AHRA: Digital tune up ensures smooth-running workflow
The challenges of today’s healthcare economic climate are such that practices can no longer afford to conduct business in the same manner as they have in the past. One of the ways in which a radiology group can meet these challenges is to tune its digital workflow for maximum efficiency.
“Yesterday’s workflows hamstring today’s technologies,” said Eduard Michel, MD, in a presentation Tuesday at the 2009 Association for Medical Imaging Management (AHRA) meeting in Las Vegas.
Michel, chief medical officer of Eden Prairie, Minn.-based teleradiology services provider Virtual Radiologic, advised his AHRA audience to analyze the workflow drivers in their practice.
“The number one element in digital workflow that we’ve identified resides with the radiologist,” Michel stated.
As the radiologist is responsible for the interpretation and report of exams conducted by the practice, maximizing their efficiency pays the greatest dividends.
Radiology worklists should balance the case load among a practice’s physicians. Michel suggested that radiologists should have a mixed balance of easy cases, such as chest x-ray, and difficult cases, such as neurological perfusion, in their daily workload.
By structuring an open worklist from the RIS or PACS, identifying which members “cherry pick” the easier cases of the group is simple.
“Open worklists are where you can see that not everyone plays nicely in the sandbox,” Michel observed. “Some radiologists will opt toward taking the easy studies, leaving the more difficult cases for their colleagues.”
Michel noted that this behavior can generally be changed via a coaching session with the group president.
Vision-dependent workflow navigation is an area where seconds here or there add up over the course of a month, Michel said. Interface tools and menus should be streamlined so that the interpreting radiologist has as few distractions as possible when reviewing exams.
Comparison cases on film or disk also can abruptly halt a smooth-running digital workflow. In these cases, Michel advocates scanning or importing the images into the group’s PACS.
Multiple worklists on multiple workstations mean radiologists will be shuttling back and forth between several applications. Michel’s solution is to merge these worklists, so a group’s radiologists will be working from one worklist on their RIS/PACS.
An inadequate physical infrastructure, such as network bandwidth and workstation processing power, can cause RIS/PACS slowdowns.
“Don’t skimp on IT hardware or bandwidth,” Michel said. “If it takes two minutes per case to download, over a 120-case workload, a total of four hours is wasted.”
Multi-site practices often have the challenge of reading from multiple RIS/PACS products. Michel suggested that a practice should aggregate its work onto a single platform for interpretation and reports.
Another road-block to digital workflow efficiency is physicians performing non-physician work, Michel said. A call center staffed with personnel handling behind the scenes work, such as locating a referring physician, can streamline consultations and improve workflow.
Outdated or non-updateable systems in a practice are often time drains that detract from the bottom line. Given the lean budget that many practices have in place, the best a RIS/PACS administrator may be able to accomplish is to modify the current applications in order to gain efficiencies, Michel said. Preparing a return-on-investment document for desired system upgrades can also help for a more favorable budget allocation in the future, he noted.
He recommended investigating application service provider (ASP) or software-as-a-service (SaaS) offerings as these solutions can help a practice avoid large upfront capital expenditures.
“Both hospitals and practitioners will need to change their practices and increase efficiencies to meet the challenges of decreased reimbursement for procedures,” Michel concluded.
“Yesterday’s workflows hamstring today’s technologies,” said Eduard Michel, MD, in a presentation Tuesday at the 2009 Association for Medical Imaging Management (AHRA) meeting in Las Vegas.
Michel, chief medical officer of Eden Prairie, Minn.-based teleradiology services provider Virtual Radiologic, advised his AHRA audience to analyze the workflow drivers in their practice.
“The number one element in digital workflow that we’ve identified resides with the radiologist,” Michel stated.
As the radiologist is responsible for the interpretation and report of exams conducted by the practice, maximizing their efficiency pays the greatest dividends.
Radiology worklists should balance the case load among a practice’s physicians. Michel suggested that radiologists should have a mixed balance of easy cases, such as chest x-ray, and difficult cases, such as neurological perfusion, in their daily workload.
By structuring an open worklist from the RIS or PACS, identifying which members “cherry pick” the easier cases of the group is simple.
“Open worklists are where you can see that not everyone plays nicely in the sandbox,” Michel observed. “Some radiologists will opt toward taking the easy studies, leaving the more difficult cases for their colleagues.”
Michel noted that this behavior can generally be changed via a coaching session with the group president.
Vision-dependent workflow navigation is an area where seconds here or there add up over the course of a month, Michel said. Interface tools and menus should be streamlined so that the interpreting radiologist has as few distractions as possible when reviewing exams.
Comparison cases on film or disk also can abruptly halt a smooth-running digital workflow. In these cases, Michel advocates scanning or importing the images into the group’s PACS.
Multiple worklists on multiple workstations mean radiologists will be shuttling back and forth between several applications. Michel’s solution is to merge these worklists, so a group’s radiologists will be working from one worklist on their RIS/PACS.
An inadequate physical infrastructure, such as network bandwidth and workstation processing power, can cause RIS/PACS slowdowns.
“Don’t skimp on IT hardware or bandwidth,” Michel said. “If it takes two minutes per case to download, over a 120-case workload, a total of four hours is wasted.”
Multi-site practices often have the challenge of reading from multiple RIS/PACS products. Michel suggested that a practice should aggregate its work onto a single platform for interpretation and reports.
Another road-block to digital workflow efficiency is physicians performing non-physician work, Michel said. A call center staffed with personnel handling behind the scenes work, such as locating a referring physician, can streamline consultations and improve workflow.
Outdated or non-updateable systems in a practice are often time drains that detract from the bottom line. Given the lean budget that many practices have in place, the best a RIS/PACS administrator may be able to accomplish is to modify the current applications in order to gain efficiencies, Michel said. Preparing a return-on-investment document for desired system upgrades can also help for a more favorable budget allocation in the future, he noted.
He recommended investigating application service provider (ASP) or software-as-a-service (SaaS) offerings as these solutions can help a practice avoid large upfront capital expenditures.
“Both hospitals and practitioners will need to change their practices and increase efficiencies to meet the challenges of decreased reimbursement for procedures,” Michel concluded.