Category: RIS/PACS

04 Feb 2019
PACS

Picture Archiving and Communication System (PACS) and Its Benefits

Technology and innovation play a major role in today’s healthcare system as it is crucial for sustaining health. It has enhanced the quality of medical care offered to patients, and PACS system in hospitals & health facilities is one such example of technology improving medical care.

PACS (Picture Archiving and Communication System) has changed the way radiology works and is now considered one of the most essential requirements in healthcare facilities. Sharing of instant medical images electronically and reporting them remotely is now very easy and quick, thanks to this invaluable software. With AI (Artificial Intelligence) enabled technologies now becoming available in PACS, their functionality is growing by the day

What is PACS?

PACS (Picture Archiving and Communication System) is a medical imaging technology that provides economical storage, presentation, retrieval, distribution, and management of medical images. Transmission of electronic images and reports takes place digitally via PACS. Thus, manual filing, retrieving and distribution of film jackets is no longer required. It allows storage and viewing of all types of medical imaging by healthcare organizations both internally and externally.

A radiology PACS is often deployed with RIS. An RIS is used to record patient history and schedule appointments, whereas PACS focuses on image storage and retrieval.

The four major components of PACS are:

  • The imaging modalities
  • Transmission of patient information through a secured network
  • Interpreting and reviewing of images through a workstation
  • Storage archives for retrieval of images and patient reports

Benefits of PACS

PACS improves efficiency in electronic data handling workflow. It offers a cost and space advantage due to decreasing price of digital storage. Benefits provided by PACS are many, but here we highlight few of the most important ones:

Improved Viewing and Analysis

An effective viewing and analysis is possible as PACS’ digital images enable you to zoom in and operate the images for a more elaborate analysis.

Where the conventional film can only exist in one place at one time, PACS enables simultaneous multi location viewing of images. It enables collaboration among radiologists as they can seek each other’s opinions by viewing the cases simultaneously and discussing them under peer review module. The interpretive skills of the professionals prove beneficial for the patients as well. The high-quality images make it possible to give a more accurate diagnosis.

Easy Accessibility to Images and Reports


PACS enables instant and easy access to images and reports. No matter where the tests are performed reporting can be done remotely and results can be shared anywhere, even if it is an isolated facility. PACS enables submitting reports, archiving images and transferring them through a portable media anywhere in the world. Practitioners at different physical locations can access the same information concurrently for teleradiology. In addition, quick access to prior images is also possible at the same institution. Radiology history of patients is available, which allows comparison with previous studies.

User-friendly Software


User-friendly since there are several customizations available for easy use of the software for staff and beneficial for patients. PACS is a great integration platform for other automation systems such as Radiology Information System (RIS), Electronic Medical Record (EMR), and Hospital Information System (HIS). The PACS database automatically groups all images chronologically, correctly labelled according to their examination. They can also be retrieved easily with the help of criteria’s such as name, hospital, referring clinician, etc.

Efficient Data Management

The system provides an efficient, seamless review of radiology cases within a physician’s daily workflow as it makes it easier to store and organize imaging data, with a centralized and accessible system. Data management becomes more efficient as the number of duplicate images can be reduced as previous data is available with the system.

Steps to Consider While Purchasing or Upgrading PACS

While purchasing or upgrading to a new PACS, one should look for features such as scalability and user-friendliness. The features should be easily configurable and should have uploading features for prior studies. Other than that, it should have a voice recording feature, integration with the Hospital Information System (HIS) and the Cloud feature. It is also beneficial switching to a new system when it has in-built AI algorithms.

An integrated RIS-PACS is a great advantage to radiology department as it can give evidence-based insights such as enhanced productivity of radiologist, turn-around time, modalities being used for improved workflow, and referring physicians sending maximum exams. RADSpa, one of the best integrated RIS-PACS available, provides a customizable work-flow suiting the requirements of radiologists.

A RIS-PACS’ rich intuitive AI integrated workflow, supporting all DICOM modalities, an orchestrated work-flow, multilingual software, advanced application supporting MIP/MPR and 2D/3D viewer, a scalable architecture and ability to integrate with any existing PACS and 3rd party AI algorithm, is sure to add value and increase productivity for any radiology department.

