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A small hospital in Alaska is showing the way for much bigger institutions when it comes to transmitting medical information via the cloud. The latest (July-August) issue of RBMA Bulletin reports how eMix user Central Peninsula Hospital (CPH) in Soldotna, Alaska, has improved patient safety by using eMix to send files.
Now imaging files and reports can be delivered in just minutes to the hospitals where CPH transfers patients -- compared to the hours or days it took with CPH’s previous methods. As author Katherine Leslie, CPH Imaging Services Director, writes, “Where emergency patients are involved, that difference could mean saved lives.”
Cloud-based medical information exchange is also saving CPH hard dollar costs to the tune of $9,000 per year. That’s figure would be proportionately greater at hospitals larger than CPH’s 49 beds with comparably larger imaging volumes. eMix also saves CPH significant time and labor, as it would at any hospital.
Finding a better way to exchange imaging files was a pressing need for CPH because as a small facility, it continually refers patients with severe trauma or other complicated conditions to Providence Alaska Medical Center or Alaska Regional Hospital in Anchorage, about 140 miles away.
As large, urban hospitals, Providence and Alaska Regional are equipped to handle cases that a CPH can’t. But they need transfer patients’ imaging files to plan treatment. As most other hospitals still do today, CPH used to burn files to CD and send them in the ambulance with the patient, express mail them, or deliver them by courier.
These older methods were costly in time, labor, and hard dollars -- e.g. $60 per CD for express mail. They were also too slow for emergencies and otherwise problematic, because CDs are commonly lost, misplaced, or unreadable for technical reasons.
CPH’s foresight in addressing its problem with eMix is a major reason it was named one of America’s “Most Wired Hospitals” in the Small and Rural category by Hospitals and Health Networks magazine. But the larger point here is that the motivations that drove CPH to seek a cloud-based solution also exist for even the largest hospitals.
Leslie’s article, by the way, captures the essence of a presentation she made at 2011 Fall Educational Conference of the Radiology Business Management Association (RBMA), held last October. You can read the full article, which also describes how CPH overcomes barriers with partner hospitals to receiving files via the cloud, here.
eMix user Billings Clinic is the safest hospital in America. So says Consumer Reports, a national leader in advocating for better patient safety, in their first-ever list of the best and worst medical facilities from a patient safety standpoint.
The Billings, Mont. facility ranked number one on Consumer Report’s top-ten list of the U.S.’s safest institutions. Congratulations are in order. So is a closer look at how eMix figures into the patient safety picture at the clinic.
Consumer Reports’ project was spurred in part by a 2010 U.S. Department of Health and Human Services report that says as many as 180,000 Medicare patients die every year from preventable medical errors. This, of course, means a large number of non-Medicare patients must be suffering a similar fate, as well.
The respected consumer advocacy group collected information on more than 1,100 hospitals in 44 states. The hospitals were evaluated on six different factors that measure safety: infections, communications about safety issues, how soon patients return to the hospital after discharges, common complications, fatality rate for multiple conditions, and overuse of CT scans.
Because Billings Clinic uses eMix to receive imaging files and reports from other facilities, safety-enhancing technology such as eMix helps the clinic avoid unnecessary high-radiation exams such as CT scans. When medical institutions rely on traditional methods such as CD burning to receive imaging files, redundant imaging is a common result.
Here’s a typical scenario: A transfer patient arrives at Hospital A to be treated, but the doctors there need to see imaging files from the patient’s exams at Hospital B before they can plan care. They request the files from the hospital, which then burns them to CD and sends them by courier. Numerous problems might then ensue. The files could be misplaced after they arrive at Hospital A. They may also be unviewable.
Even if everything goes well, the whole process may still be too slow to suit Hospital A’s physicians, particularly if the patient is an emergency case. In such circumstances, the doctors are likely to order a new imaging exam – exposing the patient to additional radiation that will increase his/her lifetime cancer risk.
Using a fast, reliable file transfer method such as eMix avoids such problems and eliminates a significant cause of excess imaging. Nor is that the only patient safety implication of cloud-based file transfers.
Cloud-based medical information exchange services are no longer the new kid on the block. They utilize an established technology with clear advantages in speed and dependability over burning CDs.
