New PACS, same values: A Texas hospital stays focused on its mission with new technology

When your organization puts values first, those values inform everything, from how patients are treated to the technology you install to provide care.

Hill Country Memorial in Fredericksburg, Texas, is definitely one such provider. The 86-bed, community-supported hospital serves eight counties with a drive to integrate its core values—putting others first, compassion, innovation, accountability, stewardship—in every decision. The laser focus on values earned Hill Country Memorial the 2014 Malcolm Baldrige National Quality Award, one of just 19 healthcare organization to receive the award since 1998.

Dustin Embrey, director of imaging services for Hill Country Memorial Hospital, explains that this commitment to values had a major influence on a recent decision to upgrade the facility’s PACS.

“As an organization, we wanted to advance where we stood on the platform of a PACS system,” says Embrey. Not only did the hospital want to invest in cutting-edge technology—in keeping with the value of innovation—but as a non-tax-supported hospital, Hill Country also wanted to give back to the community that funds operations. The facility has relied on galas to raise millions for digital mammography, CT equipment, and many other projects.

“That’s why customer service is so important, because the people we’re serving are the people who are buying the equipment,” says Embrey.

An extensive, years-long decision-making process led the hospital to work with Merge Healthcare and install the Merge Unity PACS™ in the summer of 2015.

Seeing results

The effect of the new system was immediately apparent; Hill Country Memorial Hospital was able to consolidate. Leveraging Merge’s Mammography with Breast Tomography and Mammography Tracking software, the Merge Unity system took what used to be a disjointed workflow for breast imaging and combined operations into a single system for PACS, reporting, and mammography interpretation.

Previously, physicians needed to run back and forth from their primary reading stations to dedicated mammography stations. While beneficial to the step counts on the radiologists’ Fitbits, it didn’t help provide efficient care. Susan Bacon, director of the Hill Country Memorial Breast Center, says the radiologists appreciate now being able to read mammography in the same office as other imaging.

“[The new system] is less disruptive to their workflow and provides us faster access to reports,” she says.

With the time-saved in workflow, staff can again refocus on the organizational values, such as compassion and putting patients first. Embrey says mammography techs and radiologists would do excessive consulting between exams to get patients started on next-steps for care as quickly as possible. “We like to do on-the-spot service, such as discuss follow-up ultrasound, as part of our full-service breast center,” says Embrey, and not having to constantly change workstations made more time for these conversations.

As a director, Bacon says she’s been impressed with the MQSA tracking tools for breast exams in the new system and all the management report options. Merge staff assisted in the creation of these reports, making it easy to monitor radiologist and technologist continuing experience stats, recall rates, biopsy stats, and more.

“We like the ability to print forms associated with exams,” adds Bacon. “This eliminated a lot of manual forms we were using. Category 0 tracking is easy to use and tracks all communication. It is easy to correct patient data such as incorrect laterality or medical record number.”

Since the Merge Unity PACS system came online, Embrey says there’s been roughly a 17 percent increase in the number of mammography exams performed each day. The facility can now offer tomosynthesis to its patients, with Merge’s help managing the large datasets involved.

The new software has also solved some downtime issues that were present with the previous system. After having to deal with downtimes of 5-10 percent on a monthly basis—an eternity for a provider—those issue are now gone, reports Embrey.

Adding the structured reporting capabilities in the new system also helped radiologists stay accountable—another one of those core values—to referring physicians. Reports are more robust and more quickly produced, thanks to the system automatically pulling data that needs to be included, such as radiation doses and ultrasound measurements.

“It allows us to be very consistent,” says Embrey. “It helps our radiologists’ workflow, and for our referring physicians, I think that consistency helps them in their job… Anytime you can standardize a process, the outcome is better for everybody.”

A supportive partner

With any big installation, the actual technology is not the full story. Support from the vendor is important to launch any new system, including training staff and post-implementation assistance.

Merge’s professional services leverage the “Merge Methodology for Success,” a structured program for implementation with five stages of specific deliverables, from pre-install workflow planning to execution to transition to full staff control.

This level of collaboration also fit the values that Hill Country Memorial was looking for. Bacon explains that Merge staff assisted in the creation of her admin reports, while Embrey says the promise of robust follow-through and communication factored into their decision on PACS vendors.

“The values alignment, the physician satisfaction, the efficiencies gained, and the long term supportive relationship we saw we were going to get allowed us to make that decision,” says Embrey.