During the last several years, various U.S. organizations have made efforts to modernize the nation's health information infrastructure. The Health Information Technology for Economic and Clinical Health (HITECH) Act initiated the concept of electronic health records -- meaningful use (EHR-MU).
The U.S. Centers for Medicare and Medicaid Services (CMS) and the U.S. Office of the National Coordinator for Health IT (ONC) deemed the meaningful use of interoperable electronic health records throughout the U.S. healthcare delivery system as a critical national goal, with the rollout occurring in phases.
Phase 2 of EHR-MU focused on ensuring patient imaging and data can be accessed through a healthcare organization's EHR. In response to EHR-MU phase 2, John Kaminski, PACS Manager, Diagnostic Imaging, Tuality Healthcare -- an Oregon Health & Science University (OHSU) Partner -- was tasked with finding a solution to streamline imaging access throughout the Tuality network and beyond.
"I was looking for a way to not only provide access to imaging studies to physicians inside our health system, but also to streamline secure access for referring physicians outside of our network, too," said Kaminski.
That was a tall order as the solution would need to serve Tuality's physicians as well as hundreds of referring doctors across a number of facilities in surrounding communities.
Moreover, the technology would have to be speedy, reliable, easy to use, and highly secure. With these factors in mind, Kaminski set out to find the ideal application.
He talked with various vendors, but also explored options with Fujifilm, as the company's Synapse PACS was already in clinical use in the hospital.
Ultimately, Kaminski chose Fujifilm's Synapse® Mobility Enterprise Viewer. The solution provides instant access to the entire patient imaging record, including DICOM and native non-DICOM images and reports on iOS, PC, MAC, and mobile platforms through a zero-footprint viewer that requires no code download. That meant it would be easy and functional for clinicians -- no matter where they might be, no matter when they needed to see images.
Most importantly, Synapse Mobility delivers access to the complete imaging record from all departments and locations inside and outside a facility to support a comprehensive enterprise-imaging strategy.
Smooth rollout, increased satisfaction
Tuality's Mobility implementation was rolled out in phases, starting with referring physicians. Today, Mobility is in clinical use with more than 400 clinicians throughout the Tuality-OHSU community.
The zero-footprint, device-agnostic solution allowed Kaminski to understand the vast possibilities and robust, intuitive uses for this new technology. So he developed a concise training program for all users.
"We weren't deploying a device; there is no icon on their computer because I didn't put it there, so I needed to show people how to use the application," said Kaminski. "I developed the training program where I give them all the information, and then go through the primary tools of how to launch studies, find patients, tweak images in different modes, and ensure they are using the solution confidently."
The feedback on the training and the system has been overwhelmingly positive. Physicians and nurses have commented on the power of the application, ease of use, and the exceptional diagnostic quality of the images.
Finally, referring physicians have expressed increased satisfaction because they have immediate access to patient images. In fact, Mobility has helped build repeat business and customer loyalty for Tuality, notes Kaminski.
Speedier care, better collaboration
Tuality has experienced multiple other benefits thanks to the implementation of Synapse Mobility. For starters, patients receive quicker care -- and that's an important quality improvement.
For example, Tuality accepts transfer patients from all over the state. Prior to Mobility, transfer patients sometimes arrived at Tuality along with their images on a CD. Other times, Tuality clinicians would have to wait for a courier to deliver the disc -- which could take hours or days.
"We would be relying on the other hospital to tell us their interpretation of the imaging and the problem," said Daniel Friedman, MD, Neurologist, Tuality Healthcare. "Now, our transfer center gets the films queued up in Synapse Mobility so we can look at images before we've even spoken to the doctor on the phone about the transfer patient, and we can decide the most appropriate course of care. It really helps patient care to see the films for yourself and know what you're looking at before the patient even arrives. And, it helps us avoid unnecessary repeat imaging."
Overall, Dr. Friedman says Synapse Mobility makes clinicians at Tuality much more efficient. He cites the time a young man who had experienced a seizure came to Tuality. The original radiology report said it was a benign vascular malformation. With Mobility, Dr. Friedman was able to look at the MR images himself.
"I thought 'that doesn't look benign to me,' so I shared the images with our neuroradiologist and ultimately, we determined it was a tumor," said Dr. Friedman. "Being able to access the images directly and not rely on someone else's interpretation was critical to that particular patient's care. Otherwise, there would have been a delay in diagnosing the problem and addressing treatment."
With Mobility, collaborative care is enhanced as well. Because all appropriate parties have secure access to images, doctors from various facilities consult with Tuality physicians -- while they are all viewing the same images.
"I can see images when I'm at my desk, at home, or on call. If a hospital emergency room doctor calls and says, 'I don't know what to make of this radiology interpretation, what do you think?' I can look at the images myself and give my opinion," said Dr. Friedman.
Physicians can access images anywhere, anytime with Mobility -- as many times as needed. That's important, too, said Kaminski, because specialists need to see images more than once to drive better outcomes.
"If you're doing a knee replacement you want to look at the images multiple times to see where the device is going and to check measurements," Kaminski said. "And neurologists want to look at any kind of progression of a brain disease, and that requires comparing multiple images over the course of time."
Finally, Synapse Mobility allows physicians to get their patients more involved in their own care. The tool supports an effective and interactive dialogue about their health.
"We get a lot of patients with multiple sclerosis that progresses over time, so we do yearly MRIs to look for changes," said Dr. Friedman. "Synapse Mobility lets me show the lesions and changes to patients during an appointment. They can see for themselves and really get a sense of what we're looking at."
Finally, Kaminski believes the investment in the technology is paying big dividends, too. In addition to better patient care, eliminating the need to make CD copies for referring doctors saves money. Unlike some technologies on the market, there is no cost per view with Synapse Mobility, which makes it a cost-effective solution, says Kaminski.