Futureproofing workflows

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Freddie-Adorno.jpg - Freddie Adorno
Freddie Adorno, Manager of Enterprise Imaging Informatics, Nyack Hospital, Rockland County, N.Y.
Source: Shay Frey

When the merger and acquisition frenzy catches up to your organization, will it cause headaches for your imaging workflows?

Integrating new staff and different systems together is daunting on a number of levels, but it brings specific stress to radiology. Hospital networks that are merging and happen to be using separate vendors for viewers will need to learn to coordinate effectively with one another, for example.

Change is constant, and beyond full-scale mergers, hospitals and imaging groups may form and change any number of affiliations and partnerships. Plus there’s the normal cycle of staff turnover and shifting responsibilities among individual physicians.

All of this means imaging workflows need to be nimble and adaptable. However, most workflows are organized around manual processes. That’s how it was at Nyack Hospital in Rockland County, N.Y., according to Freddie Adorno, Nyack’s manager of enterprise imaging informatics. “Changes occurred at the workstation level rather than a push mechanism on the enterprise level,” he says.

If a study lingered on a worklist too long, it was up to a staff member to monitor and call their colleagues to address the issue. Any gaps in workflows had to be addressed retroactively rather than in real-time. Hospital staff were looking for more automation in their imaging workflows.

They found it with the Conserus Workflow Intelligence system from McKesson. As a module on a software platform the hospital was already using, Adorno said the decision earlier this year to automate workflows through a beta version of Conserus made the most sense from a strategic perspective.

Automation has reshaped how Nyack’s imaging workflows are managed and updated. What used to be filter-based enterprise worklists with basic organization have now become more dynamic and granular in the way studies are prioritized. A rules engine easily modified by radiology administrators can order studies within the worklist based on modality or what department they came from, while funneling certain cases to specific readers to make sure the most qualified physician is interpreting the study.

But one of the best aspects of the new system, according to Adorno, is how easy it is to change workflows on the fly. Reshuffling interpretation priorities or looping different subspecialists into the workflow no longer requires contacting every affected staff member; it simply requires editing the rules engine governing the enterprise worklists.

“We’re in an era of massive consolidation and this can only help in that process,” says Adorno.

Experts agree that change is in the air. Analysts at PricewaterhouseCoopers say overall healthcare industry deal volume was up 25 percent in Q1 2015 compared with the previous year. The American College of Radiology Commission on Human Resources notes a 10 percent drop in the number of radiology groups from 2010 to 2013 as they grow through consolidation or radiologists leave to seek institutional employment.

Having a vendor independent enterprise worklist that can aggregate and organize worklists across multiple PACS systems reduces the cost and complexity of integration. Adorno knows that many times when organizations merge or form a partnership, there’s going to be multiple viewers involved, and having an efficient, adaptable system offers potential for savings and easier planning. 

“From a strategic standpoint, one of the many benefits is the fact that you can, from one worklist, launch multiple PACS viewers,” he says. “That in itself saves a lot of time, effort and cost.”

Such wider restructuring isn’t yet happening at Nyack, however the workflow intelligence system they are using now will help them prepare for any uncertainties on the horizon. In the meantime, they are refining their alerts and processes with their radiologists, all with an eye on improving efficiency and value.