The role of integration in radiology

Larchmont Imaging Associates: Insights with Robert Walsh, Director of Professional Services at DLC Technology Solutions, Inc.

Market background

Imaging centers are under increasing pressure to exchange data. Internal systems, such as the RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More, PACSPicture Archiving Communication Systems (PACS) are devoted to the storage, retrieval, distribution, ... More and billing must be able to communicate and exchange patient data with one another to optimize the patient experience. External systems and groups, such as HIEs, referring physicians, hospitals, clinics and labs must also have access to the images and reports generated by the radiologist and radiology technicians. Not exchanging data effectively and efficiently risks business relationships in addition to the most important element of all, patient safety.

Implementing and managing the various applications can be complicated. Working within the traditional information sharing model using pointto-point interfaces would require a significant amount of time and financial commitment. However, having a modern integration solution gives you the flexibility to manage the interfaces for the integration projects while creating leverage to realize even higher value initiatives and goals, using less time and saving money.

For the radiology industry in particular, having a competitive workflow is critical for business success. Despite the competition among machine and application offerings, the competition for referrals and patients from customer service has greatly increased in the past decade. Wait times, turnaround times and patient report access are some of the key factors radiology facilities leverage to gain business, referrals and ultimately improve their bottom line.

Radiology practices that have realized the benefits of leveraging an integrated environment are able to process patient information faster, and with fewer complications, than practices that have maintained a traditional, manual information sharing strategy. Leveraging an integrated environment is a strategic differentiator and is being taken advantage of by leaders in the radiology industry.

Background

Insights with Robert Walsh, Director of Professional Services at DLC Technology Solutions, Inc.

Larchmont Imaging Associates, located in Hainesport, New Jersey, is an imaging center with four facilities serving Burlington County and its surrounding communities.

Approximately, three years ago, we began the initial stages of our integration environment evaluation. We were replacing the Sage Medical Manager RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More with Sage Intergy RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More in order to improve workflow and accommodate more recent data sharing expectations of the industry.

It is not uncommon for a health care facility to reevaluate their integration strategy when making a major upgrade or replacement. Our initial integration challenges required a solution that would integrate the new Sage Intergy RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More with our PACSPicture Archiving Communication Systems (PACS) are devoted to the storage, retrieval, distribution, ... More and external mammography tracking system. Additionally, the solution would be required to identify and differentiate results and demographics between the Virtua Memorial Hospital and Larchmont Imaging Associates workflows.

Corepoint Integration Engine was initially selected to manage our new integration environment. It was then we realized there were many more initiatives coming our way, such as HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More connectivity, that we needed to act upon. It was at this pivotal point we really realized the power of a robust integration platform and how it could be used to enable our strategic and operational plans.

Following the implementation and use of Corepoint Integration Engine, we discovered an opportunity to leverage the integration infrastructure to meet new demands and challenges productively and feasibly. We were able to leverage participation in the local health information exchange, or HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More, integration with a voice recognition dictation system, integration with an outside coding company for billing and integration for the billing of services provided to the local hospital.

Biography of Robert Walsh

Initial integration challenges solved

Outlined below are some of the projects which we scoped for in our initial integration engine evaluation. Corepoint Integration Engine was chosen to help establish the workflow between our RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More system and the HISHospital Information System (HIS) is the main system in a hospital used by most caregivers. Sends AD... More system at a local hospital, and the time we saved using Corepoint Integration Engine was incomparable to the time we would have spent establishing these interfaces in our previous method. The freed time allowed us the opportunity to focus on more complex interfaces as well the ability to focus on the analytics of the connections.

Initial problem solving opportunity

Applications involved

  • Sage Intergy RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More and CodeRyte—RABC

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More challenge

  • Workflow required Intergy RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More to use file based methodology for results and DFT imports

Solution

  • Corepoint Integration Engine was used to build DFT batch files from CodeRyte for the RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More and also used to build individual ORU files with a master index file for the RIS’ results import process

Sage Intergy RIS and CodeRyte Connection with Corepoint Integration Engine Diagram

Initial problem solving opportunity

Applications involved

  • Siemens HISHospital Information System (HIS) is the main system in a hospital used by most caregivers. Sends AD... More and Sage Intergy RIS—RABC

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More challenge

  • ADT, DFT and ORU messages needed from Virtua Memorial to Sage Intergy RIS—RABC

Solution

  • Established interface from Virtua to Corepoint Integration Engine and an additional interface from Corepoint Integration Engine to Sage Intergy. Corepoint Integration Engine used to perform gap analysis between Siemens and Intergy message structures and resolve mapping and formatting issues

Initial problem solving opportunity

Applications involved

  • Sage Intergy RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More and Centricity PACSPicture Archiving Communication Systems (PACS) are devoted to the storage, retrieval, distribution, ... More

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More challenge

  • Multiple applications required the same data that was already being exported from the RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More
  • With the possibility of implementing a voice recognition system for dictation, getting orders and results into the PACSPicture Archiving Communication Systems (PACS) are devoted to the storage, retrieval, distribution, ... More system as quickly as possible was a priority

Solution

  • Integration engine was used to filter, modify, format and route to the appropriate applications according the contents of each message

