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Hospital B The selection processGE Centricity/Cosmos

Siemens

By Roxanne DeshongState University of New York

College of Health Related ProfessionsMedical Informatics Program

Medical Imaging 5204 October 2012

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A facility in the central area of Brooklyn which is connected to two other hospitals with combined beds 1350 . The hospital is in the process of replacing its current out dated radiology system .

There are a number of issues regarding the present system making it very difficult for the hospital to make a profit and to provide the best care for the patients. Inefficient workflow and image routing distribution Front office and billing not integrated, Issues with processing workflow with electronic claims submissions Huge loss in charges Too many errors Poor turnaround time Large amounts of film storage area required Not cost effective to name a few that are

Introduction Hospital B

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Growth in referring physician satisfaction Establish core clinical documentation Improving report turnaround time Increase efficiencies in workflow Allow for increased marketing Increase understanding of revenue stream Functionality in terms of diagnosis workstation tools Improved communication Integrated and automation Reduction in lost charges Faster report distribution

Measurable Benefits

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Healthcare Information and Management - HIMSS

Systems Society Radiological Society of North America - RSNA

GOLD STANDARD Integrating the Healthcare Enterprise - IHE Comprehensive Multi-vendor Integration

Specification - CMIS Digital Imaging and Communications in

Medicine- DICOM Digital Medical Work List- DMWL

Important Contributing Factors

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Contributing Factors

HL7 – Provides the framework and related standards

Broker-A software and hardware device that accepts HL7 messages

Open Architecture-permits an inexpensive way for a system to be updated as needed

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HospitalB The selection process

GE Centricity/Cosmos Siemens

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Further consideration Preliminary Phase

Image viewing for specialized purposes Image Distribution Server Hardware Workstations Image archive and budget requirements Local RIS/PACS administration and supports

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Centricity* RIS/PACS-IW Solution is a totally interfaced, end-to-end, web-based workflow important

for ambulatory imaging. This solution is scalable from one imaging center to a location with many locations. It can be implemented as a ready to use or customized solution. Centricity RIS/PACS offers a variety of features :

Voice recognition Digital dictation Disaster recovery

GE CentricityCase Studies

This system gives a thorough workflow solution that includes an outpatient imaging center and multi-specialty group practices. It is also made for deployment and to meet the business needs of facility . Centricity also provides a single archive and integrated infrastructure to manage cardiology data, facilitating the electronic patient record.

Integration: Open architecture.

Scalability: Scales up and down.

Physician activity

Patient visits Payor mix

Improved productivity Lowered costs

Saves time Increased services

Boosted care and quality Increased revenue cycle effectiveness Fee schedule calculations from Deficit Reduction Act (DRA) and

Outpatient Perspective Payment System (OPPS) payors

GE Centricity

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Centricity RIS/PACS benefits your organization by:

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Cosmos Siemens is a German based company with branches in the

United States.

SIENET Cosmos integrated RIS/PACS enterprise solution for hospitals and imaging centers which allows users to access patient exams and reports from any place in the network with a typical internet browser.

The Cosmos workplace features Siemens syngo common user interface and integration with Soarian Clinical Access, providing the basis for an electronic health record (EHR).

Soarian Clinical Access gives clinicians browser-based, real-time access to the complete patient record, including images and data.

Cosmos Siemens

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SIENET Cosmos presents a solution for the Medical Imaging department, from Scheduling The examination Diagnosis Reporting Archiving Data distribution Documentation Billing. A single log- in provides secure, user-specific access to all important patient dataat a single workplace. SIENET Cosmos also provides the user with optimumfront and back end integration for Imaging Workflow Management. Back-end synchronization with RIS systems from other manufacturers is available in accordance with IHE.

Cosmos Siemens

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Has implemented Centricity PACS in 2003 and RIS

in 2001— Now joined the two, enabling a more efficient RIS-

centric workflow. The benefits are across the entire enterprise that

has more than 21 locations 1,100 beds that serve patients in the Bronx and

Westchester County areas of New York. Combined facilities perform more than 465,000

radiology studies each year, and provide images to a medical staff of 2,000.

