Inside the Top 25 Connected Healthcare Facilities

It’s that time—we present our annual selection of the most connected healthcare facilities. Since health IT and interconnectivity are booming, this year we’ve upped the list from 10 organizations to 25. The winners include large IDNs, community hospitals, academic medical centers, an imaging center and an orthopedic center. They are presented in alphabetical order as they collectively share the designation as one of Health Imaging & IT’s Top 25 Connected Healthcare Facilities.

A seamless path for incoming and outgoing patient information is the goal for all the facilities nominated this year. More have succeeded than ever before. All are more than 90 percent digital and the majority have wireless access throughout their facilities. Business is booming as most have seen a significant increase in the annual number of imaging procedures performed over a year ago. All but one have the ability to access images via the web.

Recent studies predict that spending on wireless technology applications will reach $1.5 billion by 2010, the total IT spending for the electronic health record market will increase to $4.8 billion by 2015, and the U.S. health IT market will hit $47.9 billion this year. This year’s Health Imaging & IT Top 25 Connected Facilities have no doubt contributed to those figures but also have experienced impressive benefits. They have implemented digital imaging and electronic records, installed necessary infrastructure components, and provided the training needed by staff and physicians. Most report they have far exceeded their return on investment. A benefit, for sure, but better, faster patient care is the ultimate end result we all cheer.

The Fine Print

Healthcare organizations that included academic/teaching hospitals, city/county/government-owned hospitals, community hospitals, corporate/for-profit hospitals, integrated delivery networks (IDNs), regional health information organizations (RHIOs), freestanding imaging centers, specialty imaging facilities and physician group practices were invited to submit online nominations for the Top 25 Connected Healthcare Facilities from June 27th through July 21st. Some 575-plus healthcare facilities were represented in the balloting. The ballot included 24 questions which were submitted electronically. Nominations were not considered if required fields were omitted. If certain fields were missing, an automatically generated email was sent to the party nominating the facility.

Among the factors differentiating the winners were percentage of facility that is filmless, percentage of procedures that are digital, the number of modalities and departments that send and utilize images from PACS and the ability of in-network physicians and referring physicians to access electronic images. 

Alegent Health System, Omaha, Neb.

Alegent Health includes nine acute care hospitals, more than 100 sites providing healthcare services, over 1,200 physicians on its medical staff and roughly 8,400 employees. Alegent Health is sponsored by Catholic Health Initiatives and Immanuel Health Systems. The high rate of physician rotation among the facilities required an enterprise-wide image distribution system. Alegent also has enterprise-wide HIS, EMR and RIS. The newest facility, Lakeside Hospital, opened in 2004. It is filmless, paperless and has all wireless technology and an all-digital diagnostic center.

Facility Stats

Licensed Beds: 900-999

Annual Imaging Studies: 300,000-399,999

Employees: 7,000-7,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 10-20 million

How many locations offer imaging services: 5-10

Physicians with online access to images: 90% and up

How referring physicians access images: online and CD

Monthly images viewed by clinicians: 400,000-499,999

Monthly electronic radiology reports: less than 10,000

Technologies that exchange images with PACS

• Advanced Visualization - Terarecon • C-Arm - Siemens • Cardiac Cath Lab - Siemens • CR - Fuji • CT - Siemens • CAD - R2 • Data Storage - EMC, Siemens • Digital Mammography - Siemens • DR - Siemens • Echocardiography - Siemens • MRI - Siemens • PET/CT - Siemens • Ultrasound - Siemens • Workstation (Diagnostic) - Siemens • Workstation (PACS) - Siemens • Voice/Speech Recognition - Dolbey • X-ray (Portable) - Fuji

Information Systems that share images with PACS

• CVIS - Lumedx • EHR - Siemens • EMR - Siemens • HIS - Siemens • Nuclear Medicine - Siemens • Radiation Therapy - Siemens • RIS - Siemens • Teleradiology - Merge • Vascular - Siemens

Brigham and Women’s Hospital, Boston

This 755-bed non-profit teaching affiliate of Harvard Medical School is a member of the Partners HealthCare System. The multi-institutional, multi-disciplinary BW/F Medical Imaging IT program includes computerized physician order entry with decision support, speech recognition and integration into the EMR. The facility’s mission is to use systems thinking and design to implement seamlessly integrated information technology tools capable of knowledge delivery at the point of care to create a safe, high quality and efficient practice environment. Brigham and Women’s has seen clinical care improvements attributable to having ‘any image, anywhere, anytime,’ cost reductions and productivity gains.

Facility Stats

Licensed Beds: 800-899

Annual Imaging Studies: 500,000-999,999

Employees: 10,000-14,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 100 mil. and up

How many locations offer imaging services: 5-10

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 2 - 2.5 million

Monthly electronic radiology reports: 100,000-199,999

Technologies that exchange images with PACS

• Advanced Visualization • C-Arm - GE • Cardiac Cath Lab - Philips, GE • Clinical Decision Support - Medicalis • CR - Kodak, Agfa, Konica, Fuji • CT - Siemens • CAD - R2 • Data Storage - EMC • Digital Mammography - GE • DR - GE, Swissray • Echocardiography - GE, Siemens, Philips • MRI - GE, Siemens • PET/CT - GE, Siemens • SPECT - Siemens • Ultrasound - Siemens • Workstation (Diagnostic) - Agfa, GE • Workstation (PACS) - Agfa, GE • Voice/Speech Recognition - Dictaphone • X-ray (Portable)

Information Systems that share images with PACS

• CVIS - GE, Philips, Medicalis, Agfa • CPOE - Medicalis, Partners Information Systems • EMR - Partners Information Systems • HIS - Partners Information Systems • Nuclear Medicine - Siemens, GE • RIS - IDX, Meditech • Teleradiology - Philips, Medicalis, Amicas • Vascular - Siemens

Centra Health, Lynchburg, Va.

Centra Health is a regional, not-for-profit healthcare system located in the heart of Central Virginia. More than 4,000 employees care for patients in a variety of settings. Centra boasts patient satisfaction levels in the 93rd percentile and ED physician satisfaction in the 97th percentile. That’s partly due to digital imaging which has allowed for an increase in imaging procedures of 10 to 12 percent a year with no increase in staff. A link to the city of Lynchburg’s metroLAN has allowed Centra to link physician offices in the area to a high bandwidth connection for immediate access to images.

