Prognosis Is Excellent for Health Network After Imaging System Conversion

Oakwood Healthcare, Inc. (OHI) knew its Radiology Department had to switch from traditional film X-rays to digital imaging, which was clearly the wave of the future. It was just a matter of when, how and with whom. Thanks to an exceptionally high level of collaboration among all members of the project committee, which included Compuware’s Professional Services team, the changeover to a digital Picture Archival and Communication System (PACS)— supplied by Stentor—was accomplished in record time and below budget at OHI’s four hospitals and select ambulatory sites. In fact, said Paula Smith, OHI’s CIO, it created a new "gold standard" for implementation efforts throughout the Oakwood system.

"We had a very strong project team," stated Smith. "I think that was one of the major factors of success for this particular project. Right from the beginning when we approved the project we had strong support and sponsorship across all of our hospitals, from the radiologists themselves across each of the different groups to nurses and others that needed to be involved in this process.

"People really devoted their time and made their commitment to being part of that team coming to the weekly meetings, providing feedback, assigning staff for training of their resources, all those kinds of things. This has become a new bar for us at Oakwood, and how we would like project implementations to occur."

"We knew there were innumerable advantages to being filmless, in terms of patient care and turnaround time and physician satisfaction. There were so many advantages, we knew that we had to do it; we just had to figure out a way to accomplish it," said Dr. David Yates, Director of Radiology at OHI’s largest hospital, Oakwood Hospital & Medical Center in Dearborn.

As Compuware had successfully handled previous implementations and production support for OHI, working with software from various vendors, OHI knew the company’s Professional Services team had the strong project management skills required for this highly visible undertaking.

According to Dr. Yates, the Compuware team meshed seamlessly with OHI staff throughout the project. "To be perfectly honest with you, sometimes I was never sure which was which of these people. I just needed to accomplish certain things, and these people did it for me."

Accelerating the Timeline

At the request of OHI administration, the original 30-month timeline was shortened to 24 months, accomplished by building and testing the third and fourth hospital sites simultaneously and having back-to-back "go-lives." An additional three months were shaved off the timeline as OHI began to benefit from the new digital imaging and storage system, and the project team looked at other tasks that could be combined.

"The implementation came up ahead of schedule; we were able to accelerate the project and bring things up quicker than initially planned," noted Smith, again crediting an extremely motivated, task-oriented project team.

The process started with PACS vendor selection in July 2004. After OHI contracted with Stentor at the end of December 2004, "We pretty much hit the ground running in January 2005," said Smith. Implementation rollouts began in May 2005 at Oakwood Hospital & Medical Center.

Despite the shortened timelime, succeeding rollouts went extremely well and were completed in July 2006. "We had a very, very smooth implementation. Our transition was a lot smoother than anybody anticipated," commented Dr. Ashok Jain, Director of Radiology at Oakwood Annapolis Hospital in Wayne.

Reaping the Benefits

Benefits of implementing the filmless PACS system were many, according to OHI healthcare workers and staff, and included cost and time savings, increased user satisfaction and improved patient care… as well as industry recognition.

Turnaround time—OHI’s goal was to improve radiology turnaround time by at least 25 percent, and it has achieved that goal—in fact, it has surpassed it at Oakwood Hospital & Medical Center, where turnaround time has improved by 50 percent. The improvement has benefited not only radiologists, who can now process results faster, but also general physicians and their patients.

"Physicians are getting the results much more quickly in a more real-time environment, so rather than seven, eight, 10 hours later, they’re getting the results in sometimes minutes, or at least, less than an hour," said Dr. Yates. "Physicians, therefore, have the results sooner and can act on those results more quickly, so theoretically they can get the patient out of the hospital sooner. Length of stay should be impacted, although I don’t know we have data yet that would reflect that."

"Everybody benefits," concurred Dr. Jain, who said the biggest advantage at Oakwood Annapolis Hospital has been a dramatic improvement in radiology turnaround time for the Emergency Department. "Our average turnaround with PACS has been about 21 minutes. Both the Emergency Department and [Radiology] are able to look at the images faster. From the technical perspective, our technologists don’t have to develop the film. And patient stay improves a lot because we get the images done faster."

Cost savings—At a time when healthcare systems are forced to cut operating expenses due to a decrease in insurance reimbursement, OHI saw significant reductions—as high as 85 to 90 percent at its largest site, Oakwood—in costs associated with X-ray film processing. Expenses included the film itself as well as chemicals to develop it and film jackets to store it.

"In some areas, it’s just a phenomenal improvement," said Smith, "but I think overall it was anywhere between a 25 percent to 30 percent reduction in cost."

User satisfaction—Diagnostic images are available immediately in the emergency rooms, ICUs and CCUs, which has been a boon to clinicians.

According to Smith, while the metrics aren’t yet available to support it, physicians have experienced significant time savings since the PACS implementation. "They used to have to come in, go over to the Radiology Department, request for film to be pulled, wait to find a viewing station, review the films and hopefully catch a radiologist if they had any particular questions, and now that time has pretty much been eliminated. They can pull the film up themselves and look at it; if they need to call a radiologist, that radiologist isn’t bogged down with all these people looking at films in their particular area and they can have that conversation."

OHI physicians are especially impressed, noted Smith, by their ability to access information no matter where they are: "They no longer have to go over to the Radiology Department to request the film; they can pull it up on any workstation within the organization. They can even pull it up remotely."

"Physician satisfaction is huge," added Dr. Yates. "Every day I would get complaints from physicians that they couldn’t find the films, there was a delay in trying to find them, they may or may not ever find them, constant problems along those lines, whereas now … a lot of the physicians that complained all the time, I never see anymore because they don’t have to come to the department to go over the results, and that’s a good thing from my perspective."

It’s a good thing from the patient’s perspective too, said Smith. "This has become a key tool to all the primary physicians in the daily care of their patients, to be able to go to any network PC and bring up a patient’s image, whatever it is, before they even go in and talk to the patient or before they lay out a treatment plan."

Improved productivity—As there is currently a national shortage of radiologists, implementation of the new PACS system didn’t happen a moment too soon, according to Dr. Jain. "With PACS, our biggest advantage is, we are able to reduce FTEs and do the same work, and our productivity has gone up by about 20 percent."

Dr. Yates also has observed a significant post-PACS impact on radiologists’ productivity. "We can read particularly big dataset images much more efficiently in a filmless environment rather than putting up dozens of hard-copy films on viewing boxes to be able to scroll through the images. And it just makes it a lot more efficient for us."

There’s another big plus to the new multiple-site system, he pointed out. "If I have a couple of spare minutes, I can be knocking off images from another place, and take the load off that location, and, again, get these images read much more quickly."

Industry recognition—In addition to the many internal benefits OHI realized, it also received an outside award: It was named a "Most Improved" winner in Hospitals & Health Networks’ "100 Most Wired Hospitals and Health Systems" study for 2005. Oakwood was the only healthcare system in southeast Michigan so recognized.

Ready for the Future

Thanks to the successful implementation of the PACS system throughout its network, OHI is not only reaping multiple benefits now, it is also well positioned for the future in southeast Michigan’s competitive healthcare marketplace. By gaining a significant knowledge base in the area of digital imaging—not just for radiology, but for all areas of medicine where a static hard-copy image was historically stored—the company has helped ensure it will continue to attract talented professional staff as well as the patients who use its services.