Friday, June 1, 2012

Cloud Considerations For Radiology Practices

The following is a guest post by Steve Deaton of Viztek LLC regarding how the shift to cloud computing will affect Radiology practices.

To better understand the benefits of a cloud-based solution for radiology, consider the ability to have instant access to exams, and the potential benefit of having a specialist always available.  One example would be a car accident that occurs during the early morning hours in a rural area. If the local hospital does not have a radiologist on site at all hours, the staff can call an off-site radiologist and give them access to their cloud-based PACS solution. This allows them to quickly gain information so they can either proceed with immediate treatment or call for transportation to a larger facility.  The diagnostic process can be shortened so that critical patient care can begin quicker.
Benefits
Cloud-based PACS systems enable practices to grant system access on-the-fly, allowing one physician to quickly communicate with a colleague in order to review time-sensitive images. In the car accident example, such speed and flexibility can quickly help the physician determine if the patient needs immediate treatment or not.
The right Cloud solution puts the practice’s entire workflow into the cloud. Geography and the time of day are removed as constraints, allowing patients to always receive the best level of care. This availability to multiple specialists who can access the system from any internet-enabled device does, of course, raise security concerns. For practices that choose a stand-alone EHR or PACS product that is bundled with a cloud service for web access, the security between the end user and the cloud hosting company needs to be thoroughly reviewed. IT and administrators at the practice should be wary of the partnering cloud provider, and ask detailed questions about security protections, breach responses, and who is ultimately responsible for the security of HIPAA information.

A cloud-based PACS solution means the practice no longer needs to connect to an onsite server or worry about complex setups such as VPNs.  This promotes better image sharing and personal care and also enables the practice to be closer to the longer-term goal of implementing a 100 percent electronic records practice. It’s also the perfect solution for multiple location practices, or those that read images for multiple institutions.
Cloud solutions are the ideal fit for practices that need to manage expenses and can benefit from a pay-per-usage plan that is dynamically scalable to meet growing or falling demand. Digital radiology images that need to be archived for years require a considerable amount of space, and the right cloud provider can offer any amount of needed space at the right price point. Cloud services can reduce capital investments in both ongoing maintenance and server equipment, and related IT staff needed to keep those systems running. Such savings can be substantial, especially over the longer term as the costs of cloud storage continue to decline.

Vendor Review
Truly web-based solutions will utilize an image viewer that is a web-written application and runs on any computer. There is not a need for high-powered diagnostic workstations, or the need for special in-system hardware that is running locally. Placing data on the cloud is not worthwhile if it comes with restrictions in terms of how staff actually access and use the data.
Careful review of prospective PACS, RIS, and EHR vendors is vital to understand the different levels of how solution providers can be “in the cloud.” Some providers who have been in existence for a decade or more often take pride in still running on their original platform. While this might sound like a smart decision that offers continuity and stability, it doesn’t take full advantage of technological progress. When these older heavy systems are put into the cloud, the users are, in essence, remote controlling a large workstation. Internet speeds and the rate of compression are not typically good enough for fluid image adjustment that is required for effective radiology viewing. This causes the familiar problem of image lag, making image manipulation a challenge.
These solutions with older coding might technically operate over the cloud, but they are available with limitations. If all of the tools and functionalities are not available to doctors when reading remotely, then the integration of a cloud system might not be worthwhile. These older solutions may not support mobile devices such as the iPad, which are transforming radiology practices and patient interactions. Practices should explore vendors that not only can meet the demands of today’s mobile and instant-access users, but also look to the future and proactively build systems that are in touch with the latest broader technology developments. Cloud-based PACS and EHR systems have not taken off as quickly as anticipated because it is being put in place on top of older systems that can’t harness all of its benefits. Vendors that offer a 100 percent web-based solution are poised to best take advantage of the cloud and gain widespread adoption among radiology practices.

So what is the solution? Top vendors will completely update their code every few years and start fresh, allowing them to build thin-coded systems that are cloud-friendly and enable all functionalities from any web-enabled PC. Utilizing the latest coding toolsets is the only way to ensure that a Cloud-based solution is a leap forward technologically over an in-house thick-client system.  Otherwise, legacy systems claiming to be on the Cloud do not provide all of the pieces needed to complete the workflow and ensure quality and consistent care. Steve Deaton is a VP of Sales at Viztek LLC, a leading cloud-technology provider.