Facility Stats

Licensed Beds: 600-699

Annual Imaging Studies: 200,000-299,999

Employees: 4,000-4,999

Physicians: 200-299

How much of the facility is filmless: 90% and up

Increase in digital procedures: 10%-15%

Total images archived: 500,000-999,999

How many locations offer imaging services: 2-4

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD

Monthly images viewed by clinicians: 10,000-24,999

Monthly electronic radiology reports: 10,000-24,999

Technologies that exchange images with PACS

• Cardiac Cath Lab - Camtronics • Clinical Decision Support - McKesson • Data Storage - IBM • Digital Mammography - McKesson • DR - McKesson • Echocardiography - Pyramis • MRI - Siemens • PET - Siemens • Workstation (Diagnostic) - McKesson, Camtronics • Workstation (PACS) - McKesson, Camtronics • Voice/Speech Recognition - Lanier

Information Systems that share images with PACS

• CVIS - Camtronics • CPOE - McKesson • Critical Care/ICU/CCU - McKesson • EHR - McKesson • EMR - McKesson • Emergency - McKesson • Endoscopy/Gastroenterology - Provation • HIS - McKesson • LIS - Misys • Nuclear Medicine - McKesson, Lumedix • Oncology - Varian • Orthopedics - McKesson • Radiation Therapy - Varian • RIS - McKesson • Surgery/OR - McKesson • Teleradiology - McKesson • Vascular - Witt

Clarian Health Partners, Indianapolis, Ind.

Clarian Health Partners is comprised of Methodist Hospital, Indiana University Hospital and Riley Hospital for Children and is an Indiana-based, private, non-profit organization, offering a broad base of tertiary services, specialized pediatric care and a Level 1 Trauma Center. Clarian is Indiana’s largest and most comprehensive health system, comprised of 17 hospitals and health centers. Clarian employs more than 1,400 physicians, admits more than 53,000 in-patients and almost one million outpatient each year. CHP is partnered with Indiana Radiology Partners (IRP), which is one of the largest radiology practices in the nation with more than 75 physicians and expertise in more than a dozen sub-specialties.

Facility Stats

Licensed Beds: 1,000-1,999

Annual Imaging Studies: 500,000-999,999

Employees: 10,000-14,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 10%-15%

Total images archived: 100 mil. and up

How many locations offer imaging services: 11-15

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 1-1.5 million

Monthly electronic radiology reports: 25,000-49,999

Technologies that exchange images with PACS

• Advanced Visualization - Siemens, Philips • C-Arm - Siemens • Cardiac Cath Lab - Siemens • CR - Agfa, Kodak, Fuji • CT - Philips, GE • CAD - R2 • Data Storage - EMC • Digital Mammography - Hologic • DR - Kodak, Siemens • MRI - Siemens, GE • PET/CT - Siemens • SPECT - Siemens, Marconi, Philips • Ultrasound - Philips • Workstation (Diagnostic) - GE • Workstation (PACS) - GE • Voice/Speech Recognition - Nuance • X-ray (Portable) - GE

Information Systems that share images with PACS

• CVIS - GE • Critical Care/ICU/CCU - GE • Dermatology - GE • EMR - GE • Emergency - GE • Endoscopy/Gastroenterology - GE • Nuclear Medicine - GE • Oncology - GE • Ophthalmology - GE • Orthopedics - GE • Radiation Therapy - GE • RIS - GE • Surgery/OR - GE • Teleradiology - GE • Vascular - GE

Deaconess Health System, Evansville, Ind.

Deaconess Health System covers the population of 26 counties in Indiana, Kentucky and Illinois. The system consists of five hospitals, a freestanding cancer center, a physician practice group with 14 ambulatory sites, two urgent care facilities, a preferred provider organization, and multiple partnerships with other healthcare providers. A physician portal allows clinicians to remotely access computer applications including PACS and EMR. Deaconess considers IT vital to all aspects of its business, including efficiency, safety and physician convenience.

Facility Stats

Licensed Beds: 500-599

Annual Imaging Studies: 200,000-299,999

Employees: 3,000-3,999

Physicians: 750-999

How much of the facility is filmless: 90% and up

Increase in digital procedures: less than 5%

Total images archived: 500,000-1,000,000

How many locations offer imaging services: 2-4

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 10,000-24,999

Monthly electronic radiology reports: less than 10,000

Technologies that exchange images with PACS

• C-Arm - GE • CR - Kodak • CT - GE • CAD - Confirma • Data Storage • DR - GE • MRI - GE, Philips • PET/CT - GE • Ultrasound - GE, Philips • Workstation (Diagnostic) - GE • Workstation (PACS) - GE • Voice/Speech Recognition - Dictaphone • X-ray (Portable) - GE

Information Systems that share images with PACS

• EMR • HIS • Nuclear Medicine - GE • RIS - GE • Surgery/OR - GE • Vascular

Decatur County Memorial Hospital, Greensburg, Ind.

Decatur County Memorial Hospital opened in 1922 as a memorial to the 800 men and women in the Decatur County area who served in World War I. As a small, rural facility with just one radiologist, digital technology takes on a new importance at a facility that performs 25,000 to 30,000 imaging procedures a year. A web-based RIS has increased the radiologist’s productivity by about 30 percent and reduced film costs by 90 percent. The system also makes it easy to send certain studies off-site to sub-specialty radiologists for interpretation.

Facility Stats

Licensed Beds: Less than 100

Annual Imaging Studies: 25,000-49,000

Employees: 300-399

Physicians: 25-49

How much of the facility is filmless: 80%-89%

Increase in digital procedures: less than 5%

Total images archived: 100,000-250,000

How many locations offer imaging services: 2-4

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 10,000-24,999

Monthly electronic radiology reports: less than 10,000

Technologies that exchange images with PACS

• CR - Agfa • CT - Siemens • Data Storage - Agfa • MRI - GE • PET/CT - GE • SPECT - Siemens • Ultrasound - Philips • Workstation (Diagnostic) - Agfa • Workstation (PACS) - Agfa

Information Systems that share images with PACS

• RIS - Evolved Digital • Teleradiology

Delnor-Community Hospital, Geneva, Ill.

Delnor-Community Hospital focuses on combining a personal touch and state-of-the-art medical technology. It is one of the 3 percent of U.S. hospitals with Magnet Nursing Designation and has topped physician satisfaction surveys. A multi-disciplinary IT Strategic Council drives the facility’s commitment to new systems such as emergency department information system, portals, and single sign on, which are all interfaced with the PACS. Implementation of CR and digital mammography makes Delnor 100 percent filmless, and document scanning makes the facility essentially paperless.

