It’s as extreme a transition as any IT professional could imagine: moving from a remotely hosted RIS to a fully integrated RIS/PACS over the course of just a few short months. Bill Cummins and his team, however, had ample motivation to make the switch. The director of medical imaging at Cheyenne Regional Medical Center (CRMC) in Wyoming had seen both customer service and turnaround times suffer at the hands of the facility’s legacy RIS.
“We weren’t in control of our own destiny, so to speak, with the database servers,” Cummins recalls. “We were working via two modems, and on the technical side, that was difficult. We couldn’t access the database the way we needed to; it always took a phone call or a service request to get something done. A hosted solution should have made our lives easier, but once we identified the right solution, we knew it would be easier to run our own RIS/PACS.”
CRMC implemented the remotely hosted RIS about six years ago, but it would be another three years before the facility would bring in its first PACS. The process of coaxing the two systems into working together highlighted some of the RIS solution’s inefficiencies, Cummins says. “We ran into complications in trying to interface between the two systems,” he explains. “The long-distance remote hosting didn’t give us enough control over our own timelines when we went to connect the PACS, and the technology wasn’t conducive to what I wanted for my department in the future.”
In addition, CRMC’s radiologists, technologists, and referring physicians had all expressed problems with the hosted RIS. “End-user dissatisfaction was the biggest factor that drove our decision to transition to a new RIS,” Cummins says.
Shopping for an Integrated Solution
What Cummins wanted was a fully integrated RIS/PACS platform with the cutting-edge features that his department needed to optimize workflow and improve service to referring physicians, as well as the technical support necessary to tweak the system as the department’s needs changed over time. The savings associated with an integrated platform were also a deciding factor.
“My ultimate goal was a fully integrated RIS/PACS,” he says. “Other systems just weren’t there. They always got proprietary, and the cost of interfacing, duplicating any changes back and forth across the two systems, was difficult at times. With a fully integrated system, we wouldn’t have to worry about the interface cost.” Cummins hoped to trim hardware and software support costs as well. “With our previous RIS, we were paying $18,000 a month just for support,” he notes. “It didn’t logically make sense.”
CRMC had implemented the Synapse PACS from FUJIFILM Medical Systems USA Inc, Stamford, Connecticut, in 2006; when the company acquired the Encompass RIS (now known as the Synapse RIS) from Empiric Systems in November 2008, Cummins saw all the pieces in his RIS/PACS puzzle begin to slide into place. “I had seen how the Encompass product worked in the past, and it met all of our criteria,” Cummins says. “Coincidentally, FUJIFILM wound up purchasing it last fall. The product is very robust, but affordable, and we knew it would work well with the Synapse PACS we already have.”
Flipping the Switch
In transitioning to the Synapse RIS, Cummins was surprised and pleased to achieve additional cost savings. “Because it’s an integrated system, our additional hardware expenses were limited,” he says. “All we had to purchase were two more servers, because the RIS could already leverage the infrastructure we had set up for the PACS, with redundancy and long-term archiving.”
The migration process has enabled CRMC to leverage its PACS test server, which allows the facility to test any changes to the system before flipping the switch. “That was a capability we were lacking before,” Cummins says. “It was always a total rebuild every time we wanted to make a change. Now, with a test server and a production server, we can test changes before implementation.”
On August 26, the full system is scheduled to go live, and CRMC is currently in the midst of deep tests of the integration, with the help of FUJIFILM support staff. “They’ve been wonderful in working with our clinical systems to make sure the flow of information between the two systems is as smooth as possible,” Cummins says, “and RIS support is included within FUJIFILM’s Synapse support shop, so you’re not working between two different technical-support groups.”