The Situation
Riverside Medical Clinic based in Riverside, Calilfornia is a high-volume facility that does about 19,000 studies annually among its three sites. Unfortunately, the clinic was experiencing delays in reading both their screening and diagnostic exams as excessive time was necessary for all studies to transfer to the workstation for evaluation.
For Radiologists, longer wait times result in inefficiency in the workplace, and affects business operations and directly impacts a facility’s revenue. In Radiology, the quest for the most rapid turnaround time is integral to workplace optimization.
Achieving quick report turnaround times requires an efficient RIS/PACS solution with closely integrated tools, such as speech, intelligent display protocols, 3D visualization, and other clinical applications. These tools are designed to shave away the amount of time it takes a radiologist to read a study and return his or her diagnosis in a timely manner to a referring physician.
Riverside Medical Clinic turned to Candelis to significantly improve the radiologists’ reading turnaround times. Some issues prior to the Candelis upgrade included:
- Use of EMR-driven workflow slowing down image movement
- Absence of case management and waiting for prior images is a significant activity
- Transfer of large study size causing delays
Interview with Dr. Odulate
The Opportunity
Candelis perfected its Advanced Breast Imaging Workstation, an enhancement of the ImageGrid™ platform, to become the fastest mammo platform for reading high resolution studies. It also provides multimodality and multivendor viewing of breast images with a complete diagnostic tools set. Due to its advanced features, radiologists are now able to read more Tomo studies per hour.
This is due to a number of background enhancements together with two new features:
Study Worklist Saving: Once a study is on the reading workstation, it will not need to download again. This eliminates the need to re-download and cache studies to the workstation, an exercise that may have previously taken hours.
Prior exam images sent ahead of diagnostic exam: For diagnostic studies, prior imaging is sent to the reading workstation before the patient arrives. Therefore, once the diagnostic image is acquired, it is sent to the workstation and ready to read with the patient’s priors. Diagnostic exams are now read in minutes.
The Customer
Riverside Medical Center in Riverside, California features seven clinic locations in the Inland Empire staffed by over 120 specialized physicians. A medical facility in place over 75 years, it is a staple healthcare organization in the Inland Empire area.
Ayodale Odulate, MD, one of Riverside’s staff physicians, specializes in diagnostic radiology and has over 17 years of experience in the field of medicine.
“I was experiencing speed issues primarily with diagnostic studies. Since diagnostic patients require their results immediately, it was stressful for me, as a Radiologist, as well as the patient, when there is any delay in reading the images. When the large, 3D mammogram images were taken, I would have to wait for quite a long time for the current images, and up to 10 prior studies to download to my reading workstation,” said Dr. Odulate.
“Additionally, when I logged into my workstation, I would have to wait for each study, and their priors, to download and store to my local workstation. This took away critical time from the patient's diagnosis and limited the number of studies I could read per day,” Dr. Odulate added.
These delays created a significant burden on the entire Riverside radiology staff as intense manual retrieving and reconciliation of prior studies is necessary before a possibly time-sensitive diagnosis.
The Challenge
In order to provide Dr. Odulate and the other Riverside radiologists faster access to patient priors during reading, Riverside Medical Center asked Candelis to provide an optimized technological infrastructure to ensure reliability and speed of study transfer.
Riverside wanted a solution to prefetch relevant priors from their PACS when the current exams are performed. Additionally, priors would need to be reconciled and route to the workstation as one patient record for interpretation.
Finally, a speedy and consistent preparation and distribution of a current study especially when reading tomosynthesis or ultrasound was a must.
The Solution
- Candelis installed its Advanced Breast Imaging Workstation with the following benefits:
- Retrieval of prior studies from multiple PACS systems
- Prefetch occurs at night – before mammographers arrive
- Traffic on the network is limited to walk-in appointments and current studies only
- Prefetched studies are reconciled automatically via MWL-driven conditional tag morphing
- Delivery of prior studies to the workstation during non-peak hours – before patients are seen
- Mammographers can exert a great deal of control over workflow:
- Whether they’re going to read studies that lack priors
- Placing studies on temporary hold by requesting priors
- Automatic re-posting of exams on the workstation when (new) priors become available
- Automatic re-posting of exams when a user-defined time period expires and priors don’t become available
- Automatic re-posting of exams when priors show up shortly after exam is read, giving the mammographer the ability to optionally create an addendum
- Ability for administrator to request an addendum from a mammographer
The Results
With the new Candelis system firmly in place, delivery of both current and prior exams simultaneously to the reading workstation along with notification of availability for reading, improved the radiologists’ turnaround times.
The enhanced mammography prefetching tools further reduced the time required before studies can be read and eliminates all information that can cause a patient mismatch.
“After my ImageGrid upgrade, the Candelis enhancements have vastly improved my efficiency, patient response time, and the number of studies I am able to read in a day. Thanks to Candelis, I have doubled the number of patients I can read per day, making my business even more efficient and profitable.” said Dr. Ayodale Odulate of Riverside Medical Center.
All of these added features of the Advanced Breast Imaging workstation are a huge improvement for breast imaging workflow. Better diagnostic tools and more efficient workflow processes will further allow imaging centers and clinics to focus on patient care.
