Leading Medical Facility Eliminates Difficult-to-Manage Images on Disc
Good things come in small packages-and sometimes some not so good things! Just ask Phil Larkin, Operations Manager for the Department of Imaging Informatics at The Ohio State University Medical Center (OSUMC).
While the hundreds of medical images on compact discs (CDs) that pass through his department each week offer numerous benefits over yesterday’s hardcopy films, often they are also fraught with a whole new set of problems. From incompatible file formats and exams gone missing, to significant costs both for integration into hospital workflow and creation for external use - OSUMC is finding these petite packages of patient information can become a major stumbling block to the efficiencies of the digital imaging age.
A Significant and Growing Problem
“On the surface, it may appear trivial, but anyone who works with CDs in a fast-paced hospital environment knows otherwise. Even a small, regular volume of CDs has a significant impact on imaging department costs, clinical workflow and even patient care. OSUMC was so caught up in the CD challenge that it launched a major initiative to address the situation. And we are not alone.”
OSUMC is a large and prestigious medical facility with seven separate imaging departments. It produces nearly 500,000 of its own patient imaging studies annually and supports more than 1,000,000 outpatient visits each year often involving images from other institutions. As a result, it experiences the CD challenge exponentially more than many other healthcare facilities.
“The sheer number of patients who bring CD studies into this facility is staggering,” Larkin comments. “We have people who import and export CDs all day long. That’s all they do. That’s not very efficient, and the costs are astronomical.”
One seemingly obvious strategy to alleviate some of these difficulties would be to download all the images into the hospital’s enterprise-wide PACS and manage them within the application. “For many reasons, that simply is not an option,” Larkin says, noting that the storage space alone required would be a major barrier. “If the images are not in our PACS, we cannot communicate them digitally using the system’s communications tools. Further, those tools would be useful only to transmit images to physicians within our hospital system-never on the fly.”
Additionally, many of the CDs that pass through the hospital contain images of patients who never actually proceed with treatment at OSUMC. The medical center has no need to store these images long term. Moreover, many discs contain multiple images, including older and irrelevant exams in a wide range of non-DICOM formats. “This is because many people actually request patient CDs for their own viewing, preferring not to let their doctors know they are seeking consults or second opinions. They end up with data in JPEG, TIFF and other non-DICOM formats we cannot use,” he explains.
Another issue is that, like most hospitals, OSUMC do not let staff casually slip just any CD into a computer connected to the IT network essential to the workflow of the entire enterprise. Those wishing to view foreign CDs must follow special IT department procedures, which takes time and adds cost to the CD viewing process.
While essential, this process can impact patient care, particularly in emergency situations, when seconds count and image accessibility can make a crucial difference in treatment. OSUMC has had some procedures in place to speed CD access. But at other medical facilities, some physicians have been known to resort to taking CDs to the local Internet café for faster access to speed clinical intervention.
Frequent loss is another CD problem not to be overlooked-particularly for critically ill patients being transported in ambulances with small discs tucked into their personal belongings.
A frequent but undesirable solution to many of these issues can be to repeat an imaging exam, with additional costs to insurance, often patients themselves and the healthcare system overall-not to mention unnecessary additional patient radiation.
