Best-of-breed RIS is equalizer between rural hospital and big-city counterparts

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 - Cory Cino and Peggy Hise
Cory Cino, PACS Administrator and Peggy Hise, Director of Radiology at Wyoming County Community Health System

To Cory Cino, the history of Wyoming County Community Health System in Western New York divides neatly between “before RIS” and “everything since.”

The PACS administrator vividly recalls his radiology department doing patient scheduling and tracking on sheets of loose-leaf paper in three-ring binders and reporting via cassette-tape transcriptions on a homegrown database. Then there was perhaps the most cumbersome practice of all: storing pretty much everything the department produced—reports, tapes and, prior to PACS, films—wherever an untaken spot could be found…including on the roof.

“It’s actually kind of fun to talk about where we were,” he says. “It helps us appreciate where we are now.”

Where they are now is in their sixth year with Synapse® RIS from FUJIFILM Medical Systems, Stamford, Conn., in large part, for how seamlessly it integrated with Synapse PACS, which WCCHS had previously implemented to great satisfaction.

The complexity of “trying to pseudo-organize multiple locations based on years and folder sizes” was becoming unmanageable, adds Cino. “We could talk a lifetime about how we used to do things in comparison to how much more efficiently we do those things now.”

WCCHS is a 62-bed, 103-year-old institution about equidistant from Buffalo and Rochester. An attached skilled nursing facility with 138 accredited beds and an adjoining mental health care unit with 12 bring the total bed count to 212.

The radiology department is accessed by 13 radiologists who collectively read the institution’s 30,500 exams—CT, MRI, ultrasound, mammography, bone densitometry, nuclear medicine and, of course, x-ray—per year.

The health system’s utilization of a best-of-breed RIS stands as a sterling example of how this technology can help a rural community hospital offer patients and referring physicians radiology services that match, stride for stride, those found at the biggest and best urban medical centers.

Then and now

Cino’s supervisor, Director of Radiology Peggy Hise, remembers the six-month process that led up to the selection of Synapse RIS. The choice came after a buying committee led by Hise and Cino sat through several vendor presentations and spoke with numerous RIS-experienced colleagues at other hospitals. “The Synapse system had the functionality we were looking for, and it was in the price range that the hospital was able to afford,” she says. “At a community hospital, price points are very important.”

Hise adds that a WCCHS-affiliated radiologist proved a crucial champion of the drive to modernize. “She often worked alone, and we had three different reading rooms where we would be hanging film and reports, stapling papers together,” she says. “The stacks of x-ray jackets were all over the place in her office. Trying to keep that all organized was a continual project.”

Hospital leadership began getting comfortable with the idea of a RIS purchase when they observed the manual processes in action, noting the strains these put on both staff and patients. The deal was sealed when they realized that RIS automation would allow them to right-size the overstaffed—yet paradoxically overworked—radiology department.

“There’s not an aspect of our day-to-day that we didn’t improve when we acquired the Synapse RIS,” says Cino, “from the way we schedule patients to the way techs complete exams to the way radiologists dictate reports to the way we transcribe them. The levels of efficiency and organization we have now are just miles ahead” of the old way.

For Hise, a favorite benefit has been the interdepartmental team building the RIS facilitates. Communications between the main office, the techs and the radiologists are all conducted swiftly via electronics, she says, and that has markedly improved working relationships.

“We also use a lot of the alerts functionality,” she adds, giving as examples a warning that appears when a doctor calls to book an MRI for, say, a patient with a pacemaker, along with notations on patients’ special physical needs and allergies to contrast agents.

“Cory did a great job interfacing us with the lab, so when we need to have lab results prior to contrast material, the tech just clicks on ‘Lab Results’ and it pops right up,” she says. “You don’t have to go to another system, log in again”—and risk not thinking of everything.

“Fast lab results is a big patient-safety factor,” Cino adds. “It’s one of the things in our RIS that makes our radiology department as good as any radiology department

Dave Pearson is senior writer for Radiology Business Journal and a contributing writer for Radinformatics.com.