Facility Stats

Licensed Beds: 100-199

Annual Imaging Studies: 100,000-199,999

Employees: 1,000-1,999

Physicians: 400-499

How much of the facility is filmless: 90% and up

Increase in digital procedures: less than 5%

Total images archived: 10-20 million

How many locations offer imaging services: 1

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 24,999-49,999

Monthly electronic radiology reports: less than 10,000

Technologies that exchange images with PACS

• Advanced Visualization - Terarecon • C-Arm - OEC • Cardiac Cath Lab - Philips • CR - Konica • CT - Toshiba • CAD - GE • Data Storage - EMC • Digital Mammography - Hologic • DR - Hologic • Echocardiography - Siemens • MRI - GE • PET/CT - GE • Ultrasound - Toshiba • Workstation (Diagnostic) - HP • Workstation (PACS) - HP • Voice/Speech Recognition - Dictaphone • X-ray (Portable) - GE

Information Systems that share images with PACS

• HIS - Meditech • Nuclear Medicine - ADAC, Siemens • RIS - Meditech • Teleradiology - Images-On-Call

Desert Orthopaedic Center, Las Vegas

Founded in 1970, Desert Orthopaedic Center has grown to 17 certified/eligible board-certified orthopaedic surgeons. This physician group practice is the largest in the Las Vegas area and provides care for every subspecialty area of orthopaedics including sports medicine, total joint replacement and revision, arthroscopic reconstruction of the knee and shoulder, microscopic hand surgery, pediatric orthopaedics, scoliosis and spinal deformities, spinal surgery and foot and ankle reconstruction. Aside from significant reductions in equipment and supply costs, Desert’s clinicians can provide better patient care since more information is available and they have more options available for pre-operative planning.

Facility Stats

Licensed Beds: N/A

Annual Imaging Studies: 100,000-249,999

Employees: 50-99

Physicians: Less than 25

How much of the facility is filmless: 90% and up

Increase in digital procedures: 10% - 15%

Total images archived: 100,000-250,000

How many locations offer imaging services: 2-4

Physicians with online access to images: 90% and up

How referring physicians access images: online or CD

Monthly images viewed by clinicians: 10,000-24,999

Monthly electronic radiology reports: less than 10,000

Technologies that exchange images with PACS

• Advanced Visualization - Sectra • CR - Konica • CT - Sectra • Data Storage - Sectra • MRI - Sectra • Workstation (Diagnostic) - Sectra • Workstation (PACS) - Sectra

Information Systems that share images with PACS

• Orthopedics - Sectra • RIS - Sectra • Surgery/OR - Sectra • Teleradiology - Sectra

INTEGRIS Baptist & Southwest Medical Centers, Oklahoma City, Okla.

Oklahoma’s largest state-owned health system includes hospitals, rehabilitation centers, physician clinics, mental health facilities, independent living centers and home health agencies throughout much of the state. INTEGRIS Health Inc. is a not-for-profit corporation and has placed great emphasis on providing state residents the very best and latest technology available in healthcare delivery. From digital radiology and cardiology imaging coupled with powerful patient information systems, to the latest in networking and remote access by means of infrastructure investments that include high speed LAN and wireless access, INTEGRIS has placed great value in giving physicians the tools they need to provide high-quality patient care.

Facility Stats

Licensed Beds: 900-999

Annual Imaging Studies: 300,000-399,999

Employees: 5,000-5,999

Physicians: 500-749

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5% - 10%

Total images archived: 30-40 million

How many locations offer imaging services: 2-4

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 300,000-399,999

Monthly electronic radiology reports: 10,000-24,999

Technologies that exchange images with PACS

• Advanced Visualization - Vital Images • C-Arm - OEC • Cardiac Cath Lab - GE • CR - Agfa • CT - GE • CAD - R2 • Data Storage - StorageTek • Digital Mammography - GE, Hologic, Fischer • DR - Kodak • Echocardiography - Acuson, GE • MRI - GE, Siemens • PET/CT - GE • Ultrasound - Acuson, GE • Workstation (Diagnostic) - Agfa • Workstation (PACS) - Agfa • Voice/Speech Recognition - Dictaphone • X-ray (Portable) - GE

Information Systems that share images with PACS

• CVIS - Heartlab, Camtronics • CPOE - Cerner • Critical Care/ICU/CCU - Agfa • EHR - Cerner • EMR - Cerner • Emergency - Agfa • HIS - Siemens • Nuclear Medicine - ADAC • Oncology - GE • Orthopedics - Agfa • Radiation Therapy - Agfa • RIS - Cerner • Surgery/OR - Agfa • Teleradiology - Agfa • Vascular - Agfa

Lehigh Valley Hospital and Health Network, Allentown, Pa.

Lehigh Valley Hospital and Health Network (LVHHN) is a major clinical campus for Penn State University’s College of Medicine at the Milton S. Hershey Medical Center. The network has served the Lehigh Valley for 100 years and was Pennsylvania’s first Level I Trauma Center. LVHHN treats more than 43,000 inpatients a year and more than 100,000 emergency department cases. With a president and CEO who is a national patient safety advocate, LVHHN’s investments in digital imaging and information management systems are investments in patient safety, diagnostic accuracy and physician convenience and communication.

Facility Stats

Licensed Beds: 800-899

Annual Imaging Studies: 500,000-999,999

Employees: 7,000-7,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 20% - 25%

Total images archived: 500,000-1,000,000

How many locations offer imaging services: 11-15

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 3 mil. and up

Monthly electronic radiology reports: 10,000-24,999

Technologies that exchange images with PACS

• Advanced Visualization - Vital Images • C-Arm - Siemens, GE • CR - Kodak • CT - Toshiba, GE • CAD - Cadstream • Data Storage - IBM • Digital Mammography - Fischer, Hologic • DR - Canon • MRI - GE • PET - GE • PET/CT - GE • SPECT - Philips, GE • SPECT/CT - Philips, GE • Ultrasound - Philips • Workstation (Diagnostic) - Richardson • Workstation (PACS) - Dell • Voice/Speech Recognition - Dictaphone

Information Systems that share images with PACS

• CPOE • Critical Care/ICU/CCU • Dental • EHR • EMR • Emergency • Endoscopy/Gastroenterology • HIS • LIS • Nuclear Medicine • Oncology • Radiation Therapy • RIS - GE • Surgery/OR • Teleradiology • Vascular

Main Line Health System, Bryn Mawr, Pa.

Main Line Health is comprised of three of suburban Philadelphia’s most respected acute-care hospitals as well as one of the nation’s premiere facilities for rehabilitative medicine. Each year Main Line Health trains more than 100 interns, residents and fellows. Main Line Health implemented the Enterprise Imaging System three years ago to develop a highly redundant imaging and distribution system which eliminated the need to print film. Enterprise images are available to clinicians on any in-house PC as well as 100 dedicated viewing PCs located in the ORs, critical care units, and high volume areas. Over 1,000 clinicians have been trained to date on the PACS.

