Transcript PACS Deployment-LUMC

BEAMING IMAGES
RADIOLOGY PACS IMPLEMENTATIONTHE 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
Opportunity for
Improvement
Radiology operation has shifted from a primarily
hospital based operation to a combination of
hospital, out-patient and multi-satellite. Hardcopy 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.
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
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. Tu’s group to post images &
results in the EMR
 Deployed PACS viewing workstations in
strategic areas
 Designed QA processes to monitor key steps
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.
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
PACS Deployment-LOC,
Cancer Center, Satellites
 Outside
of the hospital we
installed workstations in;
 LOC-Radiology
 Women’s
Health Radiology
 LOC-Ortho Clinic
 LOC-Ambulatory Surgery
 Cancer Center
 Orland Park Primary Care
 Oak Brook Imaging Center
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.
Percentage of Specific Modality
Volume
Studies in "Complete" Status
3.00
2.50
2.00
1.50
1.00
0.50
0.00
US
NM
MRI
Specials
(Neuro/Vasc.)
Specials-Neuro
Diag
CT
% of
Studies
June
2003
% of
Studies
(Nov
2003)
Average Report TAT is less than 1 day
Completed Test to Final Report
120
Turnaround Time (Hours)
100
80
Mean = 73
Implemented
Voice
Recognition
technology
Implemented
PACs
60
40
Mean = 36
20
Mean = 20
0
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
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:

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Images can now be viewed
concurrently in multilocations
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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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
Next Steps
Expand
QA processes to cover
Computerized Radiography and
Digital Radiography operations
to ensure optimum quality of
images sent to PACS.