BEAMING IMAGES

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BEAMING IMAGES

• RADIOLOGY PACS IMPLEMENTATION- THE ROAD TO A
  FILMLESS ENVIRONMENT

Members Robert E. Henkin, MD, Mary Olson, MD,
Robert H. Wagner, MD, Denise Punka, James Halama,
PhD, John Tu, MD, Art Krumrey, Tess McCoo, James
Ryva, Mario Ayala, Gary Stevens, Renee Abelarde,
Ron Price
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Opportunity for Improvement

• Radiology operation has shifted from a primarily
  hospital based operation to a combination of
  hospital, out-patient and multi-satellite.
  Hard-copy films were no longer serving the demand
  for viewing the study in various locations at the
  same time. Due to manual distribution of films,
  there was a significant risk for losing or
  misplacing them making it unavailable for review,
  reading or copying.

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Most Likely Causes

• Multi-disciplinary physician practice requires
  the films to be reviewed by multiple physicians
  in various locations on the same day
• Transport of films from site to site was a manual
  process which takes time and sometimes
  contributes to the loss of films
• Lost film sometimes cannot be reconstructed and
  this causes non-read of films, repeat procedures
  and bad service to clinicians
• The network served by the department is dispersed
  into a large geographical area such that manual
  distribution of films no longer serves the needs
  of the operation

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Solutions implemented

• Replaced old X-Ray equipment with DR and CRs
• Purchased implement a PACS system
• Purchased CR plates for small satellites
• Integrated modalities and the PACS
• IT arranged access to images via web-browser
  worked with Dr. Tus group to post images
  results in the EMR
• Deployed PACS viewing workstations in strategic
  areas
• Designed QA processes to monitor key steps

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Radiology PACS

• PACS ? What is PACS?
• PACS stands for Picture Archival and
  Communication System. It is a technology that
  allows images from procedures (CT Scan, Nuclear
  Medicine, Diagnostic X-Rays etc) to be stored in
  digital form in a computer (central archive). The
  images can then be accessed by various users such
  as a Radiologist to interpret the study or an
  attending physician to look at the pictures and
  to view the report. Images can be viewed using a
  special workstation or on a regular PC via a
  web-browser.

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PACS Deployment-LUMC

• PACs Workstations are in
• Main Reading Room
• CT Reading Room
• Neuro Reading Room
• Nuclear Medicine
• Ultrasound
• Special Procedures Reading Room
• ER
• OR-Physician Lounge

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PACS Deployment-LOC, Cancer Center, Satellites

• Outside of the hospital we installed workstations
  in
• LOC-Radiology
• Womens Health Radiology
• LOC-Ortho Clinic
• LOC-Ambulatory Surgery
• Cancer Center
• Orland Park Primary Care
• Oak Brook Imaging Center

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Results

• PACS implementation facilitated interpretation of
  studies by making the images readily available.
  The number of cases in complete but not read
  status declined significantly.

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Average Report TAT is less than 1 day
Completed Test to Final Report
120
100
Implemented Voice Recognition technology
Implemented PACs
80
Mean 73
Turnaround Time (Hours)
60
40
Mean 36
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Mean 20
0
Jul 02
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Sep 02
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Mar 04
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Radiology PACS

• PACS workstations were deployed in all major
  sites of operation in addition CR plates were
  purchased for smaller satellites so that images
  taken from those areas can still be read and
  archived on PACS
• Due to technology restrictions Mammography is not
  yet on PACS

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Conclusion
Radiology embarked on a collaborative effort to
implement PACS, a new technology to store and
distribute images across the health system. This
project resulted in tremendous improvement

• Increased patient physician satisfaction
• Increased availability of images- web , EMR
• Film security- prevent loss mirror archive
• Positive impact on report turnaround time
• Implemented QA process on workstation performance

• Images can now be viewed concurrently in
  multi-locations
• Achieved goal of being filmless. Note the new
  LOC is built with this in mind
• Addressed problem of unavailability of films

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Next Steps

• Expand QA processes to cover Computerized
  Radiography and Digital Radiography operations to
  ensure optimum quality of images sent to PACS.

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