28 Oct I’m Still Waiting for the Information Age in Healthcare
Healthcare must transition itself to the information age similar to what the business world did six to eight years ago to increase the productivity of our staff, reduce costs, and improve our quality of service. This transformation process is a considerable engineering effort that requires hospital officials to look inward and understand how they operate and how they can embrace the changes that will improve healthcare.
I will speak about my neck of the woods, image management and Radiology, which is one of the big ancillary services in hospitals.
Radiology today is ready to go filmless. Just as the commercial photographic market has moved to high-resolution digital cameras, so too has the medical photographic market. Cost effective technology enablers are in place in terms of processing, storage, display, and networking. Most of the imaging modalities within Radiology such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Ultrasound (US), Positron Emission Tomography (PET) are inherently digital in that they require a computer to generate the images in the first place. With Picture Archiving and Communication Systems (PACS), the radiologist reads the images off a computer monitor and clinicians access the images wherever they are and don’t spend time tracking down the films. PACS can be a panacea to a hospital. A study at the Baltimore Veterans Affairs hospital showed a PACS has the potential to save the average clinician 50 minutes per day. A PACS also can improve the productivity of the imaging technologists and radiologists. Hospitals are experiencing severe staffing shortages in both of these positions.
So today, we are generating digital images but we are printing them out on film to read them. Only 10-to15% of the market today utilizes PACS. Of those hospitals that have deployed PACS systems, few were able to truly get rid of film in their institution and reap the full cost benefits. The challenge is in re-engineering the workflow of radiology. When trying to map our workflow we discovered, as did many institutions in our nation, that it took as many as 58 steps to get a simple chest x-ray in our department. The process to generate the images and a report is a tangled web involving registration, the imaging technologists, film room clerks and archivists, radiologists, and transcriptionists. A study done at the University of Maryland concluded that with effective information systems, the process could be cut down to 11 steps.
Healthcare was never consciously designed; it was organically grown, with layer upon layer to meet additional needs. Today it needs to be overhauled and re-engineered for using information systems for better efficiency and efficacy. This is not an atypical problem. Businesses in the 90s found they had to re-engineer their internal processes to take advantage of electronic systems.
The biggest challenge is that there are few people today in healthcare that can re-engineer the process. Healthcare needs knowledge workers who combine good information technology principles with intimate domain knowledge of workflow. Healthcare must change from within, and that takes professionals who can bridge organizational boundaries and provide the leadership to change. Healthcare needs to understand the role of knowledge management similar to how larger organizations have done to become learning companies and embrace quality management processes.
The role of the Chief Technology Officer (CTO) is overdue in healthcare. A CTO can weigh an enterprise vision with new technology investments, weigh the benefits and risks of single source versus best of breed solutions, and understand the role of standards in obsolescence protection. The bottom line is healthcare needs to look inward and know thyself before it can reap the benefits of the Information Age.
To learn more about how to set a vision for your organization and understand what it will take to transform medicine come to the Wisconsin Technology Summit on November 7th at the Medical College of Wisconsin. For more information http://wistechnology.com/healthtechnology.php.
Paul Nagy is an assistant professor of radiology and the director of the radiology informatics laboratory at the Medical College of Wisconsin. He is a diagnostic medical physicist whose expertise is in imaging science and information technology (IT). His passion for physics and IT has coalesced and taken root in the area of PACS. He has published over 25 papers on PACS. He has been an invited speaker on PACS and IHE at the Radiological Society of North America (RSNA), the Society for Computer Applications in Radiology (SCAR), and at the Hospital Information Medical Society(HIMSS). Dr. Nagy founded the PACS administration curriculum for SCAR in 2003.