Images, Internet considered critical for multisite EMRs

Images, Internet considered critical for multisite EMRs

New vendors surface at TEPR meeting

The need to reduce the occurrence of inappropriate or unnecessary diagnostic exams, improve throughput, and reduce costs is driving the integration of electronic images and online patient records, according to presentations at the “Toward an Electronic Patient Record” (TEPR) 2000 conference in San Francisco May 9-11, sponsored by the Medical Records Institute. As a result, new multimedia patient-record products—some of which were on display at the TEPR meeting—are making their way into the marketplace.

The Internet has become central to this trend because it enables referring physicians, specialists, and radiologists to access and consult on patient-specific information and images regardless of location or computer capabilities. One advantage of this approach is that it allows higher procedure volume at a time when per-procedure revenue is declining. But it also contributes to better use of imaging resources by reducing the incidence of unnecessary imaging exams, according to Mitch Goldburgh, vice president and general manager of Technology Marketing Group, a market research firm in Des Plaines, IL, that tracks radiology and cardiology imaging practices across the U.S. Goldburgh chaired the TEPR session on integrating radiology information into the electronic patient record.

Goldburgh cited a study, conducted by Blue Cross/Blue Shield and a major radiology management company, of 22 million radiology procedures. The study compared the reason for each exam with the CPT code that was assigned to the exam and found that 30% to 40% of the exams were considered inappropriate. Since an Internet-based network that links referring physicians with the radiology group has been established, that number has dropped to less than 20%, according to Goldburgh.

In fact, with imaging being used more and more for therapy and planning rather than just for diagnostic purposes, the focus is shifting toward linking referring physicians with radiologists in order to improve clinical decision-making and get patients out of the hospital more quickly. The key, Goldburgh said, is to create an online relationship that facilitates consultations from the get-go.

“In order to increase referrals and volumes, there is a need to integrate radiology departments and practices with referring physicians,” Goldburgh said. “Diagnostic imaging needs to be integrated at the beginning of clinical care, and it can impact outcomes at the end of the process. This is how PACS and the Internet need to relate to one another.”

Glenn Fields, manager of healthcare systems for GE Research and Development in Schenectady, NY, took this notion one step further in a presentation on secure Internet distribution of radiology reports and images. Many information technology vendors claim that integrating electronic images with patient data outside the radiology department is not necessary. But Fields contends that primary-care physicians often require reports and representative images, while surgeons and other specialists want diagnostic quality images in their hospitals or offices and at least representative quality images at home. Radiologists want diagnostic quality in the hospital and often at home as well.

“The bottom line is timely access to radiology reports and information by referring physicians and improved productivity for both radiologists and referring physicians,” Fields said.

GMD, a German software company making its U.S. debut at the TEPR conference, has taken the multimedia medical record concept to heart with its e-health.solutions product suite and ASP model. A Web-based medical record and connectivity platform, e-health.solutions is designed to integrate existing clinical systems and improve clinical workflow by providing interactive tools for data entry and retrieval. Using e-health.link, authorized providers can access any patient data or image (including video) residing in the RIS/PACS, LIS, or enterprise HIS from a single desktop interface, thus creating an electronic medical record at the point of access.

GMD, which is headquartered in Munich and has about 40 employees, has installations at hospitals in Germany, the Netherlands, France, Spain, Greece, and Australia. The company is establishing sales and support centers in the U.K. and the U.S.