Implementation best practices: Going live with new imaging tech
Imaging technology is used daily, constantly, in healthcare. It’s crucial to the successful delivery of care, and radiologists and other caregivers need to be able to rely on it, rain or shine.
An effective deployment of new imaging IT at a hospital or outpatient facility is key to caregivers using it successfully. The highly complex and expensive systems must be brought online perfectly, and healthcare CIOs and other executives know this.
What they might not know are all the best practices to getting the technology up and running. Here, four imaging technology experts offer best practices and other advice for healthcare CIOs and others preparing to go live with new imaging tech.
Identify all workflows
The most important element of imaging technology implementation occurs before introducing the technology, or even purchasing it: Once an organization has identified the need for new technology, it’s essential to find every workflow that new technology will be involved in, from the actual direct clinical use to cleaning, PACS interface, scheduling and others, said Alex Lennox-Miller, a senior analyst at Chilmark Research, a healthcare IT research and consulting firm.
“Major clinical workflows are usually the focus, but new technology deployments will impact other areas and it’s important to identify and understand what those are,” he said. “Stakeholders from those areas should be involved in the needs review and in evaluating different product offerings. This helps produce staff and provider buy-in for the new technology, something that can be a significant barrier in realizing the benefits of new technology.”
Ignoring or losing track of those less obvious workflows can often create new problems, sometimes seriously impacting clinical practice and patient safety, he added.
The first best practice of imaging technology implementation is in the selection process of the technology itself, said Jim Conyers, chief product officer at Apollo Enterprise Imaging, which markets an imaging technology that addresses more than 45 specialty workflows.
The landscape for imaging has changed drastically over the last few years with a significant amount of confusion created around the concept of imaging in healthcare, he said.
“What was once normal best practices for selecting imaging technologies and solutions do not conform to modern day challenges,” said Conyers. “The first and most important best practice in selecting imaging solutions is be mentally prepared to challenge the vendor, technology and solution. Do your research first, internally, to understand the workflows for using imaging in patient care.”
Demand more from the vendor
Keep an open mind, but prepare to demand more from the vendor and the technology, he added. A healthcare organization is engaging in a purchase that is costly and has a very direct impact on patient care, safety and outcomes.
“These potential solutions must be vetted to ensure they meet the current and future needs of the organization and can produce the outcomes the vendors claim they can achieve,” said Conyers.
“Delivering consistent imaging across multiple workstations is extremely important for achieving an accurate diagnosis and providing procedural insight.”
Steve Romocki, Carestream Health
“Vendors will push back and provide alternatives to these modern-day requests,” he said, “but the foundation of this best practice is to be prepared to walk away if the vendor cannot provide the proof you deserve to witness in the demonstration of a valid imaging solution.”
Imaging extends far beyond the image and systems themselves, he added. A regularly overlooked, critical component is the unique and clinically specific workflows needed to produce the most successful outcome for a patient and to contribute to the overall patient experience, thereby resulting in improved high-quality patient outcomes.
“There are different technologies available in the industry that claim to address workflows for clinical capture and management of patient image content,” said Conyers. “This is where it is important to challenge these solutions and to see the potential imaging solution in practice addressing your real-world problem.”
A major challenge is to identify and compare these workflows with the clinicians and physicians and ensure they will not negatively impact the efficiency and effectiveness of the clinician and physician, he added.
“The workflow capabilities must be custom and provide clinical-specific features, tools and user experience, one size does not fit all,” he said.
“What we have learned over the past 24 plus years is that the answer to the problem is always in the workflow and the imaging solution must adapt to each specific clinical need and the solutions you are investigating should easily be able to demonstrate precisely how it will help your health system be successful.”
Connect tech with trends
Another best practice when implementing imaging technology is to connect the technology with deeper trends in the changing healthcare landscape, said Morris Panner, CEO of Ambra Health, a medical data and image management SaaS company.
“Imaging technology is becoming more and more core to the future of healthcare,” he said. “A CIO at a leading facility is someone who has to be able to connect deeper trends in the changing healthcare business climate with how technology can advance new business realities.
“For example, key trends today include the rise of the consumer and increased price competition as we see higher deductible plans. How does that play out in imaging?”
“With the rise of AI and machine learning, pixel level analysis is transforming the way scientists and pharmaceutical companies view imaging.”
Morris Panner, Ambra Health
First, realize that the health system has to have a technology platform that is flexible enough to deliver care wherever and whenever the consumer wants it, he stated. The consumer of today is able to access everything online and expects to be able to have the same kind of access to their healthcare records.
“Patients all but expect that their healthcare providers and healthcare information will be available to them from a web portal,” he said. “Online patient management systems have gone from competitive advantage to mandatory. How does the health system integrate into that extended environment?”
