Imaging In and Imaging Out

Medical imaging is more spread out than ever before across a geographically distributed and diverse referral and patient community. For example, in New York City, a large health system like Weill Cornell has a wide range of physicians, some who are affiliated with the institution and some who aren’t. They’re also one of the medical schools and practices that are part of the New York Presbyterian Healthcare Organization and have a sister institution with Columbia Presbyterian. The net result is patients frequently coming and going and a real need to streamline image workflows across a disparate network.

In an era where efficiency is everything, improved image exchange can ensure that imaging gets to the right person, whether physician, radiologist, or patient faster. It’s also a critical step in reducing duplicative imaging. Pairing an image exchange strategy with the cloud enables imaging to be finally freed from the confines of on-premise silos, enabling it to be connected to referring physician and patient portals, downloaded or uploaded with just a hyperlink, or even tightly integrated with EMR, EHR, and CDS systems, all to improve accessibility and clinical decisions.

When we talk about imaging, we need to discuss BOTH imaging in and imaging out - how is imaging entering a facility, exiting, and returning to various key stakeholders.

An effective image management strategy must take into account each unique stakeholder. First, you have radiologists who find themselves in the middle of an increasingly image-centric healthcare model. They’re looking for strong follow-up from referring physicians, increased involvement in patient care, and clear prioritization of relevant studies, especially when pressed with increasing image volume. In return, referring physicians measure value in radiology in the quality, speed, and efficiency of the radiology services they request, like the turnaround times on orders. Then, of course, we have our patients, who are acting as consumers more than ever before. Patients gauge how smoothly both imaging procedures are scheduled and managed as part of their treatment plan and how fast they get radiologic results from their physician. In the meantime, IT staff look to engage with radiology by ensuring that imaging is easily accessible yet compliant with privacy and data security policies.

The first step in improving any image management workflow is the elimination of CDs. Data we have gathered at Ambra Health has shown that healthcare facilities are wasting over 84 days per year on CD upload, burning, and patient data matching. Relying on a medium-based transfer method like CDs also leads to increased spending for hospitals, sometimes well over $100,000 a year on courier costs alone. A recent study published in the American Journal of Roentgenology highlighted the frustrations of physicians looking for access to patient imaging; they referred to the process as both time-consuming and cumbersome.

When it comes to inbound imaging, facilities need a strategy for accepting imaging electronically, uploading CDs as needed, and perhaps, most importantly, rapidly matching patient data. At one leading facility, the film library struggled to keep-up with the demands of CD burning, ingestion, and matching of patient data often leading to back-logs, missed revenue opportunities, and most importantly, delays in clinical care. After switching to a cloud-based solution, image intake was sped up to just minutes including accurately matching imaging with patients within their EHR system.

Receiving imaging isn’t the only challenge; sending it out can prove just as difficult. We’ve seen many facilities move to using cloud image sharing and gateways to route imaging across regional networks. Imaging informatics doesn’t just cover imaging acquisition, it also includes getting the information back to the referring network or directly to the patient. Report turnaround time is perhaps one of the least well-analyzed areas of radiology, yet it is one of areas that is ripest for improvement and the most measurable. Keep in mind that forcing your referring physicians to sign up to an image sharing service, change their current technology or workflows, or requiring them to install or pay for software puts barriers between you growing your referrals.

Opening the doors to rapid cloud-based image exchange can provide your facility with a wealth of opportunities, ranging from revenue generating programs like second opinion portals, to AI and machine learning and workflow improvements, and even opportunities for new research and innovation. Consider your entire network and each unique workflow when implementing a solution that can provide unified and interoperable image management.