The information systems team at Atlanta Medical Center is not only keeping pace with the rate at which technology is evolving in healthcare, they’re taking the lead. A facility with a reputation for technological innovation in healthcare, AMC developed a comprehensive solution to a new challenge faced by information systems management when deploying a PACS client enterprise-wide in a large healthcare facility.

Not all that long ago, radiologists hailed the coming of PACS as a means for increasing the number of images they could read and for extending a certain amount of freedom by making studies accessible away from close proximity to the film library.  Now that the film library has gone the way of the fax machine and the cassette tape, today’s radiologists and other healthcare providers have the freedom to read and view imaging studies from various access points within the healthcare facility, from their personal laptops and via mobile devices. However, wider access and increased mobility has brought with it greater complexity in terms of managing system updates, upgrades, monitoring, security and reporting. Ron Gilbert, BS, RT(R), ARRT, PACS administrator with AMC discusses his team’s experiences in workflow optimization and engineering to execute the deployment of the latest version of McKesson Radiology ™ throughout the entire AMC enterprise using standardized workflows that can be easily supported and secured.

Web-based PACS…What now?

Ron Gilbert, BS, RT(R), ARRT, PACS Administrator, Atlanta Medical Center

“You may find yourself saying, ‘Great, we have a web-based PACS solution’, but the real question is, ‘What are we going to do with it?’” says Gilbert.  Having executed the deployment of McKesson Radiology at AMC, Gilbert and team know exactly what to do with it, and how to manage it using enterprise tools and workflows that AMC already had in place. “When we were developing the implementation plan for our web-based PACS client, our team really put some thought into what the physicians wanted and what they needed to accomplish, in addition to satisfying the infrastructure and security requirements of our system,” Gilbert adds.

Because McKesson Radiology is web-based, it can be installed in an infinite number of places, which can be a blessing and a curse, according to many PACS administrators when asked at user meetings such as the ones held by McKesson.

“I think we’ve addressed a problem that many PACS administrators are facing when they deploy solutions that are completely web-based,” Gilbert explains. The web-based PACS can be installed anywhere and by as many people that need access. While that offers advantages in terms of mobility and accessibility for the users, and even a lot less to do in terms of installing heavy client software from an IS perspective, tracking and managing all the different locations where the client is installed can present its own challenges.

The AMC PACS Solution

The PACS users and workstations at AMC were broken down into three categories by Gilbert. There are those Gilbert refers to as the “super-users”, who need the full McKesson Radiology Solution.   These are the radiologists and other clinicians such as orthopedists, and plastic surgeons. Their workstations will run the full PACS with all of the third party integrated software for things such as orthopedic templating and report dictation. These users often also have the full PACS client installed on their laptop or home computers, on which they need to also then follow more stringent IS security protocols, says Gilbert.

There are also