Central Illinois Radiological Associates  (CIRA), headquartered in Peoria and serving Illinois communities from Kankakee to Springfield, is one of the top 10 private practice radiology groups in the nation. They serve a variety of hospital locations including numerous outlying tertiary care facilities. With over 100 reporting locations, their expanded service area and disparate reading environments challenge CIRA’s IT team to provide an efficient workflow for its radiologists.
Serving a geographically dispersed area with a quality-driven business model presents a wide spectrum of technology challenges. To address current and future needs of the radiology market in Illinois, the CIRA team began developing an IT Business Plan in 2009 led by Eric Weber, CFO, and Pat Ward, CIO.
After final approval from CIRA’s physician-led executive committee, the plan’s implementation began in September 2010 and has successfully solved workflow deficiencies across several areas of the practice.
Leading the creative problem solving of each unique environment, CIRA’s Systems Engineer Nate Anderson and Software Engineer Steve McHenry have dedicated their time and efforts to finding unique solutions for delivering quality, focused imaging services to all customers. The team has used the Corepoint Integration Engine DICOM gear and Web Services  capabilities to solve these interesting challenges.
The following scenarios were developed by Nate and Steve.
Scenario 1: Using the Corepoint Health DICOM Gear to Achieve Interoperability in Smaller Clinics
As most in the radiology space would know, budget strapped tertiary care facilities typically do not have the technical resources to provide or build HL7 is a Standards Developing Organization accredited by the American National Standards Institute (ANSI) to author consensus-based standards representing a board view from healthcare system stakeholders. HL7 has compiled a collection of message form... enable Radiology Information System (RIS) is the main application in an imaging center or radiology department. RIS is used by to store, manipulate and distribute patient radiological data and imagery. RIS are used for patient scheduling, tracking, and imag... or Electronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conform... interfaces. CIRA’s workaround for these technical deficiencies is a Digital Imaging and Communications in Medicine (DICOM) is a common format for image storage. It allows for handling, storing, printing, and transmitting information in medical imaging. Visit DICOM website. Synonyms: Digital Imaging and Communications... driven workflow using the facilities Picture Archiving Communication Systems (PACS) are devoted to the storage, retrieval, distribution, and presentation of images. The medical images are stored in an independent format, most commonly DICOM. Synonyms: Picture Archiving Communication Sys... or modalities. To solve these situations CIRA has adopted a customized workflow utilizing Corepoint Health DICOM Gear connection. CIRA’s logic in this environment is as follows:
- Create a standard DICOM connection with Corepoint Integration Engine
- The clinic (our customer) scans the patient and the image will exist on their PACS or other modality
- That scan is then uploaded to Corepoint Integration Engine through the DICOM gear via Transmission Control Protocol/Internet Protocol (TCP/IP) is a low-level communications protocol used to connect hosts on the Internet or a network. TCP/IP connections are established between clients and servers via sockets. TCP/IP is stream-oriented ...
- The Corepoint DICOM Gear connection parses the header data
- Corepoint Integration Engine converts the header data into XML and maps it into an HL7 message which provides for a normalized order message into PS360 and variety of other destinations such as CIRA’s billing provider and Vendor Neutral Archive (VNA) – A software solution that acts as a middleware application between one or many clinical workflow applications, formerly known as PACS, and various storage platforms and IT strategies. VNA will support: one or many clin....
CIRA has connected 15 rural clinics to its PS360, billing provider and VNA using this methodology.
Scenario 2: Using Corepoint Integration Engine Web Services to Enable Interoperability for Customers
Some facilities don’t have the resources or ability to send a digital DICOM because they are still using plain film. The solution CIRA developed involved the Web services are a standardized way of integrating applications. Using open standards, businesses can communicate without in-depth knowledge of one another’s systems, beyond the communication protocol. Because all communication is XML-based, web se... capabilities of Corepoint Integration Engine to enable a web-based order entry system through which HL7 order message can be generated.
- A web server is deployed which utilizes PHP to generate a SOAP (Simple Object Access Protocol) is a web services protocol used heavily in healthcare to implement IHE profiles. SOAP is an enterprise standard that is typically used by business applications to exchange information across the enterprise. See al... request.
- Corepoint Integration Engine receives the SOAP request and maps out all the fields for use in an action list, which is very similar to the action list utilized to support the DICOM scenario stated above.
- From there, Corepoint Integration Engine accepts the SOAP and parses it into an order message and sends the data to a variety of systems (PS360, PACS…etc) to accomplish the centralized work list.
These solutions reduce the number of support calls from physicians working in disparate reading environments and provides for a common worklist solution for physicians who would otherwise have to travel to outlying locations. Lastly, CIRA’s mission to provide greater access to subspecialty care is improved through the integration of disparate workflows with Corepoint Integration Engine.