Communication with Sage Intergy RIS and Centricity PACS using an Integration Engine Visualization

Leveraged problem solving opportunity

Applications involved

  • MRS (Mammography Reporting System)

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More challenge

  • Needed to implement an external system to track mammography patient results notification for legal reasons
  • Wanted to make the system as automated as possible to reduce staff requirements and keying errors for manually entered data

Solution

  • Established interface to MRS in order to automatically provide demographic information and orders to that application
  • Provide observation and recommendation data by “reading” the reports being sent to MRS and creating custom message segments to populate the correct fields within MRS

Connecting a MRS (Mammography Reporting System) with Corepoint Integration Engine Diagram

Interoperability challenges solved— leveraging Corepoint Integration Engine

Using Corepoint Integration Engine, we were able to reduce the amount of time we spent on workflow projects, in addition to improving the quality of the patient and physician experience with faster turnaround and wait times. As we began to realize the benefits of the data sharing capabilities with Corepoint Integration Engine, other strategic opportunities were considered. The following outlines the additional and unanticipated projects we were able to leverage by using our interoperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More platform.

Leveraged problem solving opportunity

Applications involved

  • Siemens HISHospital Information System (HIS) is the main system in a hospital used by most caregivers. Sends AD... More, Sage Intergy RIS—RABC and CodeRyte—RABC

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More challenge

  • Virtua Memorial patient results were often sent over prior to demographic information being sent. Without demographics in the RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More, the result had no patient to match against and could not be processed appropriately
  • In cases where the patient did exist, the patient IDID is a coded value data type. The value of such a field follows the formatting rules for a ST field... More did not correlate to the patient IDID is a coded value data type. The value of such a field follows the formatting rules for a ST field... More in the RISRadiology Information System (RIS) is the main application in an imaging center or radiology departm... More

Solution

  • Workflow was devised in which the hospital preceded each result with demographics and for each result received by Corepoint Integration Engine, the Sage patient tables were queried for a matching patient. If a matching patient was found, the translation was made and result was processed to CodeRyte. If a matching patient was not found, the result was stored in an order holding database table that would be polled periodically until a matching patient IDID is a coded value data type. The value of such a field follows the formatting rules for a ST field... More was found

Siemens HIS, Sage Intergy RIS and CodeRyte Workflow

Leveraged problem solving opportunity

Applications involved

  • GE Precision Reporting

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More challenge

  • Wanted to implement a new voice recognition dictation system to replace an outdated digital dictation system to allow for faster report turn around times
  • Needed to provide demographic and order data to Precision Reporting and provide completed results back to Intergy RIS—LIA
  • Electronic signature verbiage needed to be added to the results utilizing data provided within the HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (... More headers from Precision Reporting

Solution

  • Established bi-direction interface to allow for data exchange between systems
  • Corepoint Integration Engine used to authorize results by adding content to result message. This was not a feature of the upstream application

GE Precision Reporting Workflow

Leveraged problem solving opportunity

Applications involved

  • HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More (Wellogic)

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More challenge

  • The local hospital was building an area HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More and wanted our orders and reports to be available to their participants
  • We needed to provide a list of referring physicians so that a table could be built within the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More to facilitate result routing to participating practices that had direct interfaces from the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More into their EMRElectronic Medical Record (EMR), as defined in Defining Key Health Information Technology Terms (The... More system
  • After providing a referring provider backload, the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More needed to be kept up to date as referring physicians and groups were added to the Intergy RIS—LIA

Solution

  • An interface was build to send order messages and result messages to the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More
  • Used Corepoint Integration Engine to pass MFN messages to update the referring provider table as necessary

HIE (Wellogic) Workflow

Leveraged problem solving opportunity

Applications involved

  • Corepoint Integration Engine— Administration Console

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More challenge

  • Alerts needed

Solution

  • Interfaces operate continuously; however, the IT department is only staffed from 8:00 a.m. to 5:00 p.m. Alerting allows the IT department to ensure interfaces stay up by notifying the on-call person when there is a problem with the interface engineAn interface engine can transform or map the data to the receiving application’s requirements whil... More during non-staffed hours

Illustration of Workflow Alerting in the Administration Console

Conclusion

As you can see, IT infrastructure is really a strategic platform. The projects we were able to complete, in the amount of time we spent, would not even have been considered if it weren’t for the robust and flexible solutions Corepoint Health was able to offer.

As we worked to implement interfaces between different systems we ran into many issues where different vendors implemented the HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (... More standard in different ways. During our implementation the Corepoint Integration Engine was always able to resolve these differences and get the systems communicating. By leveraging a modern interface engineAn interface engine can transform or map the data to the receiving application’s requirements whil... More, it has contributed to the success of the radiology practice, and it will provide a foundation for future initiatives as accountable care organizations and health information exchanges gain popularity.

Using an integration engine allows you to leverage your application environment for anticipated and unanticipated integration initiatives that affect not only patient care, but business relationships and ultimately the bottom line. In today’s health care marketplace, radiology practices are more than referral based clinics; they are a business that provides some of the vital applications and solutions anticipated for the future of health care. In that role, integration and interoperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More are something every radiology facility should be utilizing, adding the flexibility and adaptability to address the rapidly changing requirements and initiatives within the healthcare marketplace.

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