Case Study

Tri-City Radiology Enhances Services to Referrers with PowerServer RIS/PACS

Client SnapShot

Tri-City RadiologyKenwick, WashingtonApproximate Annual Study Volume: 20,000

Facilities Served: Uses PowerServer RIS/PACS in its own full-modality imaging center and provides reads for two local hospitals.

Challenges• Lack of intergrated RIS/PACS components• Clunky, difficult-to-use system• Need to support mission of high-quality service to

referring physicians and facilities

Benefits• Ability to service current and future imaging

services to clients• Efficient image and report transmission to and

from remote facilities• Rapid responses to questions and system issues

As the only imaging facility in its area to be accredited by the American College of Radiology (ACR) in Computer-Aided Digital Mammography, 3T MRI, and low-dose MPR computed tomography, Tri-City Radiology (TCR), Kennewick, Washington is known for being on the cutting edge of technology. But the practice, which through a staff of four radiologists and subspecialty-trained Technologists offers ultra-high field, 3T open bore MRI; four-dimensional ultrasound; multi-slice helical CT imaging; screening and diagnostic mammography; and general radiology services, is equally renowned among local healthcare providers for its caliber of patient care. Part of this reputation stems from its use of the PowerServer RIS/PACS solution from RamSoft.

TCR services many local referring physicians and reads imaging studies for two nearby hospitals and a clinic; its annual study volume is approximately 20,000. Several years ago, a decision was made to enhance overall service and efficiencies by migrating from a film-based imaging system to a digital one, with a RIS/PACS as the cornerstone. “We wanted to eliminate the need to keep file cabinets full of films,” says Clarence May, MD, president. “Our more important motivation, though, was to make it easier and faster for images to be accessed and for accurate reports to be where they were needed, with minimal delays.” He and his colleagues knew that such rapid access was critical to building and maintaining long-term referral relationships, as well as to fulfilling TCR’s patient care mission.

Wanted: A Single Platform

TCR initially deployed RIS/PACS technology from another vendor. However, the experience proved to be “nightmare” from the start, states Jennifer Staley, RT, (R), (CT), (MR), PACS Administrator. The RIS and PACS components were not interfaced, and the system itself was so cumbersome that referring physicians often experienced difficulty accessing and utilizing it, while “outside” physicians encountered even more barriers. Adding insult to injury, the vendor was not particularly service-oriented: Several promises to fix the system and resolve these problems remained unfulfilled, and reassurances that the necessary changes would be

effected “with the next upgrade” proved empty. When certain upgrades were eventually performed, the system “crashed” multiple times, rendering it even more difficult to keep studies moving through the pipeline.

May and his colleagues finally opted to scrap the solution and replace it with PowerServer RIS/PACS. They were impressed not only by the system’s extreme user-friendliness, but also by the fact that it had been built on a single platform from its inception. Unlike RIS/PACS software comprised of modules acquired from other vendors and frequently modified to function collectively as a RIS/PACS, PowerServer RIS/PACS was developed in-house and is built on a single-platform database meaning all elements are designed to work together without the need for integrations. This single-platform database affords multiple advantages, including easier installation and updating and a single-user interface that is easily adopted by all users. All users can easily access the system and utilize the same screens and features, eliminating the need to learn multiple applications and verify data between them.

Information at Physicians’ Fingertips

TCR is reaping many of these benefits and more from its PowerServer RIS/PACS implementation. Notably, Staley says, report turnaround occurs at a “considerably faster” rate than in the past, enabling referring physicians and facilities to treat patients as rapidly and efficiently as possible and reinforcing their perception of TCR as a top-notch imaging services provider. The system’s web-based architecture means all physicians can log into it from anywhere; the layout, settings, and functionality stay the same whether they are in their offices or at home. Additionally, reading radiologists are also able to provide preliminary reads via the platform-independent Physician Portal which can also be accessed on mobile devices such as iPhones, iPads, and Android.

