By Jim Phillips on 04.05.2016
I’ve been known to say that “CD” should actually stand for “challenging for doctors.” It’s a quip that usually gets a few laughs during meetings.
All joking aside, imaging CDs present significant clinical and operational issues for health systems and ultimately put the “exchange” burden on the patient to physically transport their prior exams. CDs can also slow down the care process and cause patients to have to undergo unnecessary, repeat exams. In my role at lifeIMAGE, I often encounter health systems with very different takes on how their image exchange platform can or should solve their CD woes.
In one camp, there are organizations that want to get rid of every single CD right out of the gate and aim to receive all exams through the cloud. That’s a great goal, but, unfortunately, imaging CDs are not going away any time soon. Plus, not every use case can immediately be solved with a cloud-only approach. Organizations can’t set out to turn every single source of a CD into a cloud transfer. That takes time and, as a result, clinical staff may not feel the impact right away.
On the other hand, some organizations look to their image exchange platform to only improve the handling of physical CDs and the ingestion of exams that arrive on them. They view cloud transfer as a secondary initiative to address at a later time. In this case, they are missing a tremendous opportunity to improve care delivery.
Best of Both Worlds
So, what’s the right approach? I advise healthcare organizations to develop a project plan that addresses how to decentralize CD ingestion, while also receiving exams electronically through the lifeIMAGE network. It’s common to want to focus on one process over the other, but the impact on patient care and clinical efficiency is greater when they are treated as one. The most successful enterprise-wide implementations of our image sharing platform have taken both into consideration from the outset.
During the initial kick-off phase with customers, the first thing we do is identify their sources of incoming exams, and also where locally performed studies need to be shared. This helps them to connect the dots for more in-depth clinical workflow discussions surrounding CD and cloud-based image exchange. This, in turn, allows us to build a strong foundation of workflows for dealing with outside data (getting it to PACS, with or without an order, etc.) The optimization of these various workflows is what makes the project a success and drives enterprise-wide adoption.
Finding Middle Ground
Last October, one of our customers hit a threshold we’re always watching for. During that month, the organization received more exams through the cloud than they did on CDs. We love to see this.
This organization started off with the common CD challenges mentioned above. Their clinical specialists were drowning in discs. They followed our advice and set out to not only get a firm handle on their physical media, but also committed to consistently working with us to transition the sources of these CDs into cloud users. This meant looking at specific use cases, like neurology, and working to get referring physicians and practices to use the cloud. We also helped them approach the IT and Radiology staff at community hospitals that frequently send exams on CD and worked with them to route exams from their PACS or modalities right to the cloud.
Whether exams reach your institution via the cloud or on a physical CD, the experience of the care teams that need access to the data should be another top consideration. The ideal workflow for viewing external exams is within the context of the broader patient record - your EHR. This allows clinicians to immediately access exams at every point of care to quickly formulate care plans.
Through our EHR integration, outside patient demographics and procedures are automatically updated to reflect an organization's standards. Clinicians are also able to place a local order for an external study, which streamlines the process of incorporating outside data into PACS. Having a single entry point (the EHR) to both outside and inside exams means that users no longer have to search for exams and learn competing workflows.
I’ll be talking about this more in my next post. Stay tuned!
Jim Philips is the Senior Vice President of Client Services at lifeIMAGE. He oversees all departments that support our rapidly growing customer base, as well as new initiatives that help to expand the reach, scalability and features of our network.