Cloud Computing for Imaging: Ready for Prime Time

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Eric Slimmer, CEOSaint Mary’s Regional Medical Center, Reno, Nevada, first considered a cloud-based platform when its 12–year-old PACS was on its last legs. Facing a significant capital expenditure to replace it with another traditional PACS, the team at Saint Mary’s Regional Medical Center wondered whether it would be possible to achieve similar or better clinical efficiency with a pay-as-you-go solution.

Dan Ferguson, MD, CMO, says, “We had been having a lot of technical issues with our PACS and needed expensive service contracts just to keep it running. Quite frankly, we needed another approach.”

Eagle Imaging Partners, an 11-radiologist practice based in Oklahoma City, Oklahoma, found itself considering a cloud-based PACS out of necessity. The group was covering 12 facilities across a large geographic area.

As Eric Slimmer, CEO, explains, “We’re an on-site teleradiology group, by which I mean that we provide on-site radiologists, but our practice operates like a collective teleradiology practice. We needed a solution that would allow our physicians to go to any of our locations and have the same access to our entire network of images, as well as the same workflow.”

New York Radiology Alliance (NYRA), formerly S &D Medical, Bedford Hills, New York, was experiencing a similar issue in a very different environment. The 60-radiologist practice (which serves the greater New York City metropolitan area) wanted to consolidate workflow across the diverse array of facilities that it serves. These range from large hospitals to small subspecialty practices, but the group couldn’t find a solution that fit its specific needs, which could include enabling one radiologist to read for 15 facilities in a day.

Jonathan Schwartz, COO of NYRA, recalls, “We had used a bunch of different systems, but they were all limited, one way or another, in the quality of their product. For a while, we were looking at building our own system, but the big vendors never quite understood our workflow requirements.”

Hesitations and Solutions

Today, all three organizations are managing their radiology workflow using the cloud-based vRad® Enterprise ConnectSM platform from Virtual Radiologic (vRad), Minneapolis, Minnesota, complemented by the company’s cloud-based vRad ResultsSM solution, which provides referring physicians with instant access to reports and images via mobile device or the Internet.

Schwartz says that for NYRA, which is an alliance partner of vRad, turning to the cloud was the smartest option. “Radiology has become very competitive,” he observes. “A high level of quality is expected, and turnaround needs to be fast. Everyone needs more throughput to keep up with the increasing financial pressures. Without a solution like this, it’s not practical, it’s not economical—you just can’t do it.”

Cloud computing is no longer in its infancy, but health care has traditionally been slow to place its trust in new technological solutions, Ferguson notes. “A cloud-based platform was a new idea for us,” he says. “It was something we had to get comfortable with—something that had to be proven.”

For Saint Mary’s Regional Medical Center, that proof came in the customization of the vRad solution that occurred in the months after the system went live, in July 2010. “We had to do some redesign to meet the needs of the inpatient acute-care radiologists,” he recalls. “I think some people hesitate because they think they’re giving up local control. We felt very connected and in control, however—the vendor (vRad) met and exceeded our expectations at every turn.”

He adds, “It took some effort for our radiologists to move to voice recognition over a period of several months. We’re very proud of them—they deserve a lot of credit for the success of this implementation.”

From the radiology group’s perspective, Slimmer says, “The general hesitation, in my opinion, with cloud-based technology is that physicians will be waiting on images—they’ll be waiting because of network limitations, which has not been our experience.”

Schwartz adds that uncertainty from hospitals can also play a role in a practice’s decision making. “There’s always the general reaction of, ‘We don’t want to use this software, it will be a nightmare for our IT department,’” he observes. “That’s where vRad’s technical and operations staff came in; our facilities found it was not intrusive, there was no heavy hardware, and there was minimal programming.”

Advantages of the Cloud