26 Dec 2018
New Pacs

Replacing existing RIS-PACS? Or a first time RIS-PACS buyer?

Struggling with what to do about an outdated RIS-PACS? Or, planning for RIS-PACS for the first time? In either case, it is not an easy and simple decision to take. But prolonging the decision will not help either. There will always be a dilemma, for an existing RIS-PACS user, regarding whether to pay the upgradation cost and stick to the same old vendor who ask for big bucks for each single support or whether to replace existing PACS with a new system which also comes with value added features such as AI algorithms in-built into the RIS-PACS. Other factors which needs to be considered before switching to a new system include the data migration costs, training costs, opportunity costs, related hardware upgradations costs, regulatory environment., cost of upgradation versus going with a new system, all these questions have to be answered.  As per expert estimate, transition and migration to a new system may take from 30-90 days. The challenge is also therefore to identify a vendor which can fast track the transition to maximum 15 days while ensuring that the ongoing work is not affected.

Finding the appropriate RIS-PACS can be a big challenge. Few important questions that needs to be asked regarding a new RIS/PACS is that it must be affordable, faster, should have prior studies uploading feature, voice recording feature, ability to integrate with third part voice recognition system such as dragon application or PowerScribe, and ability to be integrated with the hospital information system amongst the few important pre-requisites. Growing number of RIS-PACS providers are placing emphasis on reporting on the cloud feature.

What is an Integrated Radiology Information System (RIS) PACS?

PACS, or picture archiving and communication system, is a medical imaging technology used for storing, retrieving, presenting and sharing images produced by various medical hardware modalities, such as X-ray, CT scan, MRI and ultrasound machines. While digital medical imaging has brought in enormous savings for the imaging centres in terms of archival, storing, retrieval and sharing. It is the Radiology Information System (RIS), which helps manage the radiology workflow and the business.

Older RIS/PACS consisted of disparate systems – one for archiving patient images and one for storing patient records. Often, it would be noticed that the patient data in the PACS database may not be same as the data entered in the RIS database. If there is a mismatch between patient’s name or other demographic details entered in the PACS and RIS databases, then the system will not be able to correctly access all relevant records.  Such discrepancies can cause unwanted inconvenience to patients and referring physicians while also expose the facilities to unwarranted risks and legal liabilities.

Functions of RIS

Some of the key functions of RIS includes order entry; patient scheduling, assigning studies; tracking number of exams; assistance in billing etc.  A combination of the two (PACS and RIS) is termed as an integrated RIS-PACS. An integrated RIS-PACS gives radiologists or the administrators access to evidence-based insights such as which modalities are being used the most, which referring physicians are sending maximum exams, radiologist productivity, turn-around time, busiest time, days or week of the month etc.

An imaging facility stands to make enormous gain in terms of patient and financial outcomes if they choose an integrated RIS-PACS. RADSpa is one of the best Integrated RIS-PACS available on the shelf and deployable in various situations and for different kinds of facilities.

Now, what is AI-enabled RIS-PACS?

AI -Enabled RIS PACS is a platform on which resides numerous AI algorithms developed by the RIS-PACS providers themselves or those provided by niche AI companies. For example, the RADSpa RIS-PACS platform is AI enabled. So, when you go with RADSpa, you also get access to a number of algorithms. What makes this system very interesting is the fact that there are no initial upfront investments on AI part. You pay for the algorithms, only when you use them. That, too, it is pay-per-use system.

To replace or retain?

There was a time when the average longevity of a RIS-PACS would be around 7-10 years. But now in the current fast developing diagnostic imaging space where not only the volume of imaging and its complexities are growing by leap and bound but also the regulatory and privacy requirements such as HIPAA and GDPR, which is forcing radiologists to be always hard pressed for time and for quality reporting.  Any delay or hesitation in decision making can be hazardous to imaging business.

