Top 25 Connected Healthcare Facilities: Best Practices in Imaging & IT
Best Practices in Imaging & IT
IT innovation and integration are alive and very well in 2008. This year's Top 25 Connected Healthcare Facilities bring impressive resumes, tales of major cost savings and return on investment and excellence in patient care and patient and staff satisfaction. They have established new paradigms for integrated health systems using state-of-the-art, emerging information technologies. Patient data flow seamlessly and swiftly among departments. These leaders also offer access to the most advanced imaging technology and expertise in all areas of clinical image reading.
This year's Top Connected winners include health systems, academic medical centers, two physician group practices, two children's hospitals and a variety of community hospitals spread across 18 states. (The winners are presented in alphabetical order; their listing order in no way indicates a ranking).
All of the facilities show tremendous commitments to healthcare IT and informatics. By the number and diversity of IT system integration, they show that IT has contributed to breaking down traditional clinical boundaries, allowing primary-care physicians to view images and better educate patients by sharing them.
This enables a care team to effectively diagnose, treat and educate patients more quickly and effectively.
Technology investment is significant, with the majority of the Top Connected facilities using CPOE (76 percent), structured reporting (84 percent) and having wireless access through the hospital or healthcare organization (88 percent). All of the facilities utilize CT, MRI, ultrasound and digital R&F systems. Following closely behind with 96 percent utilization rates across the winners are CR, C-arms, while 92 percent have echocardiography and DR. Eighty percent have installed full-field digital mammography systems, while 40 percent have CR-based mammography. Three-quarters of the facilities utilize SPECT or PET, while PET/CT is installed at 84 percent of the Top Connected sites and 40 percent own SPECT/CT as well.
Information system deployment is, of course, robust. Some 96 percent of the Top Connected facilities have an EMR. Most of the Top 25 have a hospital information system (92 percent), CVIS (80 percent), surgery information system (84 percent), lab information system (80 percent) and ICU information system (68 percent). In the radiology image and information realm, 100 percent read electronic images including 84 percent that utilize standalone-PACS, 80 percent have a RIS and 60 percent utilize a paired RIS/PACS solution. Interestingly, 96 percent utilize enterprise-wide PACS or RIS/PACS.
So which department IT systems are integrated with PACS? Nuclear medicine, cardiology, teleradiology, ER, orthopedics, vascular, OR, oncology, RIS, radiation therapy and critical care all see more than 80 percent integration across the 25 facilities. One area ripe for future integration with PACS is laboratory and pathology information systems'with 71 percent of the Top Connected facilities reporting they've installed these systems but they don't yet interface with PACS.
Not surprisingly for a list of Top Connected Facilities, 80 percent report that 96 to 100 percent of imaging studies are completed on digital imaging systems (the remaining 20 percent report 91 to 95 percent). Ninety-six percent of the winners are 90 to 100 percent filmless. Data growth is surging, too, with a quarter of the winners seeing 6 to 10 percent growth in the last year. Some 16 percent have seen data increase 21 to 25 percent. Only two facilities report data growth under 5 percent. Cleveland Clinic reports the most data in its long-term archive'1 petabyte!
Imaging procedure growth for half of the winners is pacing at 6 to 10 percent, with about a quarter of the Top 25 posting growth under 5 percent. Report turn-around times are impressive too, with the fastest radiology reports ready in 20 minutes at Imaging Healthcare Specialists in San Diego (28 minutes at Norton Healthcare in Louisville, Ky.). The fastest cardiology report turn-around time is 21 minutes at the University of Pittsburgh, while ER reports are ready in 15 minutes at Brigham& Women's in Boston (20 minutes across town at Mass General Hospital and the same at Alegent Health in Omaha).