Facility Stats

Licensed Beds: 800-899

Annual Imaging Studies: 400,000-499,999

Employees: 7,000-7,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 15% - 20%

Total images archived: 30-40 million

How many locations offer imaging services: 5-10

Physicians with online access to images: 80% - 89%

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 1 - 1.5 million

Monthly electronic radiology reports: 50,000-74,999

Technologies that exchange images with PACS

• Advanced Visualization - GE • C-Arm - OEC, Siemens • Cardiac Cath Lab - GE, Toshiba, Fischer • CR - Kodak • CT - GE • Data Storage - McKesson, GE • Digital Mammography - GE • DR - GE • Echocardiography - GE, Acuson, HP • MRI - GE, Siemens, Philips • PET - ADAC • PET/CT - Philips • Ultrasound - GE, Acuson • Workstation (Diagnostic) - McKesson • Workstation (PACS) - McKesson • Voice/Speech Recognition - Dictaphone • X-ray (Portable) - GE

Information Systems that share images with PACS

• CVIS - Camtronics • Nuclear Medicine - Philips • Radiation Therapy - Varian • Surgery/OR - GE • Teleradiology - Kodak

Maimonides Medical Center, Brooklyn, N.Y.

At almost 100 years old, 705-bed Maimonides Medical Center has pioneered many healthcare innovations, from the first human heart transplant to already having eight years of filmless imaging under its belt. It is the pre-eminent treatment facility and academic medical center in Brooklyn. Maimonides trains more than 400 residents and medical students each year and routinely contributes to the progress of medicine through its broad base of clinical and laboratory research. Its IT systems have allowed for a 20 percent higher volume of studies without increasing staff, 24/7 radiology coverage with two-thirds remote, file room space reduced by 90 percent and staff by 75 percent.

Facility Stats

Licensed Beds: 700-799

Annual Imaging Studies: 300,000-399,999

Employees: 4,000-4,999

Physicians: 750-999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 20%-25%

Total images archived: 50-100 million

How many locations offer imaging services: 21-25

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD

Monthly images viewed by clinicians: 500,000-999,999

Monthly electronic radiology reports: 75,000-99,999

Technologies that exchange images with PACS

• Advanced Visualization - GE • C-Arm - GE • Cardiac Cath Lab - Philips • CR - Fuji • CT - Siemens • CAD - iCAD • Data Storage - Datacorp • MRI - Siemens • PET/CT - Siemens • Ultrasound - ATL • Workstation (Diagnostic) - Aspyra • Workstation (PACS) - Aspyra • X-ray (Portable) - GE

Information Systems that share images with PACS

• Emergency - A4 HealthMatics • HIS - Eclipsys • Oncology - Impac • Radiation Therapy - Varian • RIS - IDX • Surgery/OR - GE • Teleradiology - Aspyra

Massachusetts General Hospital, Boston

MGH is the third oldest general hospital in the United States and the oldest and largest in New England. The 898-bed world-renowned medical center offers sophisticated diagnostic and therapeutic care in virtually every specialty and subspecialty of medicine and surgery. Each year the MGH admits approximately 45,000 inpatients and handles almost 1.5 million visits. MGH has an internally run radiology IT consulting group, The RCG, the largest in the industry, provides direct assistance to any hospital’s and imaging center’s IT needs. Their new center for Genetics and Genomics is set to show the industry how imaging and image mining will play a vital role in the next generation of information-based medicine.

Facility Stats

Licensed Beds: 800-899

Annual Imaging Studies: 500,000-999,999

Employees: 15,000-19,999

Physicians: 4,000-4,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5% - 10%

Total images archived: 100 mil. and up

How many locations offer imaging services: 5-10

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD

Monthly images viewed by clinicians: 3 mil. and up

Monthly electronic radiology reports: 300,000-399,999

Technologies that exchange images with PACS

• Advanced Visualization - Vital Images • C-Arm - GE • Cardiac Cath Lab - Siemens • Clinical Decision Support - Commissure • CR - Agfa • CT - GE, Siemens • CAD - R2 • Data Storage - ASM • Digital Mammography - GE, Hologic • DR - GE • Echocardiography - Siemens • MRI - GE, Siemens • PET - GE • PET/CT - GE • SPECT - Siemens • SPECT/CT - GE • Ultrasound - GE • Workstation (Diagnostic) - Agfa, Amicas, Terarecon • Workstation, Workstation (PACS) - Agfa, Amicas • Voice/Speech Recognition - Commissure • X-ray (Portable) - Agfa

Information Systems that share images with PACS

• CVIS - Siemens • CPOE • Critical Care/ICU/CCU - Agfa • Dental • Dermatology • EHR • EMR • Emergency - Agfa • Endoscopy/Gastroenterology - C-More • HIS • LIS • Nuclear Medicine - Agfa • Oncology • Ophthalmology • Orthopedics - Agfa • Radiation Therapy • RIS - GE • Surgery/OR • Teleradiology • Vascular

MeritCare Health System, Fargo, N.D.

MeritCare emcompasses the largest hospital in North Dakota and has 583 beds at two locations. Each year, it manages more than 21,000 hospital admissions, more than 43,000 visits to the Emergency Center (Level II trauma), 2,000 births, and more than 17,000 surgical cases. MeritCare uses digital imaging in all facets of its care continuum. Each provider is required to be trained in the digital tools for radiology and cardiology, which reduces costs and enhances patient visits by minimizing lost films and retakes. MeritCare’s website offers patients an extensive library of health information plus the ability to pay hospital and clinic bills online. The digital cardiology system means tests are consolidated onto one information network.

Facility Stats

Licensed Beds: 500-599

Annual Imaging Studies: 300,000-399,999

Employees: 6,000-6,999

Physicians: 300-399

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 20-30 million

How many locations offer imaging services: 25 and up

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD

Monthly images viewed by clinicians: 50,000-74,999

Monthly electronic radiology reports: 25,000-49,999

Technologies that exchange images with PACS

• Advanced Visualization - Voxar • C-Arm - OEC, GE, Siemens, Philips • Cardiac Cath Lab - GE • CR - Kodak, Agfa, Philips • CT - GE, Siemens, Philips • CAD - R2 • Data Storage - IBM • DR - Kodak • Echocardiography - Philips • MRI - Philips • PET/CT - GE • SPECT - Philips, Marconi, Picker, ADAC • Ultrasound - GE, Philips • Workstation (Diagnostic) - Philips • Workstation (PACS) - Philips • X-ray (Portable) - Siemens

Information Systems that share images with PACS

• CVIS - GE • Dental - Siemens • EMR - GE • Nuclear Medicine - Philips, Marconi, Picker, ADAC • Orthopedics - GE • Radiation Therapy - ADAC • RIS - IDX • Surgery/OR - Kodak • Teleradiology - VRC • Vascular - Parks

Merle West Medical Center, Klamath Falls, Ore.

This 176-bed, community-owned facility covers the healthcare needs of a 10,000-square-mile area in Oregon and northern California. Since installing PACS in 2001, Merle West Medical Center has reduced its film costs by 97 percent and improved the efficiency of its imaging procedures. The radiologists utilize CR, which is installed in each exam room. Both physician and patient can see images as they are taken, saving time by ensuring the image is clear and correct. Since 2005, $47 million has been spent to modernize the facility, including installation of several media centers and an electronic records system that staff can access through wireless, portable devices.

