Electronic Medical Records Mandate – What About Medical Images?
With all of the talk over the past couple of years about President Obama’s Electronic Medical Records (EMR) Mandate, there’s one topic that we seldom see addressed, and that’s the issue of including medical images in the electronic medical records. Most EMR systems are designed for storage, access and sharing of paper medical records, i.e., charts, reports, lab results, but they do not provide a way to view the images from tests that today have become standard – X-rays, CT-Scans, MRIs, Mammography, etc.
When asked, most treating doctors want to see the actual image, in addition to reading the radiologist’s report. So, even with the latest EMR system, the doctor is still going to need to see the Xray, or view a DICOM image, whether or not he has a PACs machine on which to view it. Thinking about this issue before the medical facility moves to electronic medical records can streamline the process of converting to EMR, and add to the ROI of the conversion. A well done EMR implementation should include imaging provisions.
One solution for hospitals, clinics, imaging centers and specialists is a Cloud based addition to their EMR software where the can administer and distribute images regardless of whether others that the need to share with are subscribers to the system. Radiology Services Online (RSO) provides a zero foot print Web PACs system that easily integrates with any EMR system, allowing for images to be viewed via a secure internet connection that is accessed from a pull-down menu within the EMR system. The RSO system does not require an additional log-in…it is accessed from with the EMR software, with a single login.
RSO's DICOM system delivers diagnostic quality images, within a fully HIPAA compliant Cloud. When Physicians have this ease of access to images and reports with RSO's DICOM system, it allows them to make a faster diagnosis, potentially from anywhere in the world where there is internet access. And, patients generally receive faster and more effective care when RSO's DICOM standard is used to send their imaging information to those who need it through the healthcare enterprise.
7 Ways Small Hospital Radiology Departments Benefit from Web PACS
Often small hospitals are budget-constrained and so continue doing things as they’ve always been done in order to avoid costly expenditures on new technology. If your small hospital radiology department is still using film, changing to a web-based PACs system can improve efficiencies with little additional cost and big ROI, not to mention improved patient service. 
A web-based PACS subscription service like Radiology Services Online(RSO) can mean that your physicians can get their radiologic studies in minutes, not days, with instant access to historical data for comparison, all accomplished via the Cloud. Manual filing and searching for studies becomes a thing of the past.
Web-based PACS act as a digital filing system in the Cloud, storing patients’ images and reports for easy retrieval from any web browser. This saves time and money and reduces the liability caused by filing errors and lost film.
In addition, many surgeons and specialty physicians who are called upon for consultations can see the relevant images from home in order to facilitate their decision regarding whether they need to come in right now on an emergency basis, or if it the problem can be tended to later during their regular shift. RSO DICOM sender module provides a zero foot print viewer system that allows for images to be viewed on the web from anywhere, anytime.
Or, for physicians in their office, who have an existing PACS system, we can send native studies directly to a fully functioning PACS system. Moving to filmless web-PAC technology can revolutionize every level of the radiology department, and to a certain degree the entire small hospital, directly improving patient care.
If you are currently using film, our Cloud Radiology Services Online can bring you these seven advantages:
- Rapid implementation of our service
- Low startup costs – no expensive hardware or software license to buy
- Low monthly per study subscription fee generally less than previous film costs
- Access to current and historical DICOM Web PACS images anywhere, anytime
- Full data backup, and redundancy with guaranteed uptime
- No IT or administrative personnel needed onsite to maintain system
- HIPAA compliant
Adding Image Accessibility to an EMR System
Many healthcare facilities are moving from paper to digital solutions in response to President Obama’s Electronic Medical Records (EMR) Mandate. As this shift from paper to digital continues, many institutions are finding a disconnect between their EMR system and their imaging centers and radiology departments. Most EMR systems are designed to maintain electronic versions of paper medical files, but are not designed for viewing sophisticated medical images. 
Because these sophisticated PACS medical imaging systems have remained separate from EMRs, a patient's medical images that are stored on a PACS system have no link to their medical record. This means that the physician treating the patient is not able to directly see their medical images, but only to read reports that may have been written concerning the tests.
Since most physicians benefit from the visual aspect of an image, the integration of diagnostic quality images into the medical record is a necessary bridge to improve the clinical decision-making process. This ever- increasing need for seamless integration between EMRs and medical imaging has opened up a market for solutions such as Radiology Services Online, which is a vendor-neutral solution designed to enable any EMR software to bring physicians full Dicom zero-footprint online imaging with one seamless login to the EMR software. Users can use a standard web browser to access medical imaging studies within the patient's comprehensive medical records/chart.