There are still too many large, otherwise sophisticated hospitals that lag behind Billings Clinic in updating their approach to sending and receiving electronic medical files. In this case as in many others, updating technology also means upgrading patient safety.Read More
The health information exchange (HIE) marketplace seems poised for a big upsurge in the next couple of years. That has positive implications for cloud-based medical information exchange – or at least it should. More on that below, but first let’s take a closer look at what’s happening with HIE’s.
The prediction on new growth in HIE’s comes from Black Book Rankings, a leading technology market and opinion research company. Based on a survey of 4,000 healthcare and insurance organization executives, Black Book found that 80% of hospitals and 97% of physicians have not yet implemented an HIE system. Eight of ten providers plan a significant increase in their HIE budgets by 2014, however.
The driving forces, says a statement by Black Book Partner Douglas Brown, are clearly “accountable care implementation, meaningful use implementations, the need for care coordination, outcome-based reimbursement challenges, available funding, and opportunities for regional stakeholder participation."
Of providers with an HIE strategy in place, 98% are focused exclusively on community or regional exchanges, not a national network.
It makes sense that HIE’s include cloud-based services like eMix in their strategizing. These services are the logical way for providers in an HIE to exchange large medical files such as high-resolution imaging files and associated patient information.
Specialty medical practices that expand to become large national providers gain some obvious efficiencies. Most importantly, they can aggregate the expertise and skills of elite physicians and make them available to patients from all over the country.
But if patients’ medical files can’t be easily transferred from their local providers to the national group, some of the advantages of going national go right out the window.
Such was the dilemma facing Pediatrix Medical Group, the nation’s leading provider of maternal-fetal, newborn and pediatric subspecialty physician services.
Pediatrix maintains a network of subspecialists and advanced practitioners that encompasses 34 states and Puerto Rico, so it accepts transfer patients from all over the U.S. But like other medical institutions, when it needed to receive transfer patient’s imaging files, it was forced to rely on traditional methods such as having the files burnt to CDs or DVDs and sent by ground or air.
That process was way too slow for emergency cases. It was also unreliable. Hard media can be lost, damaged, or misplaced. Even if a DVD does arrive in good shape, it may be unreadable.
Transfer on hard media was expensive, too -- $25-40 per mailing, which adds up in no time for an organization admitting the number of patients Pediatrix does. Finally, in some circumstances, courier service was not possible. For instance, one referring facility in the mountains of Colorado was sometimes snowbound, so no courier could get in or out.
When alternatives began appearing, Pediatrix reviewed them to find one that would fit its needs. It was seeking HIPAA compliance, security precautions such as encryption, and business protection in the event of an accidental breach of privacy/confidentiality.
Only one service all those criteria: eMix, which had the additional advantage of being able to transfer files at full diagnostic resolution. This feature impressed Pediatrix because it receives many files, such as echocardiograms, that are up to one gigabyte in size.
As of this writing, Pediatrix has implemented eMix at 11 of its 18 facilities, and has arranged to use it with 25 of its referring institutions. It also foresees using it for two applications related to its geographically disperse physician network:
For Pediatrix, eMix has ended both technological and financial headaches, while also offering another way to expand its influence and reach.Read More
So far, medical facilities, not patients, have been the primary end-users in the ongoing transition to cloud-based medical information exchange. But results from a new study show that, once patients are more fully included, they will be just as satisfied as medical professionals have been.
Patients in a beta project found cloud-based sharing "a faster, more efficient way to store and distribute their medical images than current options." Current options include CDs, still the most common way to share radiology files despite a host of drawbacks and limitations previously discussed in this space.
The patients are taking part in Image Share, a project of the Radiological Society of North America (RSNA). The society describes Image Share as "a network created to enable radiologists to share medical images with patients using personal health record (PHR) accounts."
Image Share is administered by RSNA and includes about 600 patients from five sites: The Mount Sinai Medical Center (Miami Beach, Fla.); University of California - San Francisco; University of Chicago Medical Center; Mayo Clinic; and the University of Maryland Medical Center (Baltimore, Md.).