Facility Stats

Licensed Beds: 100-199

Annual Imaging Studies: 50,000-74,999

Employees: 1,000-1,999

Physicians: 100-199

How much of the facility is filmless: 90% and up

Increase in digital procedures: 10%-15%

Total images archived: 100,000-250,000

How many locations offer imaging services: 5-10

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD

Monthly images viewed by clinicians: 10,000-24,999

Monthly electronic radiology reports: 10,000-24,999

Technologies that exchange images with PACS

• Advanced Visualization - GE • C-Arm - GE • Cardiac Cath Lab - Philips • CR - Fuji • CT - Philips • CAD - R2 • Data Storage - HP • Echocardiography - GE • MRI - Philips • PET - Siemens • Ultrasound - GE • Workstation (PACS) - DR Systems • Voice/Speech Recognition - DR Systems • X-ray (Portable) - GE

Information Systems that share images with PACS

• CVIS - Philips • CPOE - Meditech • Critical Care/ICU/CCU - DR Systems • EHR - Meditech • EMR - Meditech • Emergency - DR Systems • Endoscopy/Gastroenterology - DR Systems • HIS - Meditech • Nuclear Medicine - DR Systems • Oncology - DR Systems • Orthopedics - DR Systems • Radiation Therapy - DR Systems • RIS - Meditech • Surgery/OR - DR Systems • Teleradiology - DR Systems

Pella Regional Health Center, Pella, Iowa

This critical access hospital in Iowa has fewer than 50 physicians but has made great strides toward a filmless environment. The installation of PACS has led to numerous cost savings, image availability for all physicians, no lost studies, improved report turnaround time, and improved staff efficiency. The PACS is integrated with the facility’s electronic medical record system, allowing physicians to view all images directly from the EMR application. Once digital mammography is implemented this fall, the facility will be completely filmless. Construction underway this year will result in a new Medical Imaging Center designed and located to provide maximum productivity of radiologists and technologists.

Facility Stats

Licensed Beds: Less than 100

Annual Imaging Studies: 10,000-24,999

Employees: 750-999

Physicians: 25-49

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 1-5 million

How many locations offer imaging services: 2-4

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD

Monthly images viewed by clinicians: 50,000-74,999

Monthly electronic radiology reports: less than 10,000

Technologies that exchange images with PACS

• C-Arm - GE • CR - Fuji • CT - Siemens • MRI - Siemens • Ultrasound - Siemens • Workstation (Diagnostic) - Siemens • Workstation (PACS) - Siemens • Voice/Speech Recognition - Agfa

Information Systems that share images with PACS

• EMR - Meditech • HIS - Meditech • RIS - Meditech

Queens Health Network, Elmhurst, N.Y.

The Queens Health Network (QHN) is the largest healthcare provider in the borough of Queens, providing over a million ambulatory care visits annually. QHN consists of two leading acute care facilities, Elmhurst and Queens Hospital Centers, 15 community-based medical centers and practices, and six school-based health centers. QHN offers 27 residency programs and its hospital-based services are ranked among the top in the nation and have become the borough’s major resource for specialized care. In 2002, Queens and Elmhurst were the first public hospitals to receive the Davies Award for computer-based patient record systems. They also have implemented e-prescribing, which fewer than 1 percent of U.S. hospitals can claim.

Facility Stats

Licensed Beds: 800-899

Annual Imaging Studies: 200,000-299,999

Employees: 4,000-4,999

Physicians: 750-999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 30-40 million

How many locations offer imaging services: 2-4

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film, paper

Monthly images viewed by clinicians: 100,000-199,999

Monthly electronic radiology reports: less than 10,000

Technologies that exchange images with PACS

• Advanced Visualization - GE • C-Arm - GE • Cardiac Cath Lab - Philips • CR - GE • CT - GE • Data Storage - EMC • Digital Mammography - GE • DR - GE • Echocardiography - Philips, GE • MRI - Philips • SPECT - SMV • Ultrasound - ATL, Siemens, GE • Workstation (Diagnostic) - GE • Voice/Speech Recognition - Agfa • X-ray (Portable) - GE, Picker

Information Systems that share images with PACS

• CVIS - Misys • CPOE - Misys • EHR - Misys • EMR - Misys • Emergency - Misys • HIS - Misys • LIS - Misys • Nuclear Medicine - Misys • RIS - Misys

Radiology, Ltd., Tucson, Ariz.

A freestanding imaging center, Radiology Ltd. has 10 locations in the Tucson area, and has been providing diagnostic imaging services for over 60 years. Services include MRI and CT imaging, PET/nuclear medicine, bone and joint imaging, women’s imaging, interventional treatment and diagnostic and interventional neuroradiology. Currently there are more than 45 radiologists in the practice and more than 450 technical, clerical, and administrative personnel. Radiology Ltd.’s commitment to technology integration has positively impacted patient care as well as business processes. Moving to a paperless workflow has resulted in a 40 percent increase in efficiency, allowing radiologists to expand their services to two new outpatient locations.

Facility Stats

Licensed Beds: N/A

Annual Imaging Studies: 500,000-999,999

Employees: 400-499

Physicians: 25-49

How much of the facility is filmless: 90% and up

Increase in digital procedures: 10%-15%

Total images archived: 10-20 million

How many locations offer imaging services: 5-10

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film, paper

Monthly images viewed by clinicians: 10,000-24,999

Monthly electronic radiology reports: 25,000-49,999

Technologies that exchange images with PACS

• Advanced Visualization - Terarecon • CR - Fuji, Konica • CT - Toshiba, Siemens • CAD • Data Storage - EMC • Digital Mammography - Hologic • DR - Siemens, Toshiba • MRI - Hitachi, Toshiba, Siemens • PET - GE • PET/CT - GE • SPECT - Siemens • Ultrasound - Philips, Toshiba, Siemens • Workstation (Diagnostic) • Workstation • Workstation (PACS) • Voice/Speech Recognition - Fusion

Information Systems that share images with PACS

Not applicable

Robert Wood Johnson University Hospital, New Brunswick, N.J.

This principal hospital for the University of Medicine and Dentistry of New Jersey’s Robert Wood Johnson Medical School and a member of the Robert Wood Johnson Health System & Network treats more than 100,000 patients annually. The hospital’s many Centers of Excellence include the Heart Center of New Jersey, the Center for Kidney and Pancreas Transplantation, and the Level 1 Trauma Center. The facility has earned the Nursing Magnet designation three consecutive times. With imaging technologies as a core component of the overall clinical IT strategy, RWJUH has saved an average of $350,000 per year for the last five years in supplies, and labor costs of at least $200,000 a year.