Having such an integrated system allows medical professionals to better explain and present medical data to their patients at the point of care. This gives patients a visual understanding of their condition and progress while in treatment, improving patient knowledge and involvement. In addition, integrating medical images and departments with an EMR make it easier for multiple physicians to coordinate a patient's care.
Advantages of a Vendor-Neutral EMR Image Integration System
- Images are archived on secure servers outside of the EMR system
- Images are accessible via a single EMR login via web-browser access
- Server side images don’t slow down the EMR system
- No additional IT resources are required
- Getting started is as easy as adding an additional menu link with in your existing EMR
Benefits
- Low monthly subscription based upon numbers of images
- Fast implementation
- Easy access from any web connection
- Redundancy and back-up
- Secure access to images available to remote consulting physicians
Considerations When Converting to a Cloud RIS/PACS
Converting from paper-based medical records and film-based images to a Cloud-based RIS/PACS may be the best thing your organization has ever done, or the worst... it all depends upon the expertise of the company that helps you do the conversion. 
Scanning Medical Documents and Images
Document Scanning allows you to integrate hardcopy images, reports, forms, and notes into your EMR system and to associate them with a specific PACS exam, when required. This type of integrated paperless solution eliminates the need for storing printed copies of insurance cards, consent forms, technologists' worksheets, and other printed documents in paper-based filing systems. The right cloud solution can provide tools for displaying, viewing, printing, transmitting, and archiving scanned documents and scanned radiologic images and digital PACs images.
Central Scheduling
A fully integrated Cloud RIS/PACS should provide enterprise-wide, scheduling of patients, and facilities via a secure HIPAA-approved web interface. This feature provides significant savings in time, resources, and cost by reducing operating expenses, increasing workflow efficiencies and improving insurance payment cash flow while enhancing both patient and physician satisfaction. Health-care facilities should be able to configure secure access rights to different levels of r users, such as: Scheduler, Receptionist, Referring physician, etc.
Reporting
Enterprise imaging and information management optimization enables facilities to electronically view patient records anywhere, at any time, and avoid the risk of losing paper documents. This makes patient care tasks easier, leading to improved patient care, efficient staff and facility management, and overall profitability for the healthcare enterprise
DICOM Images
A comprehensive and fully integrated medical imaging solution designed to meet your specific needs enables facilities and radiologists to easily view and manipulate images online, thereby eliminating the need for expensive VPN hardware and software.
Independent imaging centers, small hospitals and large healthcare systems all benefit from medical imaging solutions that deliver increased efficiencies and advantages they need to remain competitive. A system like Radiology Services Online that provides a single user interface with maximum capabilities, and the ability to integrate with your EMR system allows healthcare imaging providers to realize these key advantages:
- Low cost of ownership/high ROI
- Fast implementation via SaaS/Cloud
- Easy to use/no ongoing maintenance required
- Simple web deployment for consultations and referrals
How to Choose a Radiology Information System (RIS)
What is a RIS?
A radiology information system (RIS) is a networked software suite for managing medical imagery and associated data. A RIS can be a web-based, subscription service, or it can be purchased software that is loaded on the radiology department’s computers.
A RIS has several basic functions:
- Patient management
- Scheduling
- Patient tracking
- Results reporting
- Film tracking
- Billing
An RIS facilitates detailed record-keeping, payments and claims and should also integrate with your PACs system.
How to Choose the Right RIS
Healthcare Facilities and Hospitals should focus on readily available commercial Radiology Information Systems (RIS), rather than developing their own. There are many good options available on the market. We are particularly partial to web-based, software as a subscription (SaaS) systems, such as Radiology Services Online. With a subscription-based service, associated IT costs, such as software and hardware maintenance and upgrades are not costs that you have to calculate into your bottom line. Overall, SaaS RIS will save money, despite the monthly subscription cost of the service. So how do you go about choosing the right SaaS/RIS?
Here are some questions to ask:
- Does the solution’s functionality meet our business requirements?
- Will the solution integrate with our existing PACs solution?
- Does the system support industry standards such as HL7, DICOM, ICD-9,/ICD-10, CPT, SWF, and PIR.
