diego | www.imaginghealthcare.com
	The San Diego imaging center leverages a vendor-neutral, cloud-based, electronic medical information exchange service to make images and reports available via the EMR or email to hospitals, physicians and patients, which has eliminated film and paper and makes results immediately available to referring physicians. Results are frequently available to physicians before patients leave the imaging center.
Indiana University Health Indianapolis | www.iuhealth.org
	In late 2009, the Indianapolis health system replaced a legacy PACS with a new system that delivered improved interoperability and an integrated workstation. The upgrade has reduced turn-around time to one hour or less in the ED and eight hours or less for routine studies. Previous routine turn-around time stretched to 24 hours or more.
Inland Imaging Spokane, Wash. | www.inlandimaging.com
	Early in 2011, the health system launched DICOM structured reporting for ultrasound exams. The system automatically captures and inserts ultrasound measurements into a diagnostic report template and has reduced clerical errors and enhanced report quality, accuracy and turn-around time. Nearly half of the health system's 5,500 referring physicians regularly use remote access to patient data and clinical images.
INTEGRIS Health System Oklahoma City, Okla. | www.integrisok.com
	The Oklahoma health system launched a telestroke program across the enterprise, allowing INTEGRIS and non-INTEGRIS facilities to send imaging exams to a dedicated server for review by a neurologist. Onsite videoconferencing allows direct consultation and immediate treatment planning. The project has reduced patient transfers from regional facilities to larger metropolitan centers, and curbed treatment delays to improve patient outcomes.
Main Line Health Bryn Mawr, Pa. | www.mainlinehealth.org
	In fall 2010, the system relocated its PACS servers to a hosted data center, which reduced the number of PACS servers by two-thirds and cut operating costs by $20,000 per year. In addition, the project decreased the staff time required to support servers while providing 24 x 7 system monitoring and security.
MedCentral Health System Mansfield, Ohio | www.medcentral.org
	The community hospital launched digital mammography in spring 2011 and realized a 15 percent drop in mammography turn-around time. Digital mammography also allowed MedCentral to eliminate two file clerks. At the same time, mammography CAD offers an additional check on studies, which improves accuracy.
Montefiore Medical Center New York City | www.montefiore.org
	The health system has adopted the iPad for clinical use. Early applications include Airstrip OB, which delivers fetal strips to mobile devices in real time. GE Healthcare Centricity Radiology Access delivers access to the enterprise PACS to the iPad. In another beta project, Montefiore partnered with Omnyx for digital pathology and has deployed histologist and pathologist cockpits in pathology.
North Shore University Health System Evanston, Ill. | www.northshore.org
	In the last 24 months, this health system has focused on imaging in the operating room and renovated 18 rooms, outfitting each with PACS connectivity and wireless portable imaging. As a result, surgeons are provided with immediate access to patient images taken during a procedure, reducing patient anesthesia time.
Penn State Milton S. Hershey Medical Center Hershey, Pa. | www.pennstatehershey.org
	The academic medical center developed a system to automatically import patient images at the first point of contact. The process adds a local medical record number and transfers images to PACS for side-by-side viewing with local images. The center also automated peer review, randomly selecting 5 percent of cases for review. Specialists meet quarterly to review misses and take appropriate action.
Poudre Valley Health System Fort Collins, Colo. | www.pvhs.org
	The health system leverages PACS for radiology, cardiology, pathology, oncology and digital photos and is working toward storage of endoscopy images and wound care photos, which has enhanced patient care and improved outcomes. The health system participates in a tri-state health information exchange (HIE) as it relates to images, which accelerates and improves trauma care for patients requiring transit.
Radiology Consultants of Iowa Cedar Rapids, Iowa | www.rciowa.com
	A major participant in the Iowa Rural Health Telecommunications project, this Cedar Rapids practice provides radiology services and shared PACS for several rural Iowa facilities. The model, which uses a high-speed, private fiber optic network, has improved service delivery and enabled immediate remote viewing of images upon completion. The result is enhanced care for critical cases by providing information necessary for transfer or treatment.
Riverside Radiology and Interventional Associates Columbus, Ohio | www.riversiderad.com
	This radiology group has parlayed its IT division into a strategic differentiator and reduced its turn-around time from three-and-a-half hours in 2010 to less than two hours in 2011, allowing the practice to guarantee an exam-to-report turn around of less than three hours. The IT division designed a radiology intelligence, productivity and quality tool to provide workflow analysis to inform real-time decision-making.
Roper St. Francis Healthcare Charleston, S.C. | www.rsfh.com
	In 2010, this health system launched an enterprise vascular lab connectivity project. The worklist-driven system allows vascular technologists to enter findings into a structured report template linked to images and enables surgeons to read exams and sign reports remotely. The project has decreased expense per unit of service from $33.61 to $29.98, saving $38,115 annually, and reduced turn-around time from days to less than 24 hours.
Shields Health Care Group Quincy, Mass. | www.shields.com
	In February 2011, the imaging center deployed an iPhone/iPad app that allows referring physicians to view reports and images from any of its 27 locations. Physicians can search for patients to find live status information or review reports with the tap of a finger. The next release will enable exam ordering and direct facetime with radiologists.
The Nebraska Medical Center Omaha, Neb. | www.nebraskamed.com
	In the first year of its voice recognition deployment, the academic medical center cut report turn-around by 42 percent. The center refined the system in its second year for an additional 13 percent reduction. The project allowed a labor redesign and reduced transcription hours, yielding a $260,000 reduction in operating expense.
Trinity Health Minot, N.D. | www.trinityhealth.org
	This system has networked with several rural facilities to bring digital mammography to the region, which has reduced time from exam to final interpretation from five days to one to two days. The model allows radiologists to direct additional views, which reduced follow-up visits, decreased callbacks and alleviated patient anxiety. Studies are stored on Trinity’s PACS to enable seamless comparison with prior exams.
University Health System San Antonio | www.universityhealthsystem.com
	This academic medical center upgraded its RIS to improve access to patient information, provide tighter integration to the EMR/CPOE, interface with the laboratory information system and enhance scheduling capabilities. Improved scheduling has translated into no-show rates below 10 percent and patient scheduling wait times of less than 20 seconds.
Wellspan York, Pa. | www.wellspan.org
	In 2010, the health system upgraded its internet bandwidth from 50 MBs to 150 MBs and deployed a redundant connection to support changes in clinical workflow such as 24 x 7 remote access to results and images. The health system deployed CPOE enterprise-wide, which allows physicians to enter and update orders anytime/anywhere.
The Fine Print: Nominations were accepted from June 6th through July 1st. The ballot included 18 multiple response questions and two open response questions. Nominations required the input of senior-level IT executives such as CIOs, chief medical or clinical information officers, chief technology officers, medical informatics officers, VPs of information systems and directors of IT. Among the factors differentiating the winners are integration of PACS and EMR, HIMSS EMR adoption stage, the number of physicians and referring physicians with remote access to clinical images and patient data, the number of methods for physician access and the number and breadth of clinical IT systems.