Coupled with that is the rise of high deductible plans, he added. Consumers are shopping for the best deal on any given procedure. Imaging is no different. The cost shifting of higher deductibles onto patients has caused them to take a much greater initiative in researching imaging exams and costs.
“The first and most important best practice in selecting imaging solutions is be mentally prepared to challenge the vendor, technology and solution.”
Jim Conyers, Apollo Enterprise Imaging
“Additionally, referring providers who are the most likely to hear patient complaints are also more likely to refer patients to more cost-effective facilities,” Panner said. “Does your technology platform help your institution differentiate in some way, either along with cost or quality? Deploying technology used to be about making something ‘work as designed.’ Those days are gone.”
An agile CIO has to deliver technology aligned with value creation that is mindful of trends and directions, he contended. When patients are presented with information on both the price and quality, they integrate both pieces of information and choose the highest value provider, he added.
Support the health system
One imaging technology implementation best practice bridges the chasm between clinical and technical. This best practice is to ensure the technology is not just clinically focused but has IT imaging-based tools and solutions to support the health system, said Conyers of Apollo Enterprise Imaging.
“Imaging is a robust content generation and management web of complex interconnected systems with requirements for collaboration and exchange of sensitive information,” he said. “IT-specific tools and features to support this complex ecosystem around clinical imaging is a critical component for success around imaging for a health system.”
It is the responsibility of IT leadership to ensure the technology is an enterprise solution and not a department-specific solution, he added. That the solution extends its capabilities through to the technical workflows of IT for the deployment, maintenance and scale of the solution throughout the health system, he said.
“IT leadership should make sure they are asking the right questions and not allowing the vendors or market to shape the interaction of the selection process,” he said. “The implementation of an imaging solution should be simple, easily managed, reproducible and scalable.”
Focus on interoperability
On another front, healthcare CIOs know that interoperability of imaging systems is essential for an efficient exchange of medical images and other types of medical information.
“The IHE Connectathon held annually in Chicago gives attendees access to impartial data about each system’s performance,” said Steve Romocki, worldwide product line manager at Carestream Health. “Connectathon judges create a report card for each supplier’s equipment with a ‘pass’ or ‘fail’ score for the interoperability of each IHE profile.”
“The training needs of a new technology introduction create the perfect environment to engage staff at all levels for a review of workflows and for departments or practices to realize the benefits of more efficient processes.”
Alex Lennox-Miller, Chilmark Research
When healthcare organizations issue an RFP and are reviewing suppliers for a purchase, this report card is an invaluable part of that process, he said. CIOs and IT managers have learned the dangers of purchasing equipment that is difficult to integrate into their enterprise, he added.
Panner of Ambra Health said a best practice is to ensure the healthcare organization has a data-first architecture.
“There is no more interesting data type than medical imaging,” he said. “With the rise of AI and machine learning, pixel level analysis is transforming the way scientists and pharmaceutical companies view imaging. Servers laden with imaging studies used to be viewed as a liability. Now, that same data is viewed as an enormous asset.”
Does the organization have the data in a form that is accessible? Panner said to take a look at the IT revolution in finance.
“One key move was to move data to the cloud so that it was easier to run analytics,” he said. “Imaging is no different. Every CIO has to have a cloud strategy to free data.”
Many large medical facilities have great amounts of data but lack a unified and organized method of storing and analyzing them. The opportunities for positive outcomes are endless, but facilities must make transparency and patient control core institutional values as they move forward, Panner stated.
“Interoperability is critical to research projects that could have positive impacts for years to come,” he said. “A data network must be created that isn’t locked behind walls of exclusivity.”
The deployment of new technology is often the best time for not just understanding one’s current workflows, but redesigning them with more clarity into provider, staff and patient needs, as well as best clinical practice, said Lennox-Miller of Chilmark Research.
“Even if the new technology doesn’t need new workflow, it’s always possible to improve your processes,” he stated. “The training needs of a new technology introduction create the perfect environment to engage staff at all levels for a review of workflows and for departments or practices to realize the benefits of more efficient processes. This can clarify needs or requirements in your purchasing process or help prioritize different offerings.”
Romocki of Carestream Health added one final imaging technology implementation best practice.
Radiologists, oncologists, orthopedic specialists and others need personalized display settings that optimize viewing for a specific body part and the reading physician, he said. These settings also provide users with a customized “look” by adjusting latitude, brightness and contrast.
“Medical imaging involves a lot of subtleties, so image quality and resolution, gray tone scale, and digital image processing are critical,” he explained. “Delivering consistent imaging across multiple workstations is extremely important for achieving an accurate diagnosis and providing procedural insight.”
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