Facility Stats

Licensed Beds: 500-599

Annual Imaging Studies: 300,000-399,999

Employees: 6,000-6,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 20-30 million

How many locations offer imaging services: 1

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, paper

Monthly images viewed by clinicians: 500,000-999,999

Monthly electronic radiology reports: 25,000-49,999

Technologies that exchange images with PACS

• Advanced Visualization - Vital Images • C-Arm - Agfa • Cardiac Cath Lab - Philips • CT - Agfa • Data Storage - EMC, StorageTek • Digital Mammography - Agfa • DR - Agfa • Echocardiography - Philips • MRI - Agfa • PET - Agfa • PET/CT - Agfa • Ultrasound - Agfa • Workstation (Diagnostic) - Agfa • Workstation (PACS) - Agfa • Voice/Speech Recognition • X-ray (Portable) - Agfa

Information Systems that share images with PACS

• CPOE - Eclipsys • EMR - Eclipsys • Endoscopy/Gastroenterology - Philips • HIS - Eclipsys • Nuclear Medicine - Agfa • RIS - Cerner • Vascular - Philips

Sentara Healthcare, Chesapeake, Va.

Sentara Healthcare is the largest integrated healthcare provider in south­eastern Virginia and northeastern North Carolina. It operates six acute-care hospitals, one extended stay hospital and more than 70 sites of care, 43 primary care practices and six imaging centers. In less than 14 months, the PACS team transformed the radiology departments at five hospitals by implementing RIS, PACS and voice recognition. Every measure of success exceeded the goals established. Ultimately, 185 PCs and 114 PACS workstations were installed throughout the facilities, resulting in dramatically enhanced delivery of Sentara’s imaging services.

Facility Stats

Licensed Beds: 1,000-1,999

Annual Imaging Studies: 500,000-999,999

Employees: 15,000-19,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 20%-25%

Total images archived: 1-5 million

How many locations offer imaging services: 11-15

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film, paper

Monthly images viewed by clinicians: 100,000-199,999

Monthly electronic radiology reports: 50,000-74,999

Technologies that exchange images with PACS

• Advanced Visualization - GE, Terarecon • C-Arm - GE, Philips • Cardiac Cath Lab - Philips • CR - Agfa • CT - Siemens, GE, Philips • Data Storage - EMC, StorageTek • DR - GE, Philips • MRI - GE, Philips, Siemens • PET/CT - GE • Ultrasound - Philips, Acuson, GE, Siemens • Workstation (Diagnostic) - Agfa • Workstation (PACS) - Agfa • Voice/Speech Recognition - Agfa • X-ray (Portable) - GE

Information Systems that share images with PACS

• CVIS - ProSolv • Emergency - Philips, GE • Nuclear Medicine - GE • Radiation Therapy - IMPAC • Surgery/OR - Stryker • Vascular - Philips

Springhill Medical Center, Mobile, Ala.

Since opening in 1975, Springhill Memorial Hospital has doubled its physical size, quadrupled its staff and increased the bed count more than fivefold. As a corporate/for-profit hospital, Springhill is the area’s only tax-paying hospital, supporting the community with more than $2 million dollars in tax revenues annually. Once Springhill Medical Center decided to implement a PACS and become a filmless hospital, the system was activated in just 90 days. Less than three months after going live, the hospital was more than 99 percent filmless. The installation reduced its file room staff, saved more than $700,000 on film alone, and improved patient care.

Facility Stats

Licensed Beds: 200-299

Annual Imaging Studies: 75,000-99,999

Employees: 1,000-1,999

Physicians: 500-749

How much of the facility is filmless: 90% and up

Increase in digital procedures: less than 5%

Total images archived: 250,000-500,000

How many locations offer imaging services: 1

Physicians with online access to images: 70%-79%

How referring physicians access images: online, CD

Monthly images viewed by clinicians: less than 10,000

Monthly electronic radiology reports: less than 10,000

Technologies that exchange images with PACS

• Advanced Visualization - Vital Images • C-Arm - GE • CR - Konica • CT - Toshiba • CAD - Vital Images • Digital Mammography - GE • DR - GE • Echocardiography - Toshiba • MRI - GE • Ultrasound - Toshiba • Workstation (Diagnostic) - Sectra • Workstation (PACS) - Sectra

Information Systems that share images with PACS

• CPOE - Eclipsys • EMR - Eclipsys • Emergency - Eclipsys • HIS - Eclipsys

University of Texas - MD Anderson Cancer Center, Houston

This world-renowned cancer center has added a research building, ambulatory clinical building, cancer prevention center, research building and soon a proton therapy center, all since the beginning of 2005. The institution is the leading facility for grants awarded by the National Cancer Institute. Since November 2000, every imaging study created is stored on spinning media. Any of the 200 million images in the archive can be accessed and displayed in two seconds or less. The organization’s informatics group has taken PACS to the next level by integrating the EMR, customized interpretation worklists, patient arm bands integrated with DICOM work lists, and image CD-ROM importation.

Facility Stats

Licensed Beds: 400-499

Annual Imaging Studies: 400,000-499,999

Employees: 15,000-19,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 100 mil. and up

How many locations offer imaging services: 1

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 3 mil. and up

Monthly electronic radiology reports: 500,000-999,999

Technologies that exchange images with PACS

• Advanced Visualization - Vital Images, GE • C-Arm - Siemens, OEC • CR - Fuji • CT - GE • CAD - R2 • Data Storage - IBM, Compaq • Digital Mammography - Hologic • DR - GE • MRI - GE, Siemens • PET - GE • PET/CT - GE • SPECT - Siemens • SPECT/CT - Siemens • Ultrasound - Philips, Siemens, GE • Workstation (Diagnostic) - Philips • Workstation (PACS) - Philips • X-ray (Portable) - GE

Information Systems that share images with PACS

• CVIS - Philips • CPOE • Critical Care/ICU/CCU - PICIS • Dental - ClinicStation • Dermatology - ClinicStation • EHR - ClinicStation • EMR - ClinicStation • Emergency - ClinicStation • HIS - Siemens • LIS - Cerner, Tamtron • Nuclear Medicine - Siemens • Oncology - ClinicStation • Ophthalmology - ClinicStation • Orthopedics - ClinicStation • Radiation Therapy - IMPAC • RIS - Siemens • Surgery/OR - PICIS • Teleradiology - Philips

University of Maryland Medical Center, Baltimore

University of Maryland Medical Center is the academic centerpiece of the University of Maryland Medical System, a regional, non-profit network that also includes two community hospitals and three specialty hospitals. UMMC provides comprehensive care for 300,000 patients a year. It was the first to be certified to perform nuchal translucency screening, a non-invasive ultrasound to detect genetic abnormalities, and stroke specialists on the Brain Attack Team were the first to use telemedicine to examine stroke patients from a distance. Meanwhile, the imaging team has built a low-cost, effective and highly scalable storage strategy to accommodate both thin slice archiving and enterprise archiving for specialties other than radiology.

