New Solutions to an Old Problem

Mention the term “workflow” and a common response is a roll of the eyes. That’s because the medical imaging facilities that have not yet achieved optimal workflow are experiencing extreme frustration while the facilities that have constructed reliable, systematic workflow are always looking for more.

Developing that “more” is the responsibility of eRAD, the technology division of RadNet, a Los Angeles-based provider of diagnostic imaging services through 251 owned and/or operated outpatient imaging centers in six states. eRAD provides distributed radiology workflow solutions, including PACS, RIS, speech recognition, and RADAR's CTRM technology.

“From the outpatient imaging provider’s perspective, there are a couple of enormous burdens we share,” says Ranjan Jayanathan, General Manager and CIO of eRAD. “One is that every second of people’s time on this expensive equipment—MR, CT, PET/CT and others—must be maximized. Every moment has to be scheduled with a patient because reimbursement is priced to have the equipment running full tilt every second of every day.

“For example, if it takes an image longer than expected to process, then that may mean an MRI machine is not operating for five or ten minutes. That doesn’t sound like a big deal, but over the course of the day or a week, those minutes add up. So our solutions ensure that the work keeps flowing with no down time.”

On a completely separate track is the radiologist who, as a result of improved workflow, may be working harder than ever. ”Each radiologist believes that he or she is working harder than every other radiologist,” says Jayanathan. “But work distribution can be effectively managed on the basis of specialty, load-leveling or even according to particular relationships with referring physicians.”

The goal for most medical imaging enterprises is the most efficient possible workflow. “Ideally, optimal workflow provides the most efficient system possible at the lowest possible cost,” says Jayanathan. “That can be an elusive goal, as there are many obstacles, including interoperability between the various modalities and computer systems that exist along the workflow continuum. We understand those obstacles and have crafted innovations to address them.”

Innovation on display at RSNA

The 2013 RSNA meeting in Chicago is particularly important for RadNet, due to the dramatic changes in healthcare over the past few years. Declining reimbursements, increased oversight, advancing consumer roles in healthcare choices and the implementation of the Affordable Care Act have accelerated the need for improvements everywhere along the medical imaging spectrum.

“At RSNA this year, we will showcase our comprehensive radiology solutions to our industry colleagues,” says Jayanathan. “That includes our software solutions and the professional services we offer through Imaging On-Call. We will demonstrate that we are a partner that can weather the coming tumult in the outpatient imaging industry.”

The tumult, in fact, is already here. The first major shot across the bow was the 2007 Deficit Reduction Act, which sharply reduced reimbursements. Through 2011, total reimbursement reductions have been estimated at $8 billion.

The importance of RSNA 2013 cannot be overstated. “We’re coming to Chicago with solutions,” says Jayanathan. “One highlight we will be presenting is eRAD RIS, which is fully meaningful use-certified. eRAD RIS is unique because from the beginning we developed it in collaboration with expert imaging center administrators, operators, radiologists, and IT professionals. The imaging know-how is built-in. The result is a new take on RIS—one that’s comprehensive, with an automated workflow, and tools and features specifically designed to meet these challenges now facing medical imaging.”

eRAD RIS features include Meaningful Use readiness with real-time analytics, integrated speech recognition and reporting, resource optimization via multi-site scheduling, integrated mammography tracking and reporting (by BIRADS© coding) and comprehensive patient and resource handling.

According to Jayanathan, attendees will also be able to experience:

  • eRAD PACS, which offers a platform for global worklists for studies from multiple originating sites, allowing disparate, dispersed reading groups to serve multiple clients with a single worklist, single viewer, and single reporting solution.
  • RADAR, a Critical Test Results Management system that provides secure communicationswith patients and referring physicians. RADAR features a cloud-based architecture that eliminates the need for costly and time-consuming installs, updates, and fixes. RADAR is regulatory compliant and expandable so that it can manage other communication as well, including lab, pathology, radiology-ED discrepancies, and more.
  • Speech Recognition, which can seamlessly integrate with third-party systems without requiring changes in existing RIS or PACS. A sophisticated, industry-leading engine goes beyond word strings to achieve speech understanding. A radiology-specific, self-learning lexicon speeds dictation, as does a roaming profile for anywhere-narration.
  • eRAD Patient Portal, which provides secure comprehensive online access to all relevant patient information.
  • Zero-Footprint Web Viewer, a high-speed web viewer that provides clinicians with access to study information, clinical reports and images when and where they need it. Through eRAD’s Web Viewer, clinicians have mobile access to exams, which they can manipulate and share without technology roadblocks. Communication remains secure and protected, with access controls that foster collaboration.

For Jayanathan and eRAD, the challenge is clear: Streamline a complex process so that it is easy to use and readily accessible, without compromising the integrity of the clinical results.

“I think the biggest thing that RSNA attendees need to know,” says Jayanathan, “is that RadNet can offer the most comprehensive set of radiology solutions to any group or hospital, and can be the most practical, plausible, productive partner for most imaging operators or hospitals.”