Charleston Radiologists in South Carolina is an 18-radiologist group that covers three hospitals, as well as several urgent-care centers and physicians’ offices that offer medical imaging. Michael Garovich, MD, a radiologist with the group, says, “For images from these smaller, outside entities to get into our PACS, the demographic information had to be entered manually. There are three PACS we read from—one for our imaging center, one for the hospitals, and one for outside interpretations.”
The challenge inherent in managing so many clients (with such disparate IT capabilities) is that Charleston Radiologists’ physicians have never had a unified worklist from which to read, Garovich says. “It’s hard to be very efficient because every system has different nuances, and every time, you have to remember them,” he notes. “If you do any one thing a million times, you get faster, but if you do a million things one time, you’re not being as efficient as you could be.”
Unifying the Worklist
In January 2011, Charleston Radiologists made the decision to transition nighttime service at all three of its hospitals to Virtual Radiologic (vRad), Eden Prairie, Minnesota, which had already been handling night interpretations for one of the group’s hospital clients. As part of the changeover, vRad also provided the practice with its Enterprise Connect software, a cloud-based solution that consolidates multiple facilities’ radiology images into a single reading/worklist environment. “As things get off hardware, building a consolidated worklist gets a lot easier,” Garovich says.
The Enterprise Connect technology enabled the practice to circumvent problems that it had been having with demographics from the smaller clinics and physician practices that it serves. “Because every system has its own rules, it was difficult to get these small entities to enter the information correctly consistently,” Garovich observes. “We had to make it simpler for them because we were seen as the problem—their staff members complained because they had to do this extra work, and it both slowed down turnaround and increased their patients’ waiting times.”
Now, he says, “For a nominal charge, we send these outside studies through vRad’s corporate office, and we don’t have to worry about them getting into our system correctly. It’s seamless.”
An additional advantage of using the cloud-based solution has been the ability to balance the caseload—not only among the practice’s 18 radiologists, but also among subspecialty radiologists at vRad. “We provided services on weekends and until 10 or 11 pm, but we’re not big enough to do it around the clock, and these outside entities don’t want to hear the excuse that one of our radiologists called in sick,” Garovich says. “This is an elegant and economical solution for us.”
Garovich explains that the decision to take on the burden of handling demographics entry for smaller client entities, with the support of vRad, was an easy one. “That’s the added value you can bring to them,” he says. “I don’t control whether their employees enter the information consistently, so I need a better solution.”
The added value doesn’t stop with the convenience of sending images from clients to the radiology group, he adds; through consolidation of its worklists, Charleston Radiology has also been able to augment efficiency on the other side of the equation.
“This allows you to read more easily, and it really helps with providing good, fast service, especially at night,” Garovich says. “The lists arrive in order, and even if we’re being fed by three or four entities, no one is getting any more or less service. In today’s radiology environment, you have to add that value: You have to be concise, accurate, and prompt with your report.”
For security reasons, Charleston Radiology is still unable to bring all of its hospitals onto its otherwise unified worklist. “Large companies have a lot of security concerns and are uncomfortable letting people get too close to their firewalls,” Garovich notes, but he believes that these issues will soon fall by the wayside. “They just have to get to that next level of connection, and I think, with cloud technology, there will be new ways to make downloading that information into another system a lot easier,” he says.
When that time comes, Charleston Radiology will be ready, Garovich says, in keeping with its overall strategy for remaining competitive in its market. “My philosophy