Facility Stats

Licensed Beds: 1,000-1,999

Annual Imaging Studies: 500,000-999,999

Employees: 6,000-6,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 1-5 million

How many locations offer imaging services: 5-10

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film, paper

Monthly images viewed by clinicians: 50,000-74,999

Monthly electronic radiology reports: 75,000-99,999

Technologies that exchange images with PACS

• Advanced Visualization • C-Arm • Cardiac Cath Lab • CR • CT • CAD • Data Storage • DR • Echocardiography • MRI • PET • PET/CT • SPECT • SPECT/CT • Ultrasound • Workstation (Diagnostic) • Workstation (PACS) • Voice/Speech Recognition • X-ray (Portable)

Information Systems that share images with PACS

• CVIS • CPOE • Critical Care/ICU/CCU • EHR • EMR • Emergency • HIS • Nuclear Medicine • Oncology • Orthopedics • RIS • Surgery/OR • Teleradiology • Vascular

University of Utah - University Health Care, Salt Lake City

Intermountain West’s tertiary care referral center is known for numerous programs including orthopedics, stroke, cancer, cardiology, genetic related diseases and organ transplant. The hospital also is a nationally verified Level I Trauma Center. Its burn center is the only burn treatment facility in the region, and has more than 5,000 clinic visits and more than 300 admissions a year. The AirMed patient-transport service completes more than 1,800 missions a year. The facility has been named one of the nation’s best hospitals by U.S. News & World Report for 13 years. The move to filmless imaging has dramatically reduced radiology report turnaround time, saved almost $3 per exam and increased technologist productivity.

Facility Stats

Licensed Beds: 400-499

Annual Imaging Studies: 200,000-299,999

Employees: 4,000-4,999

Physicians: 750-999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 20-30 million

How many locations offer imaging services: 16-20

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD

Monthly images viewed by clinicians: 50,000-74,999

Monthly electronic radiology reports: 10,000-24,999

Technologies that exchange images with PACS

• CR - Siemens • CT - Siemens • Digital Mammography - Siemens • DR - Siemens • MRI - Siemens • PET - Siemens • PET/CT - Siemens • Ultrasound - Siemens • Workstation (Diagnostic) - Philips • Workstation (PACS) - Philips • Voice/Speech Recognition - Dictaphone

Information Systems that share images with PACS

• CPOE - Cerner • EMR - Cerner • RIS - IDX

Wellspan Health, York, Pa.

WellSpan Health is a not-for-profit, community-based healthcare system comprised of Gettysburg Hospital, York Hospital and more than 40 other locations serving south central Pennsylvania and northern Maryland. Regional referral services include neonatology, behavioral health, trauma, cardiology, orthopedics, neurosurgery and cancer. York Hospital is a community teaching hospital that has been named a top 100 hospital six times, ranked among the top 100 open heart surgery programs and recognized by U.S. News and World Report as one of the country’s top 50 hospitals for orthopedics. Digital imaging has saved the organization almost $800,000 and PACS efforts have facilitated collaborative efforts between departments and entities across the region.

Facility Stats

Licensed Beds: 600-699

Annual Imaging Studies: 400,000-499,999

Employees: 7,000-7,999

Physicians: 1,000-1,999

How much of the facility is filmless: 90% and up

Increase in digital procedures: 5%-10%

Total images archived: 1-5 million

How many locations offer imaging services: 11-15

Physicians with online access to images: 90% and up

How referring physicians access images: online, CD, film

Monthly images viewed by clinicians: 50,000-74,999

Monthly electronic radiology reports: 50,000-74,999

Technologies that exchange images with PACS

• Advanced Visualization - Vital Images, Voxar, Siemens, Philips • C-Arm - GE • Cardiac Cath Lab - Philips, Witt • CR - Philips • CT - Philips, Siemens • CAD - R2 • Data Storage - Stentor • Digital Mammography - Hologic • DR - Philips • Echocardiography - Philips, Siemens • MRI - GE, Philips • PET/CT - Siemens • SPECT - Philips, ADAC • Ultrasound - Siemens, Philips, Toshiba • Workstation (Diagnostic) - Stentor • Workstation (PACS) - Stentor, Dell

Information Systems that share images with PACS

• CVIS - Philips, Witt • EHR - Cerner • EMR - Cerner • HIS - Cerner • Radiation Therapy - ADAC • RIS - GE

Honorable Mentions

While they weren’t a part of the Top 25 Connected Healthcare Facilities, there were several organizations that emerged from the pack to show they are well on their way to making our most connected list in the future. Most have shown impressive cost reductions through their health IT efforts, significant increases in digital imaging procedures and online image access for physicians anytime, anywhere. We salute these facilities—the honorable mentions.

Akron General Medical Center, Akron, Ohio

Akron General is a 511-bed hospital that treats almost 30,000 inpatients, more than 500,000 outpatients and welcomes more than 2,700 newborns annually. Physicians at the academic teaching hospital use tablet PCs and can remotely access the entire system, including PACS. The facility is working toward a totally portable electronic medical record that patients can access and take with them. Akron General plans to significantly invest in technology that enhances collaboration outside of the hospital and allows patients to be more connected to their healthcare information.

BJC Healthcare, St. Louis, Missouri

BJC HealthCare is one of the largest nonprofit health-care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. With net revenue of $2.6 billion, BJC serves urban, suburban and rural communities and includes 13 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. With more than a dozen facilities connected to each other in the St. Louis Metropolitan area, BJC has made a significant contribution to the advancement of networked medical imaging by adopting an enterprise-wide approach to PACS. BJC also has seen an increase of more than 20 percent in the number of digital procedures from a year ago. Its more than 30 million archived images can be accessed via the web and more than half a million electronic radiology reports are reviewed each month.

Boswell & Del Webb Hospitals, Sun City, Ariz.

Boswell & Del Webb Hospitals are the two hospitals of Sun Health, a non-profit, community-owned network of healthcare services. Boswell offers extensive resources for cardiac care, treating more heart patients than any other hospital in Arizona. It also is one of Arizona's leading centers for hip and knee replacement as well as other orthopedic and follow-up rehabilitation programs. Del Webb has a Center for Women’s Health and Cardiac Catheterization Laboratory, and both facilities have stroke centers. The hospitals’ PACS is designed for 99.99 percent uptime—should the system go down in one facility, the enterprise-wide PACS will be operational from the other within 20 minutes. Digital imaging has reduced procedure time by an average of 30 percent, reduced file room staff by 75 percent and helped pave the way toward an EMR. More than 90 percent of imaging studies are digital, images are accessible via the web and the number of digital procedures has increased 15 to 20 percent from a year ago.

