The Hamster Wheel: Workflow and Analytics

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Eight years of downward pressure on reimbursement has led to a sustained drive to increase productivity. This has led to the need to measure productivity, enhance workflow, and monitor and enhance quality. Here are a few of the interesting resources that exhibited at the RSNA: UMEDEX. Here is a hybrid vendor that combines radiology professional services (AMRADNET) with technology, operations, and cloud-based applications for mobile health, imaging center operations, telemedicine, and social networking. CEO Neil Iyer, MBA, describes the company as a universal medical exchange with end-to-end workflow (from registration to modality to workflow and billing). The telemedicine suite includes a universal worklist, scheduling, credentialing, billing and collections. “Through Ocean, radiologists can connect with patients, other radiologists, and referring physicians for primary and secondary interpretations, peer review, and consultations with other radiologists on complex cases,” says Iyers. Montage. This clinical analytics solution from a team at Penn has research and education applications, but it also offers the ability to interrogate your RIS for the purpose of clinical quality control. “After going live for a month, I was surprised by how many errors we had,” notes Woojin Kim, MD, who developed the solution with William Boonn, MD. A sister hospital reduced mismatches—laterality and gender errors—by 48% in one month. The solution can also help a service optimize billing in, for instance, coding for the complete number of views or studies ordered with and w/o contrast. Sectra showed a web-based suite of business analytics tools that will be available in its next PACS release, says Andrea Sowitch, Marketing Director, North America. Organized by tab and offering the ability to excavate down through the data by patient, request, exam type, report type, referrer, results, and more, the tool gives users the ability to track referral sources, turnaround time by referring physician (and all of the above) and production as measured by exam type, technologist, modality (and all of the above). In other words, it gives the user complete access to the RIS data from any location. Nuvodia, The workflow expertise that radiology has developed by leveraging informatics is proving to be marketable not just within radiology but beyond the specialty, explains Nuvodia CEO Jon Copeland, former CIO and CEO of Inland Imaging, a top practice in the Northwest. Nuvodia is not just reselling Philips iSite, but implementing the PACS for organizations throughout their service network and referring community. Copeland and Nuvodia also are working with a health system to deploy rural eHealth initiatives. The workflow, Copeland says, is “the equivalent of radiology workflow.” Medicalis. Speaking in the Medicalis hut in the South Hall, Keith Hentel, MD, executive vice chair for clinical operations, New York Presbyterian Hospital–Weill Cornell Medical Center, came to Medicalis through the Medicare Imaging Demonstration Project, but he reports that the institution will stick around for the professional solution (worklist, scheduling, analytics) for the purpose of adding to the value of the practice. One of Hentel’s great discoveries with the decision support piece is that it is not prudent—or necessary— to deploy the same rule set across the organization. You don’t, for instance, want to subject a neurosurgeon to the same decision support about brain and spine imaging to which you would subject a family practitioner. Yet that same neurosurgeon, if he decided to order an MRI of the knee, may need some decision support.