IU Health: Achieving Data Ubiquity with a Little Help from the Cloud

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 - Jonas Rydberg
Jonas Rydberg, MD

In recent years, constituents across many industries have strongly embraced a cloud-based infrastructure to achieve data ubiquity. Healthcare is not one of these segments, but there are exceptions to the rule, among them the 19-hospital Indiana University Health (IU Health) system. 

Headquartered in Indianapolis, IU Health has transitioned from CD-based to Internet image transfer, using its proprietary IU Health Radiology Cloud as a conduit for transferring imaging exam data generated at 54 area hospitals (53 in Indiana and one in Illinois) to its Synapse® Radiology PACS from FUJIFILM Medical Systems U.S.A. Two Synapse components facilitate access to that data. 

Dr. Jonas Rydberg is professor of clinical radiology at Indiana University School of Medicine and chief of radiology at IU Health Methodist Hospital.  He explains that IU Health is the main referring hospital group in Indianapolis (and all of Indiana) providing Level 1 Trauma, Level 1 Stroke, Level 1 Vascular and several other acute services. 

“To provide the level of patient care necessary in that role, we needed an alternative to CDs—which can malfunction, become lost, and are only HIPAA-compliant when they don’t get lost," Rydberg explains. "We saw the cloud and, eventually, Synapse’s features as a secure alternative; fortunately, many hospitals that refer to us got on board.”

Under the current configuration, IU Health maintains two parallel databases on its Synapse Radiology PACS. One such repository, known as the “IU Health database,” houses data from 10 different IU Health hospitals, including Methodist Hospital, University Hospital, and Riley Hospital for Children in downtown Indianapolis; two other hospitals have their own databases. 

 - IUH Cloud MapImage transfer network serviced by IU Health system.

The second database, referred to as the “Outside Exams” database, is used to store imaging exam data from hospitals outside the IU Health network, as well as exams conducted at other non-IUH facilities (e.g., freestanding imaging centers or physician offices) and downloaded from CDs. 

Outside hospitals upload images from their own PACS to the IU Health Radiology Cloud, which is supported by the SeeMyRadiology.com cloud-computing portal. Images are then automatically downloaded to the IU Synapse Radiology PACS. Via a single click, authorized clinicians can access images stored in either database from any PC within IU Health, as well as in mobile mode using a Synapse Mobility app on an iPad, iPhone or similar device.

The two databases are linked, with two components of Synapse—PowerJacket and CommonView—facilitating access to the contents of both. PowerJacket enables access to clinical information in Synapse for a particular study, including priors, study information, reports, notes, documents, and series. 

CommonView displays all studies for patients with multiple identifiers within the same database and can find exact matches using MRNs or MPIs. It can also be configured to display near-matches using configurable demographic criteria; for IUH, this includes patient first and last name, gender, and date of birth. It automatically searches across multiple Synapse data sources for relevant comparisons.  

“The intelligence of CommonView, and PowerJacket remove the barriers to making comparisons between exam data that are loaded from disparate PACS,” Rydberg says. 

Faster Treatment, Lower Costs 

Rydberg notes that harnessing the IUH Radiology Cloud with support from CommonView and PowerJacket yields significant benefits to the hospital system, patients, and physicians alike. For example, he says, eliminating the use of CDs for image-sharing and affording clinicians anytime, anywhere access to current and prior studies minimizes the need for re-scans; IU Health’s re-scan rate for acutely transferred patients now stands at 1 percent to 2 percent, down from 10 percent to 15 percent.

 - UHI Cloud

“Cutting down on re-scans saves patients money and conserves our resources,” Rydberg observes. “It costs nothing for referring hospitals to send exams through the cloud, but every time a CD is sent FedEx® overnight, it costs about $38.  Single web applications are not particularly easy for referring physicians and other clinicians to use; many have problems or delays logging in, and finding studies when you have different MRN and MPI numbers can be difficult. That’s not true now. Additionally, avoiding re-scans means lower radiation doses for patients, which is, of course, better for them and is