If there was just one thing I could tell our healthcare clients about using CDs for medical image exchange, it’s that there is a better way.
Talking about the transition from CDs to electronic image transfer solutions is an important discussion for healthcare CIOs. It’s about better communication and care coordination, better clinician satisfaction, and ultimately better patient satisfaction as well. It provides a more secure way to transfer sensitive patient information.
And it’s also about a stronger bottom line: Depending on the volume of CDs an organization is producing or receiving today, a digital solution can be a much more cost effective way to share images. If you’re even a medium-sized hospital, you probably receive in excess of 30,000 CDs a year at an estimated processing cost of $10 per CD; that’s $300,000 a year for a single organization just to receive CDs. At those rates, a digital image exchange solution could literally pay for itself with significant money to spare year over year, with the added advantage of creating happier physicians and patients in the process.
As we all know, CDs have been the standard way to share patient images, but they are quickly becoming antiquated in light of newer, faster, cheaper digital solutions. That’s because there are numerous problems with using CDs for medical image sharing that range from using the patient as a transport vehicle to slowing the development of a care plan in critical trauma cases where images are needed immediately and time is of the essence.
The answer is to adopt an electronic image exchange solution as well as an improved workflow that streamlines the addition and availability of patient images to the local Picture Archiving and Communication System (PACS), vendor neutral archive or other imaging systems.
A digital image transfer solution can have numerous advantages over CDs, but before it can be implemented, four crucial steps must be taken to ensure that the new solution will result in an improvement to the delivery of care.
Examine current practices
When considering a change, it’s important to understand your organization’s current practices and the opportunities that exist for improvement. Who is receiving the CDs today? What workflows are being used? How are the images being integrated into local PACS and other imaging systems? Are any of your organization’s departments using image exchange portals already?
To determine the answers to these and other important questions, focus first on image-dependent service lines like neurology, orthopedics and oncology to learn how they review images today. If your organization has been slow to move, individual departments may have already adopted their own image exchange solutions. If there is no enterprise solution, you may be surprised to learn that there are already two or three disparate departmental solutions in place.
The key to this first step is to understand these critical departments’ workflow challenges – with whom and how are they sharing images? When in the care process do your clinicians most need access to patient images, and how are they interacting with those images during surgical procedures? Knowing the answers to these questions will allow you to look for a standards-based solution that both meets your users’ expectations and ensures compatibility with other exchange solutions.
Prioritize use cases
In this step, the goal is to identify where the greatest impact on patient care and clinician satisfaction can be made. Talk to your organization’s doctors and identify physician champions in critical service lines; a departmental champion and physician buy-in will be needed to help you change workflow.
Then, together with that champion, prioritize use cases. Perhaps having access to external images during surgical cases has become a priority. Maybe it’s more important for specialists to be able to review images and prepare a treatment plan before a patient encounter. What about emergent patient transfers—would it be of benefit to have images arrive before the ambulance does? Would digital image receipt bolster telehealth efforts? Should images be available to patients through a portal?
These questions and more must be answered to determine the use case priorities within your organization – and those priorities will differ significantly from one organization to the next.
Make workflows routine
When developing an image exchange workflow, attention must be paid to developing a seamless integration with existing clinical processes.
In an electronic image exchange solution, as images arrive, they go to a “sandbox,” a holding area where they wait for “triage” where a human being ensures they open and that they are indeed medical images. That triage person then alerts the physician that the images have arrived, yet they reside in the sandbox without a medical record number and are not yet normalized to the hospital’s EHR.
Ideally, from within the patient’s EHR, your physicians should be able to easily see the images with a familiar enterprise viewer and, with a single mouse click, nominate the images for retention to the appropriate imaging system.
Select standards-based solutions
Purchasing a solution should only come at the end of a very thorough investigation, when the solution can be shaped based on a true understanding of your organization’s varied use cases, priorities and requirements.
Selecting a standards-based solution clearly depends in large part on what other organizations need access to the same images. If it’s a simple non-emergency hospital to hospital transfer, images may not be required at a moment’s notice, but in emergent transfers where patients are speeding between institutions in an ambulance, every second counts.
Does your organization also need to image-enable its portal? Imagine a snowbird whose regular doctor is in one state but who travels to another during the winter months; would an image-enabled patient portal facilitate ongoing care?
It is in these situations when the importance of a standards-based solution can be most readily identified and appreciated.
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