OhioHealth: Images to Go
Chuck BakerImmediate access to patient information is a powerful catalyst for improving the caliber of care in the radiology sector, as well as in other clinical disciplines. For OhioHealth (Columbus), enabling the mobile communications network to handle images represents the next step in enhancing physician collaboration and physician–patient communication, thereby raising the bar on patient care throughout the organization. OhioHealth encompasses, among other entities, eight member hospitals, nine affiliated hospitals, and 23 freestanding health and surgery centers that serve 40 counties in Central Ohio. In 2003, it implemented the Synapse® PACS from FUJIFILM Medical Systems USA (Stamford, Connecticut). The centralized PACS is administered by the OhioHealth information-services division, which is staffed by about 350 IT associates. Chuck Baker serves as the division’s PACS manager. He says that in fall 2010, Fujifilm approached OhioHealth about beta testing its Synapse Mobility application, which renders images and information stored in Synapse PACS available to radiologists and physicians using handheld devices. A Multifaceted Rationale OhioHealth had immediate and considerable impetus for accepting Fujifilm’s proposal, Baker observes. Neurologists, neuroradiologists, and neurosurgeons in the system’s department of neuroscience had determined that an image-enabled mobile platform—by yielding access to images anywhere, at any time—would afford them increased flexibility in call coverage. It would also facilitate remote collaborative consultation on cases, regardless of clinicians’ physical locations, “with everyone looking at the same image or images at the same time,” Baker says. “Physicians understand the application is used as a triage tool in the collaborative consultation process, and the image is not intended for diagnostic purposes.” He adds that the potential to extend these same benefits to the OhioHealth Stroke Network, established in 2010 to provide neurological coverage to smaller regional hospitals (in line with a systemwide effort to coordinate and combine services for the efficient delivery of optimal care), played an important part in the decision to move ahead with beta testing. While these benefits were attractive, OhioHealth wished to expand the scope of the project. Synapse Mobility provides Synapse PACS connectivity through a native application component developed by the vendor in conjunction with Apple (Cupertino, California). Once downloaded on clinicians’ handheld devices, it allows them—through its Mobility Viewer feature—to view patient images and data pertaining to those images. OhioHealth had already introduced ORB Mobile, a mobile version of its OhioHealth Results Browser (ORB) patient-information portal that is used on Apple mobile devices by about 750 physicians throughout the organization. Integrating ORB Mobile with Synapse Mobility not only would permit images and associated data to be accessed, but would also allow access to such additional patient information as laboratory-test results and the like. “It was clear that enabling the mobile network to handle images—and therefore, allowing images to be displayed on mobile devices—would have a positive impact on patient care because physicians would have the option to show images to patients and their families during hospital rounds,” Baker states. This, in turn, would make it easier for physicians to explain patients’ conditions and possible courses of treatment to them, as well as helping patients truly understand the information being conveyed to them. Nonetheless, the Synapse Mobility/ORB integration initiative—in which Fujifilm quickly consented to partner with the health-care provider —was as critical a piece of the puzzle as the image-enabling process itself, given physicians’ need for a more complete snapshot of patients during hospital visits, in their offices, at home, or wherever they happened to be, Baker says. Involving a small group of radiologists and neurosurgeons and a temporary server, the beta test of the integrated platform commenced in October 2010. Over a period of six weeks, participants discovered that its functionality mirrored the basic functionality of the standard wired version of the PACS. Depending on physicians’ physical locations and the type of wireless network (3G or 4G) used by their particular devices, the time needed to pull up images (and information) in mobile mode sometimes exceeded that required to accomplish an identical task, in wired mode, at a fixed clinical workstation. Baker, however, deems the difference negligible, noting that the advantages of offering clinicians remote access to images through the mobile application far outweigh any minor delays. Moving Forward Based on these results, OhioHealth decided, in April 2011, to proceed with a widespread implementation of Synapse Mobility and, by association, the image-enabled version of ORB Mobile. As of mid-August 2011, the permanent server component of the configuration had been installed, and the integration was in progress. OhioHealth plans to go live with the fully integrated platform by October 1, with final testing by a group of 12 physicians preceding the enterprise-wide rollout. Once this occurs, physicians will be able to download and harness the native application to view images and associated information on their handheld Apple devices, or to obtain the same information—along with the additional laboratory results and other patient data—by tapping into ORB Mobile on their iPhone®, iPod touch®, or iPad® devices from any location within or outside OhioHealth facilities. An integrated, image-enabled version of ORB Mobile for Android® smartphone users is slated for introduction later in 2011, according to Baker. Physicians wishing to access images and related reports through the native application will do so by launching Synapse Mobility directly. Those wishing to leverage ORB Mobile for image access will be presented, after a two-step authentication process involving the input of user name and password and the registration of the device in use, with an image link to the Synapse Mobility application. “Bringing up the patient’s name and hitting a radiology tab will get the user a link to any images in the PACS,” Baker explains. Whether accessed through the native application or ORB Mobile, the interactive features allow physicians to manipulate each image using zoom and window-level functions, in addition to viewing 3D images. “This, along with the overall functionality of the system and the advantages, really sold us on taking the image-enablement step,” Baker concludes. “We are sure this move will be a boon to physician efficiency and patient care.” Julie Ritzer Ross is a contributing writer for Radinformatics.com.