We congratulate each of this year's winners—you are an inspiration to all!
| The Fine Print |
| This year's online nominations were accepted from May 19th through June 24th. Some 525 healthcare facilities were represented in the balloting. The ballot included 45 questions. Among the factors differentiating the winners are the number of modalities, departments and information systems that share digital images and reports, percentage of facility that is filmless, percentage of digital procedures, the ability of physicians to access electronic images and reports, and cost savings based on efficiencies driven by integrating digital technologies. |
| Alegent Health System> | |
| Omaha, Neb. | alegent.com | Previous winner: 2006, 2007 |
 This not-for-profit, faith-based healthcare system in Nebraska and southwestern Iowa operates nine acute-care hospitals, more than 100 sites of service, and employs 1,600 physicians and 9,000 staff. Alegent offers women's and children's services, primary care, wellness counseling, and senior care as well as cardiovascular services, orthopedics, oncology, physical rehabilitation and behavioral health. Its imaging facilities offer digital technology for diagnostic and interventional radiology and cardiology. Alegent, sponsored by Catholic Health Initiatives and Immanuel Health Systems, has saved $500,000 a year from its digital imaging/digital image and data management adoption. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Banner Health System | |
| Phoenix, Ariz. | bannerhealth.com | |
 This not-for-profit hospital system operates in seven Western states with 22 hospitals and healthcare facilities, offering various levels of hospital care, physician services, hospice and home care. Providing more than $64 million a year in charity care, the health system employs more than 28,000 staff, admits more than 190,000 patients to its hospitals and treats more than 510,000 people a year in their emergency departments. Banner offers interventional radiology services for an array of medical conditions, ranging from cardiology to fetal surgery. Banner’s imaging department is completely digitized. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Brigham and Women’s Hospital | |
| Boston, Mass. | brighamandwomens.org | Previous winner: 2007, 2006, 2005, 2004 |
 This 747-bed teaching affiliate of Harvard Medical School offers outpatient services and clinics, diagnostic and treatment technologies and research laboratories. Annually, Brigham & Women’s Hospital (BWH) sees inpatient admissions totaling 44,000; ambulatory visits of more than 950,000; and the emergency department treats 54,000 patients. BWH employs more than 12,000 people with more than 3,000 physicians, fellows and residents. With the adoption of digital imaging, enterprise image-viewing is available in all its clinics, as well as in more than 40 ORs; and physicians can electronically enter and sign imaging study orders. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Bronson Methodist Hospital | |
| Kalamazoo, Mich. | bronsonhealth.com | |
 With a workforce of nearly 5,000 and a medical staff of more than 700, this not-for-profit, tertiary healthcare system serves southwest Michigan and northern Indiana. Bronson offers a range of services from primary care to advanced critical care and has 11 service locations. The health system offers the same diagnostic imaging in six of its locations, including bone density scans, CT, EKG, fluoroscopy, MRI, neurodiagnostics, nuclear medicine, ultrasound and x-ray. Its enterprise-wide PACS also allows for images to be accessed across its intranet. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Children’s Health System | |
| Birmingham, Ala. | chsys.org | |
 This private, not-for-profit hospital provides pediatric services at 16 locations in Alabama through outpatient and social services centers. The flagship Children’s Hospital is a teaching hospital affiliated with the University of Alabama School of Medicine. In its first year of digital imaging and image and data management adoption, the 275-bed hospital decreased film costs by $250,000. Due to the installation of voice recognition, report turn-around time has decreased from 24 hours to 3.5 hours. In 2008, the facility decreased transcription costs by $175,000, and has automated its peer-review process. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Children’s Hospital Boston | |
| Boston, Mass. | childrenshospital.org | |
 This 397-bed pediatric healthcare center records approximately 22,600 inpatient admissions annually. The Children’s Hospital clinical staff includes approximately 963 physicians, as well as 897 residents and fellows and 5,200 additional employees. Coupled with speech recognition, PACS adoption has allowed the hospital to reduce report turn-around times from more than two days to less than a day. Since image storage has gone electronic, image-viewing software is installed on every computer (more than 7,000), allowing for images to be viewed from anywhere in the hospital. | |
