Outlined below is an interview with Joe Moore, CIO, Radiology Consultants of Iowa (RCI). RCI recently was recognized as one of the Top 25 Connected Healthcare Facilities by Healthcare Imaging & ITmagazine. In this interview, Joe responds to questions on what led RCI to receive this recognition, and his thoughts on connected radiology workflow.
What led RCI to apply to be recognized as one of the Top 25 Connected healthcare facilities?
What we are doing is unique, and uses a model that we believe others would like to follow. We wanted to get the word out to other private physician groups on how to drive the connectivity process to benefit everyone. Ultimately, at Radiology Consultants of Iowa (RCI), we believe in our approach and the results it has produced for our outreach customers and their patients.
The stated goal of the award is to highlight firms that have a seamless path of incoming and outgoing patient information. What are RCI’s attributes in light of this goal?
Generally speaking, Radiology Information System (RIS) driven workflow is the key attribute. The workflow is triggered by specific events and the information flows downstream to the radiologist seamlessly and without much manual intervention. Orders and results, or patient reports, all flow electronically and productively throughout the radiology workflow.
More specifically, we could not find a commercial RIS that could extend our reach to remote sites economically. While the smaller healthcare facilities did not have a RIS, the larger ones did. We needed to develop an architecture and approach that met the needs of both our larger and smaller customers. Our objective was to enable our customers’ electronic order process, not RCI’s.
Our approach was to develop our own RIS (RISLite) for our smaller customers and leverage the commercial RIS at the larger hospitals and then use our interface engine – NeoIntegrate – to tie the two models together with one integrated workflow.
The new RCI model now is to communicate information electronically and seamlessly from the technologist to the radiologist, especially since the radiologist is no longer at the exam site.
Events in the RIS trigger events throughout the workflow. NeoIntegrate manages the radiology workflow logic and the message traffic between the various systems and locations. With this workflow and technology model, the results have been tremendous for our outreach hospitals and their patients.
The Health Imaging & ITarticle states that imaging procedures have grown for the award winners. What has been RCI’s experience?
Procedure volume is up, and utilization is up. Likewise, our outreach hospital customers have experienced growth because of our systems, approach, and workflow.
Previously, the family physicians sent patients for radiology service to the larger university hospitals. Today, it’s 180 degrees – the family physicians get better service from their local hospitals that utilize RCI’s services. Our outreach hospitals are now on even ground with the larger hospitals. In fact, the services that they now provide may exceed that of the larger university-type hospitals.
Another characteristic of healthcare facilities receiving this recognition is turn around time (TAT). What is RCI’s TAT experience with your current model and approach?
Our final patient report turn around time is phenomenal compared to what it was before we implemented the new systems and workflow. It is one of the key reasons that our volume and customer base have grown. RCI is now in the top 5% in the country for final patient report turn around time.
Improving patient report turn around time takes effort. You have to set goals, implement effective supporting technology, and push forward to make it happen. The difference is from days to minutes in what we have achieved with final patient report turn around time – it is truly amazing.
With volumes up and TAT happening within minutes, what has this done for radiologist productivity?
Our metrics have shown steady improvement across physicians. You have to measure, because the physicians want the performance metrics on the investments being made. You cannot just install the technology and expect the results. You have to roll-up your sleeves and make it work.
For example, physicians hear horror stories about voice recognition and how it slows productivity and error rates increase. Physicians were skeptical. In our implementation, we have proven that the error rate is equal to or less than a transcribed report. We have fewer errors and increased productivity with voice recognition technology.
We implemented the technology with our processes and concerns in mind. Consequently, we have a transcriptionist backing up all of the physicians, reviewing the reports that are being self-edited by the radiologist. Tailoring your implementation approach to what works for your operations is key. You have to be realistic in your approach.
At the core of the recognition is connectivity. How has this played a role in your accomplishments?
Focusing on connectivity has produced tremendous benefits for RCI. The physicians are more productive and happier, and the workflow is now steady throughout the day. With the focus on connectivity and workflow and applying the right technologies, we are able to accept a higher workload without adding new people. In fact, when two radiologists retired, we did not have to replace them. The results from effective connectivity are solid.
Finally, what about the patient’s experience? Has that changed?
Although the patients may not recognize it directly, the impact is clear in two primary areas: enhanced patient safety and care and availability of patient information.
Improved workflow delivers higher quality. Equally important, patients now can receive equivalent quality service from their local hospital. They no longer have to drive to an urban area to get high quality care.
Available patient information comes in two forms. First, when an ER physician transports a patient, they send a CD with them that contains the recent patient images and information. Second, because the system is shared among providers, a physician has access to all prior exams for a patient when reviewing current information. No matter where the physician is, they have access to all patient information in one place. Overall, patient care is greatly enhanced.
What we have is a model for the future, and we are happy with it. We are proud of this recognition. Being in the Top 25 Connected and being from Iowa is tough to do. It would be nice if we had the infrastructure that some places have. We could use a little less award and little more bandwidth!