The project works very much like eMix. Once patients create an account and password, they are allowed access into the system. It enables them to import their images and reports into their PHR. The transfer is secure because the information is encrypted when it is sent and remains that way until it arrives in the patient’s account.
David Mendelson, MD, FACR, is Chief of Clinical Informatics at The Mount Sinai Medical Center and Chief Clinical Investigator for RSNA Image Share. He has stated that cloud-based medical information exchange is "the next revolution in digital imaging." He describes numerous advantages of the approach including giving patients ownership over their records and making radiology information more accessible to physicians.
Plus, he says "it decreases unnecessary radiation exposure that can be caused by physicians’ ordering duplicate examinations due to records not being easily available."
We couldn’t have said it better ourselves.
We’ve been told for awhile that there’s a big change coming in how healthcare is delivered and paid for.
Update: The transformation is here, and it places a premium on efficient sharing of healthcare information.
That’s the word from Paul Grundy, M.D., MPH, a presenter at the 2012 CHIME/HIMSS CIO Forum in February. Grundy, who is president of the Patient-Centered Primary Care Collaborative and director of healthcare transformation at IBM, pointed to the growing percentage of healthcare that is now delivered via the patient-centered medical home (PCMH) model – and also the growing share of payments from private and government payers now going to PCMHs.
A PCMH is a team of providers led by a personal physician who coordinates the patient’s care with various sub-specialists. As Grundy noted, no one provider in a PCMH completely owns patients or their data, so data has to be shared with all relevant team members – smoothly, quickly, and reliably.
Cloud-based medical information exchange has a role to play in this process. Where imaging files are concerned, no method better fits the PCMH scenario than a cloud-based service like eMix that almost instantly move medical files and reports to any provider’s Web-connected computer, including tablets and smart phones.
Moreover, today's Facebooking, tweeting patients expect new types of interactions with their providers, including virtual interactions.
As one sign that medical manufacturers have already geared up for this new reality, consider VGo, a new, remote-controlled “telepresence” robot that, among other uses, enables providers to see and interact with patients as if they were in the same room.
To understand the growing potential of patient-centered medical homes, just follow the money.
Two large private payers, WellPoint and UnitedHealthCare, are redoing their reimbursement and delivery approaches. On the government side, the Centers for Medicare & Medicaid Services (CMS) has committed 11 percent of payments to approaches other than fee-for-service. This redirection of payments will drive more and more providers to adopt the PCMH model, Grundy said.
Why the sudden shift? It’s in part because payers are fed up with the inefficiencies of a healthcare system too heavily reliant on unregulated fee-for-service and rescue/specialty care, Grundy said.
The goal of the PCMH is to improve outcomes and reduce costs through coordinated care. Grundy described several studies showing that the PCMHs studied were already resulting in fewer hospital readmissions and shorter hospital stays.
What does it all mean? A new model of healthcare and provider compensation is here to stay. At the same time, robots at patients’ bedsides and imaging files shared via the cloud are carving a place for themselves in contemporary healthcare. The convergence of these new arrivals could be beneficial for all parties.
Florent Saint-Clair, eMix general manager, recently led an On-Demand Education Session of Virtual HIMSS12 titled "Cloud-Based Medical Data Exchange: What We’ve Learned So Far." Virtual HIMSS 12 was held online from Feb. 20-24.
HIMSS provided the virtual sessions as a way to take part in activities related to the HIMSS 2012 Annual Conference & Exhibition, other than attending the event in person. Attendees were able to participate from any location in the world. Virtual HIMSS12 included both interactive activities and on-demand sessions such as the one on cloud-based medical data Saint-Clair's session described the evolution of cloud-based medical data exchange from its introduction in 2010 to its increasingly wide use today. He discussed why the technology is a giant leap forward from such troublesome, limited workaround solutions as exchanging files on CDs and sending them via virtual private networks (VPNs).
CD and VPN file exchanges are plagued by such issues as time delays, reliability, and security. Cloud-based medical data exchange has created a sharp, and welcome, break with this troubled past. Thanks to the new technology, a hospital can now securely send an imaging or other medical file to a radiologist's EHR, PACS, or mobile device – indeed, any computer with a broadband connection – in just minutes.