But hesitation presents hazards

Imaging facilities need to appreciate that failing behind on modernization and working with an out-of-date RIS-PACS can have serious consequences for clinical efficiency and financial health of the centre.  In addition, sticking to system which has far outlived its lifespan can also make it tough for a facility to keep up with the expectations of referring physicians, affiliated organizations and patients.

Telerad Tech, the global health IT company and one of the leading providers of integrated RIS-PACS Workflow strongly recommends that while analyzing current RIS-PACS and its vendor, an imaging facility should do proper audit in the key areas of operations such as – administrative, clinical, information technology (IT), regulatory environment and the market.

Important points to consider

For instance, if your existing PACS or RIS-PACS chokes your competitiveness, is unable to give you important insights regarding productivity of manpower, modality machines, have a confusing user interface, or simply doesn’t give you the next generation workflow tools such as workflow orchestration that optimize your productivity, you should consider a new system. Also, you should take into account the regulatory environment such as HIPAA and GDPR and go with systems which is capable of anonymizing patient data and is able to give you patient security framework (PSF) gateway, if needed. Teleradiology companies who are either reporting or have an ambition to serve defense hospital establishments, should ideally look for RIS-PACS which comes with PSF Gateway feature. RADSpa, which comes with PSF feature, is deployed at multiple hospitals under the Navy establishment in Mexico.

Making the Switch

Finally, having decided to switchover to a new RIS-PACS, a facility should first clearly define its requirement. Talk to vendors who can help you assess your current and future growth requirements.

First Time RIS-PACS buyers

For a facility which is considering acquiring PACS for the first time, they should look for a solution which offers latest productivity tools, can integrate with the existing DICOM compliant modalities amongst other features which are explained below.

Listing the requirements

Begin your process for procuring RIS-PACS, like for any other product, by listing the requirements. If possible, involve the Radiologists, Technicians, IT Team, Operations Team, and Finance Team in the process. Your list of requirements can include:

  • RIS-PACS should easily and fast integrate with existing modality machines;
  • System should be able to integrate with existing Hospital Information System (HIS) through Health Level 7 (HL7) protocol;
  • Should be able to reduce the turn around time (TAT) and increase productivity;
  • Should be able to integrate with existing PACS, without requiring any major overhaul of the system;
  • For teleradiology companies which have complex workflow and QA requirements, the facility should look for systems which has multi-read workflow management features and whose QA and peer review module facilitates collaborations as per ACR guidelines;
  • The new system should have smart features like workflow orchestration, real-time work lists, CD burning feature, multi-monitor support;
  • The RIS-PACS should meet regulatory requirements of FDA and should be CE certified, HIPAA and GDPR compliant;
  • Should have advanced 3D DICOM Viewer Features such as Minimum Intensity Projection (MIP), Maximum Intensity Projection (MIP), Multi Planar Reconstruction (MPR), and sculpting tools;
  • Radiologists/facilities often want to customize layout in the viewport using custom feature which helps standardize the workflows as per their specific requirements. So, look for such features in the system proposed by your vendor;
  • Facilities should also look for RIS-PACS which offers hanging protocol features for each specific modality machine;
  • Vendor Neutral Archive (VNAs) technology is today a game changer. VNA is enabling imaging facilities to archive and retrieve millions of medical images generated by disparate modalities from many different vendors. So, look out for RIS-PACS which is VNA compliant;
  • If you are a new and starting small, look for solutions which will be able to grow with you, i.e., look for a solution which is scalable;
  • Depending upon your specific choice, you may go with a solution which is pure cloud so that you can jump start radiology without any major investments in IT infrastructure;
  • You may go with an on-premise solution, if your already have the IT infra and manpower in place or have the capital to invest in on-premise solutions;
  • Products like RADSpa also offers something called Hybrid solution that stores images on site in the local system, while RIS is available on cloud which gives the flexibility to report from anywhere. This type of systems can potentially reduce your investments and recurring bandwidth expenditure by up to 30%.