- Does the solution fit our budget? Are there hidden costs?
- Is the system easy to use, or will there be a long learning curve?
- What types of reports can the system generate?
- Can you talk to reference accounts who currently use the system?
- How is customer support handled?
Ask for a Trial Account
One of the advantages of a SaaS RIS solutions is that you can often start with a small, no cost or very low cost, trial account that will let you and your radiologists try the system in real-time before making a commitment.
Teleradiology – How it Has Evolved
Teleradiology is not a new concept. It has been around for ages and is part of the telemedicine concept that can be traced back through many evolutions of medicine. Through the 1970’s and 1980’s the concepts of storing and pushing an image forward became more and more available to the medical world with the rise of computer technology. Through the 1990’s as advances to the internet and greater processing technology developed, the idea of digital imaging became the basis for today’s standards in the radiology industry.
What is teleradiology?
In its simplest form, teleradiology is the practice of allowing a radiologist to view images and report findings via electronic media without being in direct proximity to the patient. Earliest versions of this practice involved the physical delivery of film-based images to an off-site physician. The physician would examine the images, and use a telephone to relay findings.
As technology became more advanced, true telephone dictation systems developed. The radiologist would still have to obtain physical possession of the images to be read, but reporting became simpler because findings were voice recorded by phone to be later transcribed into an official report. This allowed a physician to be away from his office and still provide quality care.
Teleradiology standards today barely resemble these archaic methods of the past. Through its varying evolutions, from telephone to scanners that digitalized images to computed radiography (CR) to direct capture (DR) images, the quality of care has improved. Each revolution allowed physicians to provide more effective and timely patient care.
Advances in Teleradiology
Even the word “teleradiology” bears little resemblance to the computerized methods by which physicians utilize electronic media today. Personal computers and the Internet have made the process of radiology even more accessible.
Today, a physician can be in an airport on his I-Pad and see radiology images to make decisions regarding care. Today, the courier doesn’t physically present images to the physician for reading, the “cloud” houses the images and the physician accesses them from any location where an internet connection is available.
Film and physical media for radiologic images is no longer the standard for creating renderings of the human body because today we use digital media that is incredibly defined and provides a level of care that is almost unimaginable. Today we still have DVD’s and other physical media to store or house our images, but with technology moving ever forward, what will tomorrow’s version of teleradiology hold?
With the movement to personalized care management through electronic applications like Microsoft’s Health Vault, a patient has more freedom to control their own medical care processes. By giving them access to their medical records and images, we will see yet another improvement to the practice of patient care, and perhaps another advance in teleradiology.
Content created by Sherry Alligood. Used with permission.
DICOM Online Service Provides Diagnostic Quality Images
A DICOM online solution that unites the radiologist, technician and facility by providing a versatile and economically viable solution that enables storing and viewing DICOM images online can help keep costs down and increase efficiency in your radiology practice. Radiology Services Online (RSO) is one such system. Automation in RSO helps hasten diagnosis and improve patient care. 
Radiology Services Online provides DICOM online diagnostic quality images. This SaaS/Cloud service enables online viewing of full DICOM imaging for radiologists. There is nothing to buy, install, or set up so support requirements are minimal. This is a zero-footprint solution.
We store and host all images, provide backup and restore information. We meet all HIPPA-required compliances, so patients' privacy is assured and security is provided via our image-hosting software.
About the Radiology Services Online DICOM Viewer
The DICOM viewer in the Radiology Services Online solution provides professional, diagnostic quality images and is fully compatible with all modalities and all manufacturers. Whether you want to view online, or send the images to a PACs system, the RSO DICOM viewer can handle it all.
This Radiology Services Online DICOM viewer allows you to store, find, retrieve, print and diagnosis directly via a secure web login.
Manipulate images, create and maintain patient reports, schedule and more all within the RSO DICOM online SaaS/Cloud.
Radiology Services Online was created specially to address the specific needs of radiology practices and x-ray and ultrasound providers. It is a comprehensive web-based solution designed to manage radiology images, maintain patient data, issue radiology reports, and maintain billing information. Using RSO radiologists can view their patients' x-rays and browse their medical records at the same time.
Radiology Services Online is available as a hosted solution on our servers. It doesn't require any new equipment to purchase or software to install. It works in your browser. So all you need to use RSO is internet connection. The accounts for your company can be set up in a day or two.