The technology is similar to using email and just as reliable. It is also vender-neutral, which means it neatly hurdles the fact that medical information technology systems are often proprietary and don't easily "talk to" each other. This was the problem that created workarounds such as CD- and VPN-mediated file exchanges in the first place.
Saint Clair's presentation detailed the various ways that patient care has been improved by the increased reliability and speed brought about by services like eMix. He also noted the adjustments that adopters of the services face with respect to their workflow, protocols for handling images, and business processes.
For those who couldn't make it to HIMSS, the session provided an opportunity to get updated on an important new advance in medical data exchange with the depth and sophistication that HIMSS attendees expect.Read More
The Joint Commission, which accredits healthcare organizations in the U.S, has issued a Sentinel Event Alert on "radiation risks of diagnostic imaging." Among the several concerns expressed in the Alert is the harm a patient can suffer from the “cumulative effect of … multiple doses over time."
For that reason, the Commission expects institutions to put processes in place to ensure that imaging doses are as low as possible and that unnecessary imaging is avoided entirely.
A Sentinel Alert means the Commission will now hold healthcare organizations responsible for actions called for in the alert. One way to meet the concerns raised by this new Alert is by adopting a cloud-based medical data exchange.
Services like eMix are increasingly well-established tools for avoiding the redundant imaging caused by older forms of data exchange such as burning files to CD. We've described in this blog the pitfalls of exchanging imaging files by CD and why frustrated physicians often order redundant exams when CD exchanges fail.
eMix helps minimize redundant imaging by enabling facilities to exchange files reliably in just a few minutes, even if the IT systems at either end of the exchange are proprietary products that don't normally "talk to each other." Contrast this to the frequent lost, misplaced, unopenable, or corrupted CDs that often lead to redundant imaging when transfer-by-CD is used.
The parent company for eMix, DR Systems, offers other technology that will help institutions meet the Commission's criteria on safer imaging. The Unity(™) Platform Enterprise Imaging Solution includes tools that raise clinicians' awareness of, and accountability for, appropriate dosage levels. These tools include a feature that enables a supervisor to monitor staff adherence to protocols.
The Joint Commission's Sentinel Alert highlights why patient safety and accreditation are powerful reasons to consider the approaches epitomized by eMix and Unity.Read More
Florent Saint-Clair, eMix general manager, recently took part in a panel discussion aimed at sharing and cross-leveraging military and private sector IT security savvy. When it comes to cybersecurity the military can benefit from the industry’s vast knowledge and experience.
Along with the U.S. Navy's Space and Naval Warfare Systems Command (SPAWAR), CONNECT San Diego invited several high-technology company representatives, including Saint-Clair as an expert in cloud-based healthcare information technology.
SPAWAR was a logical host for this collaborative initiative because like eMix and several other important high-technology companies such as the cybersecurity vendor ESET, it is based in San Diego.
Right now, the military's acquisition process is under pressure to keep up with the rapid evolutionary pace of its cyber-enemies, says Saint-Clair. By the time a product makes its way through the bureaucratic twists and turns of the approval process, which can take several years, it is often obsolete. Read More
We've talked here before about the advantage that cloud-based systems for sharing medical information have over traditional methods such as burning CDs. One more is becoming increasingly apparent: No barriers
of time or distance.
A service like eMix instantly creates a pipeline for medical image sharing between any two broadband-connected computers anywhere in the world. The file-sharing can be accomplished in just minutes, whether the two computers are across town from each other or on different sides of the planet.
eMix has demonstrated the global reach of cloud computing over and over in the past year. Here are some recent examples:
The physicians needed to review the boy's MRI, and that posed a challenge. The family had mailed CDs of their son's imaging studies to specialists several times in the past, often with bad results. Sometimes the Read More
Copyright© 2009-2013 DR Systems, Inc. All rights reserved. eMix is a trademark of DR Systems, Inc. with various product modules protected by one or more of U.S. Patent # 7,660,488; 7,787,672; 7,885,440; 7,953,614; 7,970,625; 8,019,138; 8,094,901, and other patents pending. Specifications are subject to change without notice.