Commentary
Can the cloud really offer better service at a lower cost?
By Rick Perez, Administrative Director of Radiology, Winthrop-University Hospital
Winthrop-University Hospital is committed to embracing innovative ways to share images and data with affiliated and unaffiliated providers throughout the region.
As a 590-bed teaching hospital located in Long Island, NY, we are a Level 1 regional trauma center and offer centers of excellence for bariatric, oncology, and stroke patients. Our enterprise imaging environment serves dozens of affiliated regional urgent care centers, orthopedic practices, physicians’ offices, and other providers. We create medical records for these patients and link all imaging exams and other procedures so clinicians can gain a comprehensive view of each patient.
Our hospital also delivers specialized care to thousands of trauma patients outside our network. For these patients, we use a cloud-based service that allows referring hospitals to upload patient information and images. Our physicians and specialists review this data as they prepare to diagnose and treat these urgent care patients. This image-sharing solution replaces a cumbersome process in which demographic information and imaging studies were loaded onto a CD and shipped with each patient or emailed while the patient was being transported.
We have found that using the cloud is a secure and cost-effective method for data sharing. Our organization’s IT specialists thoroughly tested the cloud prior to our adoption to verify that it met our security standards.
A key benefit of the cloud is that it replaces the unpredictable costs of IT technology obsolescence with a predictable operational model. It also provides access to non-network cases in a separate domain, which enhances the security of our internal enterprise imaging infrastructure.
As the volume of imaging data continues to grow exponentially, the cloud represents a vital resource. While our hospital owns the images we manage, we do not feel that the hospital needs to own all the devices that store these images. We may consider moving some of our onsite data to the cloud in the future.
It’s human nature for managers to think their own staff can do a better job of protecting patient data than an outside company. But specialization can deliver impressive benefits. We believe our centers of excellence deliver enhanced patient care because our specialists offer advanced expertise in diagnosing and treating difficult cases. The same reasoning would indicate that cloud service providers may be able to offer more efficient sharing and storage of data at a lower price. The jury is still out on the benefits and dangers of outsourcing to the cloud. Its performance over the coming years may equip us with new options as we face the continuing need to maintain and upgrade our onsite medical image management and sharing infrastructure.
Companies rally around IBM Watson
IBM has formed the Watson Health medical imaging collaborative, a global initiative comprised of 16 leading health systems, academic medical centers, ambulatory radiology providers, and imaging technology companies. The venture aims to bring cognitive imaging into daily practice.
Watson is a cloud-based artificial intelligence platform that analyzes high volumes of data, understands complex questions posed in natural language, and proposes evidence-based answers.
Founding members of the collaborative include Agfa HealthCare, Anne Arundel Medical Center, Baptist Health South Florida, Eastern Virginia Medical School, Hologic, ifa systems AG, inoveon, Radiology Associates of South Florida, Sentara Healthcare, Sheridan Healthcare, Topcon, UC San Diego Health, University of Miami Health System, University of Vermont Health Network, vRad (a MEDNAX company), and Merge Healthcare (an IBM company).
Watson will be trained on cardiovascular disease, eye health, and other conditions using data provided by the members of the collaborative or from population-based disease registries that house millions of de-identified cases from around the world. To help create new solutions powered by Watson, the industry members of the collaborative could integrate Watson into their workflow systems or image management software.
The efforts could also help physicians make personalized care decisions relevant to a specific patient while building a body of knowledge to benefit broader patient populations. This information may include data from EHRs, radiology and pathology reports, lab results, doctors’ progress notes, medical journals, clinical care guidelines, and published outcomes studies.
Initial plans include training Watson and evaluating potential new offerings in a variety of patient care environments ranging from stand-alone ambulatory settings to integrated health delivery networks. The aim is to gather data based on diverse real-world experience and to share findings on how the medical community might reduce operational and financial inefficiencies, improve physician workflows, and adopt a patient-focused approach to improving patient care and outcomes.
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Solutions
Deliver radiology results to smartphones
The Spok solution securely and rapidly transfers test results from Radiology to the right physicians and caregivers on mobile or other communications devices, speeding treatment. The Spok Mobile secure smartphone messaging app encrypts messages from the radiology information system (RIS) and sends them to the requesting clinician. The test results reach the correct clinician’s preferred device based on the requesting doctor’s identity received from the EMR and the list of matching registered users in the secure Spok directory. Clinicians can accept or reject the notifications and securely forward messages to other registered clinicians, even based on on-call schedule information. Acknowledgement of findings is written into the patient’s EMR, closing the communications loop. Spok
NovaPACS/Powerscribe 360 integration
With more than 20 years of imaging experience and 850 installations in more than 15 countries, NovaPACS now has a new capability: It supports a special custom integration with Nuance’s Powerscribe 360 Dictation Software. Features of the Powerscribe 360 integration include that it allows doctors to run the product either from NovaPACS or from Powerscribe, autolaunching of Powerscribe when signing into the PACS system, the ability to park a dictation when using Powerscribe (interrupt and table a dictation, open a new one and complete it, then return to the original one), and seamless communication of study information and status between the two systems. Novarad, Nuance
Comprehensive cancer care coordination
Break down imaging silos
Next-generation enterprise imaging
Carestream’s Clinical Collaboration Platform is a powerful enterprise image data management solution that is also available in the cloud. It makes patient images and data available to clinicians and non-clinicians who need to view them. A modular, standards-based platform reduces costs and boosts efficiency for multi-site, multi-specialty implementations. A Unified Core allows integration into an existing ecosystem, streamlines administrative tasks, and delivers a scalable deployment. New capabilities include: an expanded portal that can serve medical and administrative needs, enhanced data mining, and intelligent worklist management for radiologists. Carestream