Centricity Case Studies Montefiore Medical Center

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Prior to implementation of RIS/PACS, Montefiore radiologists had to shift from PACS workstation to RIS workstation throughout the day.

“Now the radiologist can sit at one workstation and focus purely on the tasks at hand,” Weschler says. “That eliminates a lot of delays, and improves patient care and safety.”

The most notable benefit of an integrated RIS/PACS is the ability to link Montefiore’s 10 imaging facilities.

Productivity has increased by 20 to 25 percent for each radiologist, says E. Stephen Amis, Jr., chairman of radiology. “We’re able to compare all of the available old studies in a matter of seconds.

Centricity Case StudiesMontefiore Medical Center uses GE system

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Represents the large-scale filmless radiology department

The cancer center was the first to adopt PACS adopter and first deployed digital image management in 1998.

Today, the center completes more than 305,500 imaging studies a year at its five main locations and is virtually filmless.

Nearly 150 radiologists read images One hundred imaging systems feed images into the PACS. The center has about 70 diagnostic radiology workstations 400 PACS workstations. Has a total of close to 9,000 personal computers that are

equipped with web-viewing capabilities.

Centricity Case Studies Memorial Sloan-Kettering Cancer Center in New

York City

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This center’s dictation application requires

Three production servers on site in the computer room Three mirrored servers for business continuity at the offsite location. IT also requires test systems. PACS needs three test systems:1. For current production,2. For the next software upgrade 3. For a planned major make over for improved capacity and

compatibility with RIS/PACS.

An integrated RIS/PACS/voice solution streamlines the server burden and leaves more space for the computer room.

Centricity Case StudiesMemorial Sloan-Kettering Cancer Center

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The center first deployed its current voice recognition solution in 2003, beginning with nuclear medicine and interventional radiology and bringing the system to other areas over a six-month period The center is presently a voice recognition successWith 95 % of its dictating radiologists self-correcting,Which has improved report turnaround time and cut costs. With this huge amount of exams an excess of 300,000 annually, the radiology department employs only two part-time transcriptionists.

Centricity Case StudiesMemorial Sloan-Kettering Cancer Center in New

York

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This hospital operates a14 facilities that serves a five-countyarea. Each year, the facility performs morethan 120,000 imaging procedures. In 2001,Blount Memorial issues :Lack of storageHigh cost of film and film storage,Lack of access for departments to view images from all modalities within the hospital.

Centricity Case Studies

Blount Memorial in Maryville, Tenn.

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Centricity Case Studies

Blount Memorial in Maryville, Tenn.

In choosing GE Centricity RIS/PACS,an integrated system physicians and technologists at the 304-bed, short-term care facility, have now • That Streamlines workflow processes• Reduce costs• Increase department and staff efficiency• Improve the quality of patient care at the

hospital.

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This facility houses more than 1000 beds. Performs each day up to three hundred

examinations The radiology staff consist of 16 radiologist 20 members of the technical support team

Siemens Cosmos Case Study Klinikum Ingolstadt Hospital in Germany

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Siemens Cosmos Case Study

radiologist

examine x-ray

Dictate findings

Which were

transcribed

Corrected by

another physician

Then a second and a third in

some cases

Then report

reviewed and

signed

The process took a total of

four days

Klinikum Ingolstadt Hospital Previous Workflow

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Siemens Cosmos Case Study

Times savings

Physician dictates h report in computer

Checks it

himself

Then forwards it directly to the head

radiologist

Radiologist validates

the findings

Signs the report

Entire process

four hours

Klinikum Ingolstadt Hospital Current Workflow

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This means that Klinikum Ingolstadt saw a

“98%” improvement in report generation The hospital completes two hundred to three

hundred reports that were produced daily signed and forwarded by 6pm. Most outpatients could take their reports home with them before they left the hospital.

Siemens Cosmos Case Study

Klinikum Ingolstadt Hospital

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The hospital integrated Radiology Suite Case

Studies ’, a fully integrated broker-less RIS/PACS solution was installed in the emergency department 2001 within the ICU,NICU, radiology oncology, the women's health center and the imaging department. The hospital has about 300 physicians which has access through the PACS web server. This all went live in 2002.

