Teleradiology and regional archives are pushing medical imaging beyond its traditional office boundaries
In the government arena, the sprawling Military Health System is testing picture archiving and communications systems. At the other end of the spectrum, the Indian Health Service’s 45-bed Zuni Indian Hospital in central New Mexico is also using PACS to overcome its remote geography.The hospital is 121 miles west of Albuquerque but is the nearest large medical center to that city. In the past, the hospital’s radiology department would ship copies of a patient’s films to Albuquerque Indian Hospital, where a radiologist would evaluate them. It took eight to 24 hours for those packages to reach Albuquerque.“What we needed was a way of transporting images to the radiologists,” said Neal Roush, supervisor of the radiology department at Zuni Indian Hospital.The hospital chose to develop a teleradiology approach using NovaRad’s PACS. The new system delivers images to the Albuquerque hospital in three to five minutes.“This is less time than it would probably take me to carry hard copies to a radiologist within the hospital,” Roush said. “Here, I’m doing it 121 miles away.”The hospital’s PACS sends images via the Indian Health Service’s telemedicine network at T1 or T3 speeds, Roush said.Long-distance radiology is more cost-effective than hiring an in-house radiologist. He said most radiologists make $300,000 to $400,000 a year to start. With the imaging technology, “you are not paying one individual to come to your site for $400,000. This is definitely an advantage of having a PACS.”— John Moore
Some medical facilities are taking their picture archiving and communications systems to the next level by linking them to electronic health records.Jason Launders, a medical physicist at ECRI Institute, said such connections usually happen within hospitals. But PACS/EHR integration on a national scale remains in the future. “We’re nowhere near that at the moment,” he said.George Kovacs, director of product management and marketing at McKesson’s Medical Imaging Group, said a few integration models have started to emerge. For example, Canada has created a blueprint for how to create a nationwide EHR “and how to make images a part of that.”Quebec’s project includes plans to integrate PACS into the EHR system. That linkage would enable clinicians using a Web-based EHR application to pull up a list of a patient’s past radiology exams. They could click on an icon to read a radiology report and view the radiology image. Richard Blouin, an information technology consultant who is assisting the Quebec Ministry of Health and Social Services with the project, said developers have not yet decided on the mechanism through which the images would be included in EHRs. But officials are considering an application that would pull images from a central repository, he said.NovaRad is among the companies that offer PACS products that support EHR integration. It uses standardized formatting to make integration possible, but EHRs that aren’t built according to standards can still be integrated into NovaRad’s systems with some additional interface work, officials said.— John Moore
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