Timing

Regardless of the fact that whether you are switching to a new system or a first-time buyer of RIS-PACS, it is the timing which is most important. The transition should be such that the normal operations are not affected. You can also go for a trial run for about a month so that your team is well familiarized with the software. RADSpa offers free trial to most of its prospects after properly assessing the seriousness of the customer.  So, go on, and go for your new system to leapfrog your facility to an integrated and AI-Enabled RIS-PACS environment.

09 Oct 2018

Unlock productivity, quality and communication with radiology workflow orchestration

Radiology exams are typically categorized as Stroke Cases, STAT cases, Trauma cases, Emergency Radiology, Inpatient, Outpatient and ICU cases etc. A radiologist’s workflow dashboard therefore must be organized in a manner that s/he has access to all vital information with the click of a button. But, it is easier said than done!

With increased accessibility and affordability of imaging modality machines and also due to incessant endeavors of modality manufacturers and PACS companies to provide precise imaging solution, there has been a quantum jump in the number of exams to be read. Further, the advent and availability of newer modality machines has also created the need for subspecialists readings.  A radiologist dashboard is now no less than a cross-word puzzle. What is most affected are the radiologist’s productivity, quality of work, communication between different stakeholders and the overall viability of running an imaging facility.

To overcome these challenges, companies are creating workflow orchestrators. Workflow Orchestrator is a mechanism for automatically matching imaging scans with a radiologist profile in the radiologist service provider environment. So, instead of radiologists spending their precious time figuring out which scan to read, the scans look for a perfect radiologist to read them.  Workflow Orchestrator further mines for exams in terms of priority or SLA (service level agreement), right sub-specialty and the best relationships and accordingly populates them in the worklist of the relevant radiologists for their appropriate response.

RIS-PACS with Workflow Orchestration lends itself in enhancing productivity, quality and communication.  With the implementation of intelligent tools such as Workflow Orchestration, the exams are exposed to a broader audience as time goes by. To begin with, the exams are exposed to the most suited radiologists, ones that have the best expertise and the best relationship to read that exam.

The Workflow Orchestrator also ensures that all available subspecialists are taken into the fold if a particular exam is not read or taken up quickly enough. The orchestrator delivers incalculable augmentation where quality KPI is concerned. The software also organizes exams not just by clinical but also by business priorities. The most crucial exams can be seen on top followed by the emergency and STAT exams, right after that comes inpatient exams, and then outpatient exams. Each exam is tagged by the intelligent software by the SLA so the time remaining to read each exam can be seen easily.

The productivity of the radiologists can be seen clearly from the personal radiologist dashboard. Apart from other features, there is also a break glass mechanism so that if a radiologist chooses to read out of order, the system will ask for a reason to do so. With integrated communication tools such as chat or instant messaging and more, the orchestrator’s software allows radiologists and referring physicians to easily share context of exams with each other and even ask for a specific exam to be reviewed.  The workflow orchestrator lets radiologists have the right tools to manage inaccurate exams and enhance productivity.

The Workflow Orchestrator helps direct imaging exams first to suitable clinical subspecialists, and then it makes sure that the exams are made available to other radiologists as needed to satisfy desired turnaround times. Exams also can be allocated to specific radiologists according to a referring physician’s preference and existing affiliations with hospitals or healthcare facilities. The platform’s workload balancing function can optimize reporting times.

RADSpa’s Workflow Orchestrator is one such value-added capability in the ever-evolving healthcare delivery paradigm.

  • It takes care of enhanced productivity by aligning demand with supply.Dynamic assignment automatically accelerates and assigns studies to the most appropriate, available radiologists. There is better communication through associated tools and automated notifications.

 

  • With a universal worklist, the orchestrator incorporates quality and interpretations tasks in one place. Efficiency is improved by contributing to quicker turnaround times and reduced length of stay.

When a study was conducted to see the impact of RADSpa’s Workflow Orchestrator feature, the results were overwhelmingly positive.

  • Almost 85% of the radiologists agreed that RADSpa’s Workflow Orchestrator helped them to reduce the TATs and increase productivity.
  • Statistical analysis of 180 days of logs before and after automation indicated 35% improvement in overall TAT for emergency cases.
  • Radiologist productivity per case improved by 25% as every case is auto-validated for images prior it is assigned.
  • Exam Coordinators or the Assigners reported a massive 98% reduction in effort which used to go in manually eliminating errors, and thereby more time in hand for handling greater workloads.

