A Huntsville radiological technology company, FINAO, has digitally connected Radiology of Huntsville (ROH) with more than 30 medical facilities in North Alabama, including Huntsville Hospital and Crestwood Medical Center. This system provides a sophisticated network in Alabama that can transmit electronic medical images from a picture archiving and communication system (PACS) or imaging devices securely over the internet.
FINAO provided its solution for diagnostic reading, voice recognition, and critical test results management to enable ROH to fine tune its already high quality services. ROH has been using FINAO for about eight years, and during that time about 36 hospitals and clinics in North Alabama have been added to its network. Imaging such as MRIs now can be transmitted in seconds between facilities instead of waiting days for the download and delivery of a CD containing the same image.
“All of these facilities are now able to share studies,” says Gene Cathey, Chief Executive Officer of FINAO. “Radiology of Huntsville and other radiology groups played a key role in this effort. The radiologists use our technology to get all patients’ studies, including priors, into the system regardless of origination.”
Once in the FINAO system, the studies are immediately available for general or sub-specialized diagnosis. “The radiologists use voice recognition to dictate the study, allowing the resulting report to be available instantly upon completion,” Cathey says. “It can be delivered to referring physicians securely via a smart phone or directly to an electronic medical record. ROH has seen improvements across the board with the system. More importantly, patient care has improved because this technology gets the right information to the right people at the right time. Patients have a choice of where to have medical imaging performed. Systems must allow this information to follow the patient.”
PACS and imaging devices communicate using a common file format called DICOM (Digital Imaging and Communications in Medicine). The format allows FINAO to receive images from a facility’s PACs or directly from imaging devices (MRI, CT, X-ray, etc.) “Many times when we go into a facility, the issues are not technological or financial. It’s more about breaking down the political barriers inside a facility and establishing a full understanding of how studies and reports can be managed,” Cathey says. “We go to the site, listen to the customer, and help them determine the best way to proceed.”
William F. Cockrell, FACMPE, a consultant with Cockrell & Associates, LLC, doesn’t think the issue of sharing images is critical at this point. “In cases where there are qualified specialists available to interpret studies, sharing the image itself is not as important as sharing the report of the image’s findings,” he says. “Any reluctance to share information could be related to a problem with the bandwidth needed to transfer the images, or because of the possibility of an image being interpreted differently in another facility.”
Cockrell does think that PACS sharing is more important in rural communities than it is in larger cities. “If a patient has a diagnostic test such as nuclear stress test in a rural hospital, most likely there will not be a cardiologist, or other appropriate specialist, on site to read the test there. In that case, it is advantageous to be able to send the images to a larger facility quickly,” he says. “Such sharing isn’t as important in Birmingham, for example.”
Medical information generally flows from smaller communities toward larger cities, such as Birmingham, Montgomery, Mobile, and Huntsville, Cathey points out. “The larger cities usually do not have issues with technical infrastructure and are technically easier to implement. FINAO, which stands for Failure Is Not An Option, has proven that smaller communities with less sophisticated infrastructure also can benefit from this technology,” he says. The smaller communities still need the ability to have imaging data flow into the larger communities to insure continuity of care.”
Having this capability results in numerous advantages and cost savings, Cathey says. The number of repetitive studies tend to decrease when imaging facilities share information. Also, patients are exposed to less radiation. “I can recall receiving a call from a radiologist stating that she and her colleagues finally understood the value of the FINAO system after receiving a study with a head injury. They discussed whether to transfer the patient via helicopter to Huntsville Hospital,” he says. “Because the study was on FINAO, the radiologist and neurosurgeon were able to view the study at the same time and made a decision not to transfer the patient. That’s improved patient care and real cost savings!”
The ability to share images through PACS may be important under the new Medicaid Regional Care Organizations (RCOs) mandated under the Affordable Care Act, because the RCOs capitate patients. “From a healthcare standpoint, sharing information is absolutely where we need to be,” Cockrell says, “because we need to eliminate duplication of services. That is critical in order to save money.”
PACS technology is one step in that direction. “We have to find ways to do things better. RCOs are important, but they are the same as any organization that has limited funds,” Cockrell adds. “For these organizations to survive, providers must perform services in the most cost efficient manner and streamline things as much as possible.”