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Facility Image access, reporting and data Across the enterprise | |
| Clarian Health Partners | |
| Indianapolis, Ind. | clarian.com | Previous Winner: 2007, 2006, 2004 |
 In 1997, Methodist, Indiana University and Riley hospitals united to form the not-for-profit Clarian Health Partners, serving Indiana and the Midwest. Clarian has nearly 12,000 employees at its Indianapolis hospitals, and either owns or is affiliated with 20 hospitals and health centers throughout Indiana. Over the past five years, the 1,655-bed health system has experienced a decline in film costs from $7 million to $100,000 annually since the introduction of digital imaging/digital image and data management. Also, film file staff has been reduced by 70 percent. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Cleveland Clinic | |
| Cleveland, Ohio | clevelandclinic.org | |
 This not-for-profit, multispecialty academic medical center is comprised of nine community hospitals and three affiliate hospitals throughout Northeast Ohio, as well as others in Florida, Canada and the United Arab Emirates. The medical center has 1,800 salaried physicians on staff, representing 120 specialties. Cleveland Clinic’s division of radiology offers electronic image transmission for live monitoring of cases and rapid interpretation by sub-specialized radiologists; image transmission arranged and maintained by its specialists; access to its RIS for scheduling and reports; and electronic archiving of all transmitted cases. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| General Health System | |
| Baton Rouge, La. | brgeneral.org | |
 This 544-bed community hospital has two locations with more than 3,000 employees. Among the diagnostic techniques available at the General Health’s Pennington Cancer Center are 3D treatment planning, intensity modulated radiation therapy, multileaf collimation, digital online portal imaging and high dose rate remote after-loading brachytherapy. The Cancer Center also offers diagnostic radiology and pathology, along with MRI, CT, PET, nuclear medicine and mammography. The health system has removed film at a cost-savings of more than $500,000 annually, increased physician satisfaction and reduced staff. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Imaging Healthcare Specialists | |
| San Diego, Calif. | imaginghealthcare.com | |
 Radiology Medical Group and Open Air MRI centers, two interventional radiology/medical imaging groups, merged to form Imaging Healthcare Specialists (IHS), which is now a provider of outpatient imaging services in San Diego County. IHS has 14 imaging centers in Orange County, Riverside County and San Diego. Its 350-person staff of board-certified radiologists, technologists and support personnel provide medical imaging and interventional radiology services. With the adoption of digital imaging/digital image and data management, IHS has cut costs of film and transcription, while reducing staff per relative value units. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| INTEGRIS Health | |
| Oklahoma City, Okla. | integris-health.com | Previous winner: 2007, 2006 |
 This not-for-profit corporation is governed by a 13-member board of directors made up of business and community leaders from Oklahoma. INTEGRIS serves as the parent corporation for INTEGRIS Baptist Medical Center, another Oklahoman not-for-profit corporation that operates a tertiary-care hospital in northwest Oklahoma City. INTEGRIS offers CT, MRI, nuclear medicine, ultrasound, x-ray and interventional services, among others. With the introduction of DR, its diagnostic imaging rooms reduced from 14 to 11, with an 8 percent increase in volume of patient studies performed. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Maimonides Medical Center | |
| Brooklyn, N.Y. | maimonidesmed.org | Previous winner: 2007, 2006 |
 This not-for-profit, non-sectarian treatment facility also serves as an academic medical center. The radiology department serves as an integral part of patient care, aiding in such areas as: cardiac care, stroke, women’s imaging, virtual imaging (colonoscopy/bronchoscopy) and cardiovascular imaging (CT/MR). Its radiologists are board-certified in subspecialties including interventional, MRI, neuroradiology, pediatric, nuclear medicine and mammography. The 705-bed facility absorbed a 10 percent increase in exam volume with no staff increase or increase in the radiology operational budget, after adopting digital imaging/digital image and data management. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Marshfield Clinic | |
| Marshfield, Wis. | marshfieldclinic.org | |
