Enterprise imaging spurs a bold vision of unparalleled care for countless kids in Northeast Ohio

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 - Greg-carole
William Cooper, Carole Ettinger

At Akron Children’s Hospital, the road to fully realized patient-centered care for kids leads to a scenario in which all patient information—including consent forms, admissions documents, diagnostic images and multimedia files—is readily accessible through the facility’s EHR.

“We hear from our end-users that they would like to be able to pull up everything they need from one place,” says Carole Ettinger, the hospital’s director of the information services division.

This year, the independent, nonprofit institution took an important first step toward realizing that bold vision: It began installing VNA, mobile enterprise viewer and image-exchange solutions. “In the future, as we get settled with our VNA, we will start to look at enterprise content management through enterprise imaging management,” Ettinger says. “This is not just for non-DICOM images, but it starts there.”

Ettinger was instrumental in Akron Children’s selection of Fujifilm’s VNA, Mobility and Image Exchange solutions for Phase 1, which will entail bringing into the VNA lots of non-DICOM imaging from dental, ENT, burn center and plastic & reconstructive surgery.

And as the hospital has started advancing toward true non-DICOM enterprise imaging (EI), employees are ready to build on this momentum and provide world-class service to children and families across Northeast Ohio.

Finding the right partner

Akron Children’s Hospital comprises two hospitals and approximately 60 primary, specialty and urgent care locations. With 775 medical staff providers and nearly 6,000 employees, it annually records more than 1 million patient visits. Not surprisingly, given the IT leaders’ forward-leaning stance, it has been repeatedly recognized as one of America’s “most wired” hospitals by the AHA’s Hospitals & Health Networks.

Akron Children’s has experienced incredible growth and continues to expand. Ettinger says this marker of broad success inspires those who work there to stay focused on whom they’re all there for. “Our mission states that we will turn no child away and we will care for every child as if he or she were our own,” she says. “We believe that remaining independent allows us to focus on what’s best for the kids.”

William Cooper, the hospital’s senior project manager from the IS PMO, worked closely with Ettinger on the hospital’s selection of Fujifilm’s solutions. He recalls those early days four or five years ago, when the team started gathering EI info at conferences such as RSNA and HIMSS.

“At that point, it was just a high-level assessment of who we thought was going to be on the short list once we pared it all down,” Cooper says. “Later, when we started putting together our requests for proposal, we narrowed it down to a few different vendors that we were going to send the RFP to and invite in to give demonstrations.”

Ettinger says the Clinical Image Management System as the start of EI seemed a natural next step to follow their full Epic installation, which completed in all sites in 2013. “There was all this information that still wasn’t easily accessible from the EMR,” she says.

A detailed, scripted process soon followed, bridging those early forays with the very rigorous RFP process that Akron Children’s requires for all major acquisitions.

One sample RFP question illustrates a requirement for a positive workflow already in place: Can you integrate your VNA with Epic’s Haiku and Canto applications for connecting smartphones and tablets?

“We already have people logging into Haiku and then taking a picture,” Ettinger says. “Which is great—the image links to the patient and it’s secure. Still, it can be hard for the providers to find what they need, so a key criteria in our RFP was that the vendor have some application to integrate with Haiku/Canto.”

Going forward, the plan is to allow clinicians to continue using Haiku and Canto. Except that now, when the image gets saved, it will go to the Fujifilm VNA. From there it can easily be accessed through Epic and Mobility “from wherever we decide to put the link,” Ettinger says.

Demanding by design
The Clinical Image Management selection team also knew they wanted a VNA that incorporated an enterprise, zero-footprint viewer. Now that’s a standard VNA feature, Cooper points out. “One of the things we had not originally considered was image sharing,” he says. “We’d been doing some of that with a product we have on hand. It does the job, but the licensing is so expensive that we haven’t really been able to spread it out to other departments.”

They decided to add image sharing to the RFP and see what they heard from the short list of vendors. “Image Exchange was one of the big reasons we ended up selecting Fujifilm’s solutions,” Cooper says. “It became a key part of the contract.”

Akron Children’s RFP process was rigorous, but it didn’t stop challenging vendors there. Finalists were called in, often repeatedly, to demonstrate their wares. The hurdles are high, Cooper says, and it is all by design; the demanding processes reflect the hospital’s unwavering patient focus.

Fujifilm passed the auditions with flying colors and the decision was finalized in October 2016. A technical kickoff followed in November, the servers were delivered in January 2017, and Phase 1 implementation began in April 2017.

“Hopefully we’ll finish dental, ENT, burn center and plastics by October and then get started on the second phase, which is a whole other group of specialty departments,” Ettinger says. “We are trying to finish everything within a 24-month timeframe, so we’re aiming for October of 2018 for the full Clinical Imaging Management System.”

A close partnership grows closer

It’s still early in the process, and long-term plans don’t get completed overnight, but Cooper says things are progressing well. “I’m confident we have selected the right vendor,” he says.

Cooper adds that the continued communication and attention from Fujifilm have meant a lot to his team. “Fujifilm has been very proactive in asking us for input on even things that might turn into potential future developments,” he says. “I think they’ve seen that we have some very sharp people here, including doctors who have some great ideas. They have shown that they want to help us draw some of that out so they can work with us to potentially add some of that capability into their products.”

Ettinger agrees with Cooper about this new relationship, noting that a key point in their selection of Fujifilm was the idea of truly working together as partners and pushing the limits of what is possible to improve patient care.

“Our expectation is that they will be doing more than they would on a standard VNA project,” she says. “Fujifilm has been very receptive to that. We have had some very upfront, transparent discussions.”

Looking ahead, Ettinger and the rest of her team are excited about what working with Fujifilm is going to do for their facilities. “Once we hit our stride with these first implementations,” she says, “I look forward to a lot of success for the project.”