Radiology Workflow Automation has positively impacted timely patient care specifically in Reporting Emergency cases and thereby saving lives.

  • Manual errors and allocation time is reduced by 98%, TAT is improved 35% and RAD’s productivity by 25%.
  • Zero error in case assignment to radiologists by the coordinators (assigners).
  • Radiologists receiving advance alert regarding their work list.
  • Notification to assigners regarding un-attended cases. This helped assigners to follow-up with the respective Radiologists or re-assign them to equivalent Radiologists.

This value-based care has helped radiologists achieve more and do much more. This increased cooperation between healthcare providers as well as professionals benefits all participants in the care continuum. Workflow Orchestrator is therefore a great productivity and quality boosting tool and promises to be an excellent tool for collaboration and communication.

  • It takes care of enhanced productivity by aligning demand with supplyDynamic assignment automatically accelerates and assigns studies to the most appropriate, available radiologists. There is better communication through associated tools and automated notifications.
  • With a universal worklist, the orchestrator incorporates quality and interpretations tasks in one place. Efficiency is improved by contributing to quicker turnaround times and reduced length of stay.

When a study was conducted to see the impact of RADSpa’s Concierge Automation feature, the results were overwhelmingly positive.

  • Almost 85% of the radiologists agreed that RADSpa’s Concierge Workflow automation helped them to reduce the TATs and increase productivity.
  • Statistical analysis of 180 days of logs before and after automation indicated 35% improvement in overall TAT for emergency cases.
  • Radiologist productivity per case improved by 25% as every case is auto-validated for images prior it is assigned.
  • Exam Coordinators or the Assigners reported a massive 98% reduction in effort which used to go in manually eliminating errors, and thereby more time in hand for handling greater workloads.

Radiology Workflow Automation has positively impacted timely patient care specifically in Reporting Emergency cases and thereby saving lives.

  • Manual errors and allocation time is reduced by 98%, TAT is improved 35% and RAD’s productivity by 25%.
  • Zero error in case assignment to radiologists by the coordinators (assigners).
  • Radiologists receiving advance alert regarding their work list.
  • Notification to assigners regarding un-attended cases. This helped assigners to follow-up with the respective Radiologists or re-assign them to equivalent Radiologists.

This value-based care has helped radiologists achieve more and do much more. This increased cooperation between healthcare providers as well as professionals benefits all participants in the care continuum. Workflow Orchestrator is therefore a great productivity and quality boosting tool and promises to be an excellent tool for collaboration and communication.

16 Jul 2018
Transforming Radiology Technology

The Transformation of Radiology using Technology

Radiology has indeed come a long way since 1895, the year of the spectacular discovery of X-rays by German physicist Wilhelm Roentgen. It now plays an inherently crucial role in improved and better diagnosis and patient care.

The past few decades have seen the limits of imaging informatics being pushed beyond traditional boundaries thanks to several major changes in computer and communication technology. With the advent of new technologies, such as the World Wide Web, wireless connectivity, and, now, the ever-present social networks, momentous advancement has been made in the way radiological services can be delivered. The Internet has become a crucial gateway for electronic transmission and sharing of health-related data, something we today know as “e-Health”. Many types of e-Health are currently becoming available. In many hospitals, the electronic health record (EHR) is being introduced, which allows a complete electronic record of the patient’s health information. This EHR should not only automate and streamline the physician’s workflow but also allow patients to gain control over their health data through online portals.

The move from an analog to a digital working milieu put the radiologists at the front line of producing and distributing digital images. New dedicated software products were developed. One of the most important shifts being adopted by many healthcare institutions across the globe is a paper-free environment and the Picture Archive and Communication System (PACS) and Radiology Information System (RIS). These are truly remarkable steps in this direction. Radiologists employ the PACS to store myriads of image files which can be easily retrieved at any time in the patient management. Making lives extremely convenient, the entire database of images of all patients across all modalities is just a click away. It not just saves time but with the help of software solutions like RIS, it is now possible to keep a track record of every patient from scheduling appointments to diagnosis and treatment.

