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IT Matters - Radiology workflow orchestration

by Sean Ruck, Contributing Editor | February 06, 2018
Health IT
From the January/February 2018 issue of HealthCare Business News magazine


If the patient’s information points to a certain problem, an effective EMR will present the radiologist with the other information relevant to the exam they’re reading.

“When a radiologist sees certain findings on the exam, there’s an ACR assist. When you see a nodule on the lung, it’ll tell you the information you should gather and provides the best practice guidelines,” Hirschorn says. “Nuance and MModal have already started building their systems. The American College of Radiology has it. It will walk you through questions. Does the patient have a history of smoking? But I wonder why I’m being asked. Why doesn’t that information get pulled from the EMR? Those bridges aren’t built yet.”

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According to Hirschorn, machine learning is improving as well. The information is increasingly being fed into algorithms with more accurate results as to the chance of the nodule being cancer, for example, and what to do next. The purpose of the radiologist is to provide information on diagnosis and prognosis, using the best tools to extract that information.

“Our experience [with workflow orchestration] was that it was definitely worth a fair amount of money because of the perceived benefit to load balancing and remaining competitive,” Hirschorn says. “I can search the other systems and open directly from those PACS. All I’m doing is retrieving the information and it puts it onto your screen. That’s probably the best solution since I can go in with the current case and view priors.”

Working through a system that provides a window into other PACS, the data is still located in the other PACS, but radiologists can view it using a system they’re trained on and familiar with.

Hirschorn advises hospitals to rethink their existing workflow if they’re contemplating a new system. Don’t just look into your current systems and coalesce into one big system. Think big. Use the technology. What would you do if you could do anything?

“The nature of a workflow orchestrator is flexibility. That’s not true of the other systems we’re used to using. PACS and RIS and dictation systems have many strengths, but flexibility is not their primary strength. Don’t try to fit the needs of your workflow into the orchestrator. A good workflow orchestrator should flex to meet your needs.”


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