 With 776 physicians in 80 medical specialties and subspecialties located in more than 40 centers throughout Wisconsin, Marshfield Clinic is a private, multi-specialty group practice. The clinic had more than 3.4 million patient encounters in 2007. Marshfield’s internally developed EHR system has provided cost savings by eliminating paper records. With more than 10,000 patients daily, the clinic estimates that the savings is about $1.3 million per year. Marshfield also has been migrating from film and paper records to digital imaging, which can be disseminated electronically through the outlying Marshfield centers. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Massachusetts General Hospital | |
| Boston, Mass. | mgh.harvard.edu | Previous winner: 2007, 2006, 2005, 2004 |
 This 900-bed medical center annually admits more than 46,000 inpatients and handles nearly 1.5 million outpatient visits at its main campus and its four Massachusetts health centers. A teaching hospital of Harvard Medical School, MGH joined with Brigham and Women’s Hospital to form Partners HealthCare System in 1994. Savings from transcription and film elimination is more than $3 million. Also, MGH implemented web-based radiology order entry and decision support that allows referring physicians to electronically order and schedule outpatient radiology, nuclear medicine and cardiology exams. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Midland Memorial Hospital | |
| Midland, Texas | midland-memorial.com | |
 This acute-care institution with 320 licensed beds and more than 1,400 employees provides a range of inpatient and outpatient services. Midland and Diagnostic Imaging Associates have adopted digital imaging technology in their facilities, gaining financial and management benefits from utilizing digital imaging and data management. Annual cost savings from reduced film and related expenses are approximately $1 million a year. The technology allowed the hospital to consolidate four different film locations into one central film library, eliminate seven non-clinical FTEs at an annual cost of $175,000. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Montefiore Medical Center | |
| Bronx, N.Y. | montefiore.org | |
 This medical center, the University Hospital for the Albert Einstein College of Medicine, serves residents of the Bronx and Westchester County, N.Y., at 21 locations. The Montefiore system centers around three hospitals: the 726-bed Henry and Lucy Moses Division; the 396-bed Jack D. Weiler Hospital of the Albert Einstein; and the 106-bed Children’s Hospital at Montefiore which together provide more than 70,000 inpatient stays annually. The facility has achieved 97 percent digital imaging capability, as well as improving radiologist productivity by 12 percent. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Norton Healthcare | |
| Louisville, Ken. | nortonhealthcare.com | Previous Winner: 2007 |
 This not-for-profit system includes four hospitals in Louisville, 10 immediate-care centers, 8,000 employees, 280 employed medical providers at approximately 50 locations and 2,000 total physicians on its medical staff. For its radiological services, the 1,857-bed system offers CT, digital mammography, fluoroscopy, interventional, MRI, nuclear imaging, ultrasound and x-ray. As a result of its enterprise-wide PACS implementation and the digitization of older films, Norton employees can access images from one hospital or imaging center across its network, and the implementation of voice recognition software has sped the delivery of patient information. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| OhioHealth | |
| Columbus, Ohio | ohiohealth.com | |
 This family of not-for-profit, faith-based hospitals and healthcare organizations serve patients in central Ohio. The 2,000-bed health system employs approximately 14,000 individuals throughout the six hospitals in the OhioHealth network. Across four of its hospitals, the health system offers breast biopsy (stereotactic and ultrasound-guided), CT, digital mammography (with CAD), fluoroscopy, interventional radiology, MRI, nuclear medicine, peripheral vascular lab, PET, stress testing and x-ray. OhioHealth has saved more than $1.25 million since it first adopted PACS in May 2005, and increased its imaging study volumes by 11.7 percent. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| Penn State University Milton S. Hershey Medical Center | |
| Hershey, Pa. | pennstatehershey.org | |
 This 500-bed academic medical center, along with Penn State College of Medicine and Penn State Hershey Children’s Hospital, has more than 7,400 employees, 355 volunteers and the College of Medicine enrolls more than 600 students annually. During 2007, Penn State Hershey Medical Center admitted more than 27,500 inpatients, 780,000 outpatients and performed more than 23,000 surgical procedures. The adoption of digital imaging saved the medical center $1 million in film, along with time saved for 700 residents, who no longer had to spend approximately two hours daily looking for film. | |
| Facility | |
Facility Image access, reporting and data Across the enterprise | |
| Phoenix Children’s Hospital | |
| Phoenix, Ariz. | phoenixchildrens.com | |