Transformative new technologies, many powered by cloud-based RIS-PACS, Artificial Intelligence (AI) and machine learning, promise to redefine the practice of radiology in ways that will considerably improve productivity, diagnostic quality, and medical treatment. Today, cloud-based computing in the imaging market has evolved from a service that provided cost-effective disaster recovery for archived data to fully featured PACS. It’s vendor neutral archiving services can address the needs of healthcare providers of all sizes, on the go.

Taking a look at AI, we need to identify AI’s strengths in analyzing visual images. Researchers train the algorithms to better detect potentially dangerous abnormalities, generating faster and more accurate insights to help guide clinicians’ treatment decisions. AI adoption is sure to ease the overwhelming workloads impeding the profession, facilitating radiologists to do what they’re best at and perform them better.

Going further ahead, we can examine Workflow orchestration technology too. This promises to boost efficiency and alleviate bottlenecks. By directing cases to the right recipient in the correct order, this technology optimizes the effectiveness of the read, especially in teleradiology settings. With the profession’s ever-increasing need for solutions that match demand with supply, a lot of organizations provide solutions that facilitate better collaboration across facilities for effective workflow orchestration.

Teleradiology is another field that is assisting well where streamlining workloads is concerned. Remote radiologic coverage and reliable telecom infrastructures means more radiologic analysis is being performed online to take care of workloads between hospitals. And as the field becomes progressively digitized, apprehensions regarding the security of radiology data accentuate the need for robust solutions that will not just prevent breaches but at the same time also safeguard patient information while complying with regulatory requirements.

Diagnostic images captured at the right place and at the right time give physicians, surgeons, and care centers an important tool to help provide better patient care and at a reasonable cost. For this reason, Telerad Tech has been building out solutions since 2009.

Telerad Tech was established with the goal of optimizing radiology productivity and improving patient outcome delivery through transformational medical imaging software solutions. Today, it is amongst the market leaders in providing integrated RIS-PACS software solutions for teleradiology, medical imaging centres, and hospitals of all sizes globally. Telerad Tech’s solutions cater to workflows needs across departments, including Radiology, Cardiology, Podiatry, Orthopedic, Chiropractic, Oncology and Veterinary.

We are today amongst the market leaders in providing RIS with integrated PACS with significant installations in both cloud and enterprise environment across 1500 facilities in 24 countries.

Our software solutions suite has been incubated, tested and perfected in a radiology ecosystem and are designed to address the unique needs of multiple care pathways across departments, including radiology, cardiology, dentistry, oncology, and veterinary. Our software has customizable workflow features, intelligent productivity tools & analytics and Vendor-Neutral Archive technology. It has strong patient security framework and integrates seamlessly with other systems for exchange and retrieval of electronic health information.

To enable physicians to consistently deliver optimal patient management and to augment the precious time of radiologists, Telerad Tech has also leveraged Artificial Intelligence (AI), for various radiology diagnostics.

We truly believe that the future is here

Technological development has undoubtedly prompted some anxiety among radiologists. But while tech adoption will inevitably alter the way radiologists work, technology’s clinical value will be in supplementing and adding to and not replacing or even displacing the professionals. Radiologists empowered by AI will only encounter a new, more efficient stage of radiology, helping to focus their time and attention on the most crucial elements of their job.

Also, we need to remember that image analysis is just one of the aspects of a radiologist’s job, other tasks, including discrepancy reviews, diagnostic reasoning, and patient-facing work such as invasive radiology, will still be performed by humans. Those tasks will simply be supported and enhanced by advancing technology.

The future of radiology is here, and the prediction clearly states that it will not only better health care but also the lives of all the stakeholders.

Author: Prashant Akhawat, COO, Telerad Tech

Co-Author: Ashwani Sinha, Global Head – Business Development

21 Nov 2016
RIS

What do you look for in a RIS/PACS for a Tele-radiology application

Let’s face it. Today a PACS is a commodity …has been for quite a while.
Most PACS and for that matter RIS on the market can do most everything………..at least that is what the brochures claim!