An image pre-caching mechanism also supports enhanced workflow efficiencies and user-friendliness by sending images to a given workstation providing

that the user’s computer is on and connected to the Internet. Images are temporarily stored on the workstation, eliminating waits for images to download or stream in, not only eradicating delays encountered with a typical Internet workstation, but allowing the user to work at LAN speeds regardless of where viewing occurs. Just as significantly, such QC and diagnostic modules as document scanning, CD burning and import, film digitizing, JPG-to-DICOM conversion, full mammography viewing support, dictation and transcription are all available at users’ fingertips, so neither time nor effort are expended installing, managing and juggling numerous specialty applications.

Additionally, the PowerServer DICOM engine leverages features like MPPS, Storage Commitment and TLS, all of which are defined within the DICOM standards to foster overall system efficiency. Studies are prevented from appearing on users’ worklists until they are completely ready, resulting in a smoother workflow. Storage Commitment ensures that studies conducted by TCR reach their destination, and TLS ensures secure communication across the Internet without the need for multiple VPN tunnels. With DICOM routing and prior pre-fetching modules, studies

are delivered to the appropriate location at the desired time, with all priors present and all priors pre-fetched

“Our more important motivation, though, was to make it easier and faster for images to be accessed and for accurate reports to be where they were needed, with minimal delays.”

“The system’s web-based architecture means all physicians can log into it from anywhere; the layout, settings, and functionality stay the same whether they are in their offices or at home.”

Toll-free: 888.343.9146 • Tel: +1.416.674.1347 • www.ramsoft.com

from the DICOM archives of all facilities served by TCR, rather than only from those managed by PowerServer.

“The presence of priors is valuable for all modalities, but especially so with repeat mammography,” May asserts. Drag-and-drop functionality further pushes the efficiency envelope, as do fully customizable mouse button defaults that let practitioners set the mouse to their preferred behaviors and to mimic other image viewers they may also routinely utilize in the course of their work. Dynamic zoom can be achieved by moving the scroll wheel or clicking on the scroll wheel, then moving the mouse—whichever option a given user prefers.

Further, any time, Staley can utilize a single command to monitor workflow, ascertaining studies’ status and balancing workloads to guard against bottlenecks.

Rapid Report Delivery

The ability to quickly convey study results to referring physicians, also contributes to high-caliber patient care and service and stronger partnerships with referring physicians. The latter can leverage several different methods to obtain reports, including auto-faxing, email, and the Physician Portal. The portal is a password-protected, platform independent web site through which reports and images alike may be viewed on a PC, MAC, or mobile devices.

Meanwhile, online order entry permits referring physicians to request exams, simplifying study requisition for doctors and simplifying the actual scheduling process for patients. The cutting-edge application is extremely secure as well as HIPAA-compliant, yet equally easy to use. Data remain a click away whether physicians are on the go or working from their offices.

A ‘True Partnership’

All in all, Staley notes, PowerServer RIS/PACS “ is a very easy to operate, feature-rich solution—light years away from the clunky configuration that made it impossible to produce reports in a timely fashion and make working with us the experience it should be. What’s more, she says, TCR continues to enjoy a “true partnership” with RamSoft—one that has been strong from the time the practice first reached out to the vendor to discuss its plans to implement a RIS/PACS solution. While the RamSoft team went the extra mile to ensure a smooth deployment and training process for the customer, this was only the top of the iceberg. “With RamSoft, we feel like we are part of a team, rather than just a customer taking a number and waiting for service,” Staley says. “Whenever we have a question or an issue, we receive a response right away—whether online or through a return telephone call. It’s clear that the entire RamSoft team understands our challenges and supports our initiatives to serve referring physicians and facilities and their patients. Certainly, we save money by moving away from film—but for us, the payback comes in more important ways.”

Toll-free: 888.343.9146 • Tel: +1.416.674.1347 • www.ramsoft.com