 This 345-bed facility provides inpatient, outpatient and ER services to patients throughout Arizona and other Southwestern states, with 40 sub-specialty fields of pediatric medicine. Its diagnostic equipment has pediatric features with a range of diagnostic imaging and interventional radiology services adjusted for use by infants, children and adolescents, including x-ray, CT, ultrasound, MRI, fluoroscopy and nuclear medicine. Phoenix Children opened a new ambulatory and urgent care center about 35 miles from its main campus, offering full radiology services through remote pediatric radiologists in December 2007. | |
| Facility | |
Facility Image access, reporting and data Across the enterprise | |
| Radiology Consultants of Iowa | |
| Cedar Rapids, Iowa | rciowa.com | Previous winner: 2007 |
 This imaging center provides outpatient services and features equipment, treatments and a team of physicians and staff focused on delivering radiology services. It serves six Iowa hospitals. Procedures performed at the RCI Imaging Center include x-ray, CT, MRI, mammography, ultrasonography and the Vein and Interventional Clinic. By integrating workflow between RIS, PACS and speech recognition, the turnaround-time for final reports averages less than two hours for routine reports and less than 30 minutes for stat reports. The integration has allowed RCI to save more than $100,000 annually in personnel costs. | |
| Facility | |
Facility Image access, reporting and data Across the enterprise | |
| Roper St. Francis Healthcare | |
| Charleston, S.C. | ropersaintfrancis.com | Previous Winner: 2007 |
 This 453-bed acute-care Roper, along with the Bon Secours St. Francis Hospital’s 141-bed, acute-care facility, provides imaging services at 12 locations. The health system offers CT, interventional radiology, mammography, PET/CT, ultrasound and x-rays. In the first year of adopting PACS, the system saved $280,000 annually. In 2007, the yearly savings increased to more than $450,000 as the facility converted to CR and DR, moving to a filmless environment. The hospital eliminated hard copy film at nearly all locations, reducing support staff and equating to nearly $300,000 in salary savings. | |
| Facility | |
Facility Image access, reporting and data Across the enterprise | |
| St. Agnes Hospital | |
| Baltimore, Md. | stagnes.org | |
 This 323-bed, full-service teaching hospital, a member of Ascension Health, offers services for cancer, chest pain emergency, cardiovascular, minimally invasive surgery, telemedicine and women’s health. St. Agnes supports off-site facilities, including Seton Imaging Center and the Ellicott City Surgery Center. The hospital provides a range of radiology services, including 64-slice CT, diagnostic x-ray, PET/CT, ultrasound and MRI. St. Agnes’ adoption of digital imaging/digital image and data management led to a reduction of film budget from $400,000 to $30,000, while also reducing film file by two FTEs. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise | |
| University of Pittsburgh Medical Center | |
| Pittsburgh, Pa. | upmc.edu | |
 48,000 employees (including nearly 2,500 physicians), UPMC comprises 20 tertiary, specialty and community hospitals, 400 outpatient sites and doctors’ offices and long-term care facilities. The medical center offers imaging services at 43 locations throughout western Pennsylvania, to provide such diagnostic imaging procedures as 64-slice CT and wide-bore MRI, as well as on-site, sub-specialty radiologists. UPMC experienced improved patient care with digital imaging adoption, including reduced turn-around time from four days to three hours and decreased patient length of stay. | |
| Facility | |
Facility Image access, reporting and data Across the enterprise | |
| Wellspan Health | |
| York, Pa. | wellspan.org | Previous winner: 2006 |
 As a community-based, not-for-profit organization, this 634-bed integrated health system serves south-central Pennsylvania. With two hospitals, York Hospital and Gettysburg Hospital, WellSpan has 63 additional sites in Adams and York counties, Pa., and Maryland. The health system recently moved from utilizing a private radiologist group to employing its own radiologists and the ability to load balance and read studies from anywhere. The images are consultative on high-resolution images, like CR or DR, but may be used diagnostically on low-resolution images such as CT, MRI, ultrasound or nuclear medicine. As a community-based, not-for-profit organization, this 634-bed integrated health system serves south-central Pennsylvania. With two hospitals, York Hospital and Gettysburg Hospital, WellSpan has 63 additional sites in Adams and York counties, Pa., and Maryland. The health system recently moved from utilizing a private radiologist group to employing its own radiologists and the ability to load balance and read studies from anywhere. The images are consultative on high-resolution images, like CR or DR, but may be used diagnostically on low-resolution images such as CT, MRI, ultrasound or nuclear medicine. | |
| Stats | |
Facility Image access, reporting and data Across the enterprise |