For a Tele-radiology application, these are some of the important requirements

  • What are the workflow features it supports?
  •  How easy is it for a Radiologist to set up a practice for himself or herself?
  •  How many reports can the Radiologist dictate in a day?
  •  What is the cost of ownership?

Let’s take the last one first!

Today, reducing reimbursements from insurance companies, increasing competition across the globe, and the need to provide quality care in spite of all the above – are forcing owners of imaging centers to question the cost of ownership.

This is where the cloud-based solution brings value to the table. With a cloud-based solution, the vendor is responsible for the high end redundant servers housed in class III or similar data center, disaster management solutions, archiving studies and reports for 7 years or more. This solution provides a very low or practically nil cost of ownership.

The Radiologist or the owner can focus on building the business, signing up new hospitals, and bringing the bacon home! The cloud based solution gives him a lot more flexibility and freedom to go after new prospects even if they are not in the same state or even the same country.

The number of reports a Radiologist can generate in a day translates to profits. The system must be simple to use and the reporting engine and viewer must allow him to dictate as quickly as possible. Interface with a Voice recognition system, easy content (text and audio) exchange between the Radiologist and transcriptionist, peer review with ABR codes, QA, real time collaboration between different stakeholders are some of the features to look for in a system. The Radiologist must be the last link in the chain and studies/images must reach him only when they are complete in all respects, thereby saving his valuable time. Some systems have the reconciliation feature that handles this part of the assignment. The system must support all DICOM modalities which can be added any time later with ease and also support non DICOM for use with legacy modalities.

The system must be simple to use and more importantly easy to install. The Radiologist must be able to start his business or add a new hospital within hours thereby generating confidence in his business. If the hospital or clinic that is sending studies provides a VPN -then the issue of encrypting, security, and safe transmission are taken care of and there is no need for any hardware purchase by the Radiologist. If not, a simple PC that can house the DICOM router software and route the studies fast and efficiently to the central server, is sufficient. The system must also be universal such that it should not need any proprietary hardware for viewing and should be able to log in from any browser. Viewing and distributing images on a mobile device is becoming ubiquitous today and helps the Radiologist to take instant decisions from an airport or a coffee shop!

Last but not least the workflow features are very important. It is indeed an irony that when you mention workflow, most people have the “deer caught in the headlights look”. The workflow is the most important factor which contributes to the productivity and thereby to the bottom line of the enterprise. Some systems provide a “soup to nuts” solution for the workflow from capture to archive while some provide certain modules. Here it is important to get a standard off-the-shelf software that can be customized -rather than develop one from scratch and make it proprietary, finding it difficult to change in the future. The workflow defines many conditions that improve overall efficiency.

For example:

  • Assignment of studies to a Radiologist depending upon various conditions
  • Workflow parameters like TAT, number of reads, work load, QA score for Radiologist
  • Auto assignment or through manual intervention by an Administrator
  • Monitoring TAT (Turn Around Time) and reassigning studies if TAT is not met
  • Collaboration between various stakeholders through work-list
  • Customizable work-list which enables the user to see what they want to see and hide the extraneous information.
  • Monitoring QA, reconciliation, Peer review to help improve the quality of care to the patient
  • Integration with existing front end or back end solutions using HL7 or web links
  • Accessing PRIORS and showing patient demographics to the Radiologist while reporting to enable faster and more accurate reporting
  • Enabling the patient to get hold of the report and studies through a secure patient portal.
  • Use of mobile devices and maybe a QR code to make it easy for the patient to receive the information.

These are just some of the important workflow features to look for. It is best to ask the vendor what they provide – to help you improve the productivity of the Tele-radiology center. An important characteristic the software should provide is the flexibility to customize the features to get the best bang for your buck.

Many vendors who are in this business should be getting constant feedback from their valued users and keep improving their product.

Make sure they provide 24x7x365 support otherwise all the above is not as attractive as it sounds!