Editor’s Note: The following article was recently published on ITN website and is reprinted here with permission.
CHALLENGE
Hospital consolidation is gaining momentum. At the end of 2016, Becker’s Hospital Review predicted that this movement toward fewer but larger health systems would continue. Among the drivers are an increased focus on population health, disputes between payers and providers, and lower reimbursement.
This trend has been going on long enough that mega for-profit and not-for-profit provider systems, called integrated delivery networks (IDNs, also known as integrated health networks or IHNs), have taken root. These networks have brought with them a plethora of disparate systems, each chosen and implemented by once independent hospitals and care facilities. In some instances, this has bred a cacophony of data — a specialist’s report turns somehow from “English to gibberish,” states the AHA; values appear in the wrong section of a lab report; data are dropped from critical fields in a care summary; inpatient data do not accompany patients transferred to outpatient facilities.
Going to a unified system that establishes a single platform throughout the IDN/IHN might remedy many of the problems, but it usually is not economical to do so. Installed IT systems are often viewed as investments. However, as medicine moves from a fee-based to a value-based model, healthcare IT must be managed to provide efficient and effective patient care.
In a single hospital, the challenge of connecting the various silos, each representing a different specialty, can be formidable. The subspecialties of cardiology may be viewed in much the same way, walled off from each other; patients entering and exiting different silos, data barriers reinforced by disparate IT systems–one for nuclear cardiology, another for echocardiography, another for cardiac cath.
Interoperability is the key to interfacing multiple information technologies throughout cardiology, just as it is the key to unifying IT systems throughout hospitals and the enterprise. And interoperability depends on standards.
SOLUTION
The goal is to make the best use of IT, one that optimizes the delivery of effective patient care. When consolidating several PACS, for example, the most direct way is to offer a comprehensive radiology PACS that allows collaboration between the clinician and the radiologist who can view images at the same time. Ideally such a PACS would bring together data from multiple sources as in the case of several EMR systems, each of which may have created separate patient identities. The same goes for workflow, bringing together the different ways the different specialties work.
Consolidating PACS may involve the expansion of a system to take the place of others, for example, expanding a radiology PACS to takeover for the mini-PACS dedicated to pediatric cases (a legacy system tucked away under a radiologist’s desk). Such expansion would require data migration, just as increasing efficiency to handle the increased data load may require upgrading the PACS.
So-called “single-stack” solutions are the easiest to deploy, for example, a single EMR system that handles the records of all patients in an enterprise, one that integrates data and function.
The opportunity to do so, however, seldom exists after healthcare systems consolidate. But there are ways to bring data together by implementing a centralized system.
In radiology the PACS provides the core diagnostic capability to radiologists. The Conserus platform extends this capability by adding tools that provide the ability to do a peer review of critical results, as well as to orchestrate and augment workflow. Conserus workflow orchestration tool is a rules-based engine that monitors and orchestrates different workflows throughout the enterprise.
Unifying data flow is Imaging Fellow, which connects data from multiple sources that may exist throughout the enterprise. It extracts specific bits of information, consolidates and aggregates them; then presents them to the radiologist in a way that is easy to understand and use.
Contact Change Healthcare today or if you’re at HIMSS, drop by the Change Healthcare Booth 4202 to learn more about interoperability.
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