Cassia Regional Medical Center, Burley, Idaho

As part of Intermountain Health Care, Cassia Regional Medical Center provides general medical and surgical care in rural Idaho. The 38-bed facility was completed in 1995. It has been reported by USA Today to be the lowest cost hospital in the United States. The facility utilizes PACS and speech recognition. More than 90 percent of imaging procedures are digital and the facility is more than 90 percent filmless. The number of digital procedures at Cassia has increased 5 to 10 percent from a year ago.

Cook Children's Health Care System, Fort Worth, Texas

With one million patient encounters a year, Cook Children's Health Care System has a 282-bed medical center with tertiary and quaternary services in more than 30 pediatric specialties and services. Patients come from 120 counties in north and west Texas, 35 states and several countries. Cook Children's treats more than 16,000 surgery patients, more than 1,100 pediatric intensive care patients, more than 700 newborn intensive care patients and provides more than $170 million in uncompensated care each year. The organization was an early adopter of PACS technology, installing its first PACS in 1999. As a result of a collaborative effort between Radiology and Information Services, physicians and staff, Cook Children's has been able to achieve a nearly completely filmless radiology services operation. PACS images are available not only within the medical center, including within surgical suites for intraoperative viewing, but also at remote facilities in a 110-county service area in north and west Texas. Physicians have wireless access throughout the medical center. Cook Children's has freely shared its accumulated PACS knowledge with other pediatric healthcare organizations that are considering moving to digital imaging technology.

Eastern Radiologists Inc., Greenville, N.C.

Eastern Radiologists Inc. provides radiology and medical imaging services to patients and referring physicians at three freestanding, outpatient imaging centers and nine hospitals in the eastern North Carolina region. The organization has the largest staff of radiologists in eastern North Carolina (40) offering subspecialty expertise for the more than 350,000 studies performed each year. Eastern Radiologists has engaged cutting edge adoption of technology for efficiency and patient care improvements. The connectivity has allowed even very small rural hospitals to have their images read by subspecialists who normally would not be available to these facilities. More than 90 percent of procedures are digital, more than 90 percent are filmless, images are accessible via the web and the number of digital procedures has increased by more than 25 percent over a year ago.

Inland Imaging LLC, Spokane, Wash.

Inland Imaging is comprised of four freestanding imaging center with the largest seeing up to 500 patients a day. The affiliated medical group includes 52 radiologists and 5 vascular surgeons providing services to the imaging centers and 12 rural hospitals across the region. Inland does more than 600,000 studies a year and has seen an increase of 10 to 15 percent over a year ago. More than 5,000 users utilize the organization's PACS web viewer. Installation of PACS reduced records staff from 35 people to just five and saved more than $600,000 in supplies. They are more than 90 percent digital with inter-enterprise connectivity.

Providence Saint Joseph and Holy Cross Medical Centers, Burbank and Mission Hills, Calif.

As a 254-bed, not-for-profit facility, Providence Holy Cross Medical Center is ranked among the nation's top 5 percent of hospital for clinical excellence. Four hundred and fifty five bed Providence Saint Joseph Medical Center is the area's largest hospital and opened a fully digital breast imaging center in 2005. Since initially implementing PACS in 2003, the facilities have more than 4,000 users. The cardiac cath labs have been added to the enterprise PACS while realizing a 50 percent reduction in storage costs. Storage costs have remained stable even with the recent addition of multidetector CT. The IT team supports a service area web-based physician portal that delivers PACS and provides access to all laboratory results complete with trending and critical test result alerts, all diagnostic and transcribed reports, patient lists, and secure messaging. The facilities achieved 85 percent of their return on investment goals within weeks rather than the anticipated three years. The facilities were more than 95 percent filmless within one year and cut file room FTEs by half.

Slocum Dickson Medical Group, New Hartford, N.Y.

Slocum-Dickson Medical Group employs over 60 physicians practicing in 25 specialties. Continuous expansion in recent years has allowed for installation of MRI capabilities and 64-slice CT. Plans are underway to fully convert to digital and construction efforts are designed around the anticipated workflow needs. Staff already use electronic records. The number of digital procedures has increased more than 25 percent over a year ago and the organization is more than 90 percent filmless and more than 90 percent of the physicians have online access to images.

Temple University Children's Medical Center, Philadelphia

Temple University Children's Medical Center opened in 1998. It is a 68-bed children's hospital located next to Temple University Hospital. It was planned for a new model of pediatric care in which children are cared for around the clock by attending physicians who make treatment decisions regardless of the time. Studies show that this method speeds recovery. Sixty percent of the facility is dedicated to outpatient care, with specialty programs such as primary pediatric care, asthma, endocrinology, neurology, opthalmology and orthopedics. The facility treats more than 50,000 outpatients annually. The facility is more than 90 percent filmless, more than 90 percent of the physicians have online access to images and the number of digital procedures has increased more than 25 percent over a year ago. Physicians also have access to images via the web.

The Orthopedic Clinic Association, Phoeniz, Ariz.

The Orthopedic Clinic is the first medical practice specializing in orthopedic surgery in Arizona. Today, The Orthopedic Clinic has grown to 15 physicians with four locations across the valley. In addition to common orthopedic procedures such as arthoscopy, joint replacement and fracture care, the facility's physicians are experienced in total ankle reconstruction and replacement, ligament reconstruction and cartilage restoration for knee injuries, upper extremity reconstructive surgery, surgery for complex disorders of the spine, total joint revision surgery and minimally invasive and percutaneous spinal procedures. Physicians have wireless access, more than 90 percent of images are digital and the practice is more than 90 percent filmless.

Dept. of Veterans Affairs, Washington, D.C.

As the largest and most connected healthcare network in the United States, you might expect the VA to squash the Top 25 list. In fact, that's why we did not include it in the main list—with 158 medical centers that acquires over 3 million images a month and has more than 100 million total archived images, there is no comparison.The Veterans Health Information Systems and Technology Architecture (VISTA) was introduced in 1996. By 2001, the VHA was the largest single medical system in the United States, providing care to 4 million veterans. VHA's electronic health records provide patient-specific information that support time and context sensitive clinical decision-making. VistA also includes links that allow users to incorporate commercial software and products with existing and future platforms. This integration increases the range of uses for electronic health records and meets the documentation needs of providers in ancillary and subspecialty care areas.

In the last 10 years, VistA has helped improve operating efficiencies approximately 6 percent per year and, adjusted for inflation, VHA care is 32 percent less expensive than a decade ago, with measurably better outcomes in quality, satisfaction, access and patient function. VHA has created a multimedia online patient record that integrates traditional medical chart information with medical images. Computerized Patient Record System Graphical User Interface (VistA CPRS GUI) enables clinicians to enter, review and continuously update all order-related information connected with any patient. Bar Code Medication Administration (BCMA) automates the medication administration process by providing a real-time, point-of-care solution for validating the dispensation of unit dose and intravenous medications to inpatients. BCMA also electronically updates the patient's medication administration history.