Siemens Cosmos Case StudySiemens Sienet Bethesda Healthcare Systems

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Measurable outcomes: Healthcare systems were faster Report availability Fewer repeat exams Year one cost savings for the imaging

department totaled 1,075,916,while the cost savings projection for year two ending April 30, 2004 ,stands at 1,096,599

Siemens Cosmos Case StudySiemens Sienet Bethesda Healthcare Systems

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This center has been in operation since 2002 with a fully digital Radiology

Department, excluding Mammography. McKay-Dee is part of the Intermountain Healthcare Care (IHC), The facility has 22 hospitals 100 clinics A combined 2068 beds, in the Utah area and Southern Idaho.

The mixed environment of vendors for most of the modalties, AGFA which features IMPAX ES the next phase within a continuum of IMPAX

solutions which provides an integrated system for speech as well as departmental expansion into women's care, orthopedics and cardiology.

AMICAS for PACS and web distribution MITRA for connection to RIS. .

Siemens Cosmos Case Study McKay-Dee Hospital in Ogden, Utah

Siemens Case Studies operating in a mixed enviroment

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This hospital is equipped with 425 licensed

and 273 staffed beds, 18,382 general admissions 55,173 emergency room admission, annually. For radiology, 93100 examinations were

performed in 2001 with an estimated increase of approximately 5 percent annually

Siemens Cosmos Case StudyMcKay-Dee Hospital in Ogden,

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This facility is equipped with DICOM worklist query which has

dramatically reduced the number of mistakes as it relates to patient studies and demographic errors.

Decrease the number of repeat images Corrected over and underexposure in addition to grayscale. The successful integration of systems has allowed

technologists to perform exams away from the main Radiology department

Obtaining an immediate interpretation from a Radiologist

Siemens Cosmos Case StudyMcKay-Dee Hospital in Ogden,

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Step 1. Assess your radiologist staff readiness Step 2. Plan your approach Step 3. Selecting your RIS/PACS system Step 4. Provide training pre and post before implementing

new system Step 5. Achieving IHE and CMIS standard Step 6. Continue quality improvement

Final steps toward implementation:

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Powerpoint Bibliography   1.Boochever, S.S HIS/RIS/PACS Integration: Getting to the Gold Standard Reprinted from the May/June 2004 issue of Radiology

Management HIS Article2.pdf   2. GE Centricity RIS/PACS-IW A web-based RIS/PACS solution for outpatient imaging centers and multi-specialty clinics. E:\Medical Imaging\feasibility project\GE\Centricity RIS-PACS-IW Picture Archiving & Communication System GE -

gehealthcare_com.mht   4. Enrado, P Special Projects Editor Healthcare IT News published in partnership with HIMSS Buyers Guide: PACS/RIS

solutions May 10, 2005 E:\Medical Imaging\feasibility project\immediate project needs\Buyers' Guide PACS-RIS SOLUTIONS Healthcare IT News.mht     5. SIENET Cosmos System Concept for Radiology Departments, Brochure Sienet Cosmos.pdf     6.Health Level Seven International   http://www.hl7.org/implement/standards/ 7.OpenRIMS: an open architecture radiology informatics management system. Langer S. Department of Radiology, University of Washington Medical Center, Seattle, WA, J Digit Imaging. 2002

Jun;15(2):91-7. Epub 2002 Sep 26. E:\Medical Imaging\feasibility project\immediate project needs\OpenRIMS an open architecture radiology inf

___ [J Digit Imaging_ 2002] - PubMed - NCBI.htm   8.Taylor,R (1), Scalise, T (2), Carlson,J (3), Richardson,S (4), Dalla, T (5) 1 Director of Imaging Services 2 Technical Manager 3 Information Manager 4 Business Manager 5 PACS Administrator, IHE –

The Success of Integration, http://www.ihc.com/xp/ihc/mckaydee/     9. HealthIT.gov How to implement an EMR Integrating the Healthcare Enterprise in partnership with the national learning

consortium

E:\Medical Imaging\feasibility project\immediate project needs\Integrating the Healthcare Enterprise - Wikipedia, the free encyclopedia.mht

 

10. http://en.wikipedia.org/wiki/DICOM

11. http://en.wikipedia.org/wiki/DICOM#Modality_worklist