Best practices in implementing information systems in the radiology department
Using a step-by-step process for implementing information systems in radiology departments increases the likelihood of success. What follows is the process included in a common-sense guide to implementing imaging information technology from Merge Healthcare, now a part of IBM. “From articulating a clear vision for your organization, to tracking the right metrics, to prioritizing training and education, it can be difficult to know just where to begin—until now,” the guide says.
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Create a culture of collaboration and partnership
Each member of the vendor and customer teams must understand that everyone succeeds or fails together in an imaging IT automation effort. Taking time at the outset to discuss and document the team approach pays dividends in the long run. An outsider walking into your facility should find it nearly impossible to distinguish whether an individual is employed by the vendor or the customer because everyone is striving toward the same goal.
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Clearly identify key leaders
For ambitious projects such as imaging implementations, the vendor’s team should include a project manager who can draw on resources throughout the vendor organization, such as executive sponsors, product managers, subject matter experts and any subcontractors.

A lead trainer should also be engaged from the project’s onset. From the provider side, team members must include an administrative champion, physician champion and technical champion. Other leaders may include the CEO, CIO, CMO, medical records manager, transcription manager, marketing manager, security manager and compliance manager.
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Select and empower your physician champion for success
Formally select a qualified physician champion based on excellent communication and teaching skills, commitment to the mission and leadership capability. Provide a formal job description, goals and appropriate work time.

All too often, a physician leader is expected to take on the added responsibility without any organizational commitment to provide the time to be successful or reasonable compensation. The physician champion should be available full time during any on-site training period and subsequently at least one to two days per month for continuous process improvement.
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Document team mission, vision, and values
Have all team members contribute to and sign off on foundational documents to establish direction, priorities and guiding principles. These can include the following.

Mission: Keep it short, meaningful and memorable.

Vision: Imagine your ideal result and verbally paint the picture.

Values: Each organization must identify core principles, such as safety, integrity, diligence, humility and respect.
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Establish rules for communication and decision making
Set a rule from the outset that all communications are shared among key stakeholders. Document each implementation task, assign a responsible owner and create a due date to ensure that each person is accountable and appreciates that an incomplete task means a project delay.

Collaborate and listen to team members and advisors before making your own decision. Don’t expect everyone to agree. Instead of consensus, think about pulling the herd by moving those early adopters that stand between you and the others. Agree on a key stakeholder email list that must be included in all project communications. Be sure that the physician champion and other clinical users are involved in all clinical decisions, such as report templates and workflow protocols.
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Establish clear objectives, success measures and timelines
Scheduling/registration/front desk: Measures include schedule time, exams scheduled via fax vs. direct interface with the referrer’s EMR, time between schedule request and actual appointment and patient no-show rate.

Clinical workflow: Measures include exam time to report delivery time, peer review metrics, percentage of patients who complete required follow-up exams and overall employee satisfaction by role.

Training: Measures include training courses completed, by role and level of expertise attained, per individual, per position and/or per facility.

Business and marketing: Measures include production cost per modality and exam type, accounts receivable metrics, referrers lost or gained, and exam volumes.
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Select trainers and solidify a training approach
A training team should be established at the start of the project—it should include a lead trainer from the vendor, the physician champion and other appropriate customer personnel, well in advance of “go live week."

Establish an ongoing training program for all relevant employees, with tracking by individual and rewards for successful participation. Assess trainees to confirm they absorbed the information, identify knowledge gaps and track results.
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Standardize implementation to boost quality and efficiency
Strongly consider adopting an imaging centric master file of procedure types. Often, imaging center customers simply adopt whatever list of procedures was employed with a previous system, and hospitals use whatever procedure types already exist in the hospital information system (HIS).

The procedure list should include fewer than 1,000 procedures—a bloated list of 3,000 to 15,000 imaging procedures makes every process more difficult and error prone, including scheduling, hanging protocols, pre-fetch rules and report template linking. Your imaging procedure list does not need to match the HIS if the imaging IT vendor supports two way mapping of procedures.
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Agree on white-glove inspection requirements
Clearly delineate the system and personnel tests that must be completed before you go live and before you complete on-site training. For example, set up a checklist that specifies pre-go­live system validation testing, including such items as establishing best practice default configurations, master file setup, emergency procedures and backup procedures.

Document that the pre-training procedures have been completed by each key stakeholder. Carefully plan and document the exact procedures to follow and who to contact if help is needed after the vendor is no longer on site.
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Measure, compare to benchmarks, and market the benefits
As your organization achieves improvements, communicate the achievements. Use technology and the patient visit to communicate with your patient population and continuously solicit their feedback. Applicable technology may include your patient portal, a PHR, your website or patient handouts. Similarly, let your referring staff and contracted payers understand and appreciate your achievements.