Harold Welch is the Vice President of Technical Solutions Worldwide at Novarad Corporation, based in American Fork, Utah. Welch has worked in the healthcare industry for over 15 years, and is passionate about improving patient care and workflow efficiency for healthcare providers throughout the world. We interviewed Welch about the benefits to an Accountable Care Organization (ACO) of implementing an image exchange.
Q: Drawing upon your expertise, could you explain, in lay terms, what an Image Exchange is?
Welch: An Image Exchange allows a group of individual institutions that share a business agreement to deposit all clinically relevant objects—images, studies, reports—into a repository. This would of course lead up to that complete patient record—shareable, usable, and utilized by multiple providers.
From our perspective, the MARZ universal viewer makes it very easy to combine disparate objects on a single monitor to build a patient storyboard. This results in a better diagnosis for the patient, as clinicians have access to the complete patient record.
Q: Why would an ACO be particularly interested in an image exchange solution?
Welch: By giving complete access to the patient record to authorize the ACO participants, we create a more efficient, complete patient portfolio and optimizes internal resource utilization. As a result, fewer CDs and printed reports are produced and circulated with the patient. An added benefit is that studies are rarely duplicated resulting in lower overall dose to the patient.
Q: What are some other problems that it might solve for a facility, or help prevent?
Welch: Because of the portable nature of HIPAA covered documents or materials, we understand that once you burn a CD and hand it to a patient, it’s their responsibility. I believe you are putting undue or unnecessary responsibility on that patient.
In this particular example, having a common repository would relieve the need of sending material protected by HIPAA with the patient, while accomplishing the same net results. So we’re not, if you will, creating a potential HIPAA violation—we are in fact enabling the institution to share without the additional liability and overhead.
And of course, cost. Every time you burn a CD, every time you do this type of activity, it’s not just the cost of the CD, but the operational cost: the individual doing it, handing it to the patient, instructing them.
The complexity continues when the physician puts it in his computer and it doesn’t launch properly. They then call the sending institution and say why isn’t this working? These are all items that can be avoided with an image exchange.
Q: Would you say implementing an image exchange can really help cut back on those extra things that need to be used, eliminating some of the confusion?
Welch: Absolutely. It can potentially limit the liability of the ACO or the individual institution, because regardless of what you tell the patient, they place that CD on their car and it gets lost in the parking lot, then it pops up somewhere and there’s always the question of how and when the patient information was compromised.
Q: You mentioned that this solution is also cost-effective—can we discuss this further, especially for a facility on a budget?
Welch: In this scenario, there are two important things: capital expenses and operational expenses.
Let’s talk about capital first. Capital is required to purchase services and buy consumables, for things like CD burners. Then you have the operational expense of people who are actually preparing the CDs, making sure that they’re signed for properly, cataloging that information, and in fact some of the administrative tasks that go along with supporting that device itself. This is a recurring cost that is proportional to the amount of studies being pushed out.
With the Novarad model, it’s a per-study basis. You pay per study contributed, it is placed in there once, you pay only once, and then you’re done. They are unlimited use. So, in the prior example you may have to burn a couple of CDs, one to take to one doctor and the doctor keeps it, then the patient has to take it to another physician, that physician may keep it.
Q: Do you have any parting advice for an ACO who is considering investing in an image exchange but is still unsure?
Welch: ACOs are formed to improve patient care. The more efficient, accurate, and time-conscious they are of these patients, the higher the satisfaction of this individual patient will be, resulting in a better patient experience and a more positive perception of the institutions involved.
All of the things we have talked about are patient focused, providing more efficient, accurate, and timely service. So if you do not have such a solution at the moment, it may pay to do a gap analysis and see where you’re deficient as an organization, and then allow us to come in and bridge those gaps, and provide you with some answers for how to optimize your workflow and provide your institution with a much quicker, more efficient patient experience.