By Gregory P. Burnell

Several years ago, after suffering with overly complex and costly PACS operational challenges, radiologists and technologists at Sunshine Radiology in central Florida decided to try a different approach to solve the problem. What research indicated was the primary culprit for most of the daily challenges radiologists faced, surprised everyone. It wasn’t a technology problem. It was a reading station problem. Most radiologists were simply sitting in front of underpowered, out-of-date reading stations. With more than 45 radiologists, including subspecialists, delivering services across nine facilities, inadequate and limited access to multiple PACS was a huge problem for Sunshine Radiology.

Their radiologists were in a tough spot to keep up with growing workloads, while at the same time delivering the quality of work expected by client hospitals. In considering the problem, they realized that VNAs and overlays, which attempt to remedy the multi-PACS conundrum by collecting different workflows and DICOM images into a single neutral archive, weren’t the solution. The issue with different PACS systems is they often use proprietary DICOM transfer protocols, are subject to strict HIPAA regulation and have prohibitive multimillion-dollar implementation costs. When you factor in the poor availability of high bandwidth Internet — which is critical to the success of VNAs — coupled with the years of development it takes to create a working shared image archive, the result would be a logistical nightmare.



Furthermore, these competing factors bring a level of politics that can easily derail any project. What happens when competing hospitals don’t want to share their databases of patient information? What happens when it takes a radiologist an extra 20 to 40 seconds to download a DICOM study, simply because of the time it takes for data to travel the distance between the radiologist and the third-party solution? These were seconds — and minutes — that Sunshine simply didn’t have to spare. This wasted time affects the quality of the reads being performed, the volume capacity of any given radiologist, resulting in fewer reads per shift, as well as lower patient satisfaction.

That’s when they hit upon a solution that would allow every radiologist to perform at peak productivity levels. Working closely with their engineers, the team designed a unique and elegant solution to make their lives better, less stressful and more productive. They created a “Radiology PACS Network” within their hospital region. They could now seamlessly and instantaneously access any PACS and associated work lists at any time, from anywhere.

The solution, called “hardware actualization,” as opposed to “software virtualization,” allows for instantaneous sharing and provides for improved system-wide access. It’s a completely different approach to the PACS problem. Instead of implementing a vendor neutral archive (VNA), this technology gives the radiologist access to everything using a single reading station. It’s a simple solution that takes away the headaches involved in transferring and consolidating DICOM studies, and allows the radiologist or practice to upscale or downscale as needed. Implementation is measured in hours, not months.

Hardware actualization also removes the headache of retraining radiologists to read on a new system that they don’t like. Instead, it’s PACS agnostic, which provides access to multiple PACS environments simultaneously — all with the same peripherals already in use. Multiple dictation platforms are also a nonissue for actualization. That’s because it deconstructs the entire system and gives each PACS client direct access to their exact dictation client.

In the same way, it connects to multiple VPNs without any conflict by way of bringing direct access to each system as they would appear at the facility or reading site. This hardware approach removes the need for lengthy implementation plans and huge development budgets. No more large investments in software developers and infrastructure changes. Radiologists read on their preferred PACS, practices get a direct workflow and can upscale or add new systems with ease.

Implementation is as easy as buying a new workstation and installing any PACS client on it. On top of all the above, ergonomics and environmental considerations were high on the engineering challenges. The goal was to minimize heat, noise, dust and weight while not impacting performance. Over several years, Sunshine Radiology deployed dozens of the new products to all nine facilities and to more than 80 percent of their radiologists’ homes. Now, when one busy client hospital gets overwhelmed with patients, physician resources from numerous hospital and home locations are utilized to effectively manage regional patient volume.

What’s more, Sunshine Radiology’s investment in home workstations allowed it to maintain SLAs without increasing staffing, all while hospital volumes continued to grow. Their radiologists now read between three and five additional studies per shift when compared to prior years. In 2015, that resulted in an eight percent increase in productivity!

About the author: Gregory P. Burnell is chief executive officer of Florida-based Singular Medical Technologies.