RSO has a DICOM online connectivity module that enables exchanging data with any medical imaging facility.
RSO is a unique application that is offered as a service and supports both health-care information and radiology image management. Take advantage of using it in your hospital.
Radiology Information Systems in the Cloud
Radiology Information Systems (RIS) are used by radiology departments to store, manipulate, and distribute patient radiological data and imagery. RIS often include patient tracking and scheduling, result reporting and image tracking capabilities. Today, Radiology Information Systems have advanced to the Cloud.
One of the advantages of a RIS system located in the Cloud is the ease of sharing images for remote consultation and diagnosis. For mobile radiologists, a RIS system in the Cloud unites the radiologist who does the reading with the remote technician who is capturing the images to provide fast reads, reporting and tracking from the mobile station. A RIS Complements HIS (Hospital Information Systems) and other facility information systems, and is critical to efficient workflow to radiology practices.
How RIS in the Cloud Works
Using a secure web login, the radiologists and technicians can register and schedule patients in one central location, even if they are working in multiple locations, or in mobile xray trucks. Because all of the registration is done in a central location via secure internet connection, patient list management and patient tracking is easier and more efficient, no matter what location the user is in. Users can manage modalities, reports, medical files, billing and other Radiology Department workflow anywhere they’re connected to the Internet.
The Advantages of SaaS/Cloud RIS
A cloud computing module that enables full Dicom zero-footprint online imaging , record keeping and scheduling with nothing to buy, nothing to install and nothing to set up for users means that the radiology department or mobile radiologist as minimal support requirements. This keeps IT costs and capital expenditures down. , so your support requirements are minimal.
With all images stored and hosted by the cloud provider, backups and restoration as well as disaster recovery are all taken care of for you. With a system like Radiology Services Online, which meets all HIPPA-required compliances, patients' privacy is assured and security is provided via the image-hosting software. In addition, Radiology Services Online provides true hanging protocol and supports moving modalities with windows, leveling and gamma.
How Online Dicom Viewers Aid Teleradiology
Teleradiology is the transmission of radiological patient images, such as x-rays, CTs, and MRIs, from one location to another for the purposes of sharing studies with other radiologists and physicians, thus improving patient care by allowing Radiologists to provide services without actually being in the same location as the patient. Teleradiology utilizes standard network technologies such as the internet, telephone lines, wide area network, local area network (LAN) and the latest high tech computer clouds.
Radiology Services Online provides a linkable cloud computing solution that offers teleradiologists a HIPAA-compliant Dicom viewer via secure login. This zero-footprint solution is used to transmit medical images and enable the teleradiologists to effectively analyze what could be hundreds of images for a given study. Using technologies such as advanced graphics processing, and image compression images Radiology Services Online users can send images to another part of the hospital, or to other locations around the world.
Because the Radiology Services Online is Cloud solution, there is nothing to buy, nothing to install and nothing to set up for users, so the teleradiologists’ support requirements are minimal. In addition, this it is subscription based, so teleradiologists pay only for the number of studies they upload on a monthly basis.
Radiology Services Online stores and hosts all images; provides backups and restore information. We provide true hanging protocol and we support moving modalities with windows, leveling and gamma. Your facilities and radiologists can easily view and manipulate images online with RSO, eliminating the need for expensive VPN hardware and software. Hospitals, clinics, imaging centers and specialists can administer and distribute images regardless of whether they are users.
Image-Enable Your Personal Health Records
With the national push toward Electronic Medical Records for your physician and the increased desire of individual patients to access and manage their own health records, incorporating diagnostic-quality medical images into an EMR or PHR (Personal Health Records) system is increasingly becoming an issue. Medical imaging, including x-rays, CRTs, MRIs and other similar technology, is being used with increasing frequency to examine, diagnose and treat. This images need to be part of each individuals health records.
Who needs what?
This may be one of those cases where the patient is able to have more advanced technology than the physician with regard to image access and display. Many physicians find that the level of EMR interoperability and image integration in the systems they use is very primitive. Often upgrading to a more advanced EMR system with better imaging tools gets bogged down in hospital politics and budget battles.
The current conundrum of how to provide image access for the diagnosing and treating physicians may be able to be offset by the patient including their own digital medical images in their PHR. We’re getting ready to unveil a new product that will enable patient to do just that. Watch this space for more information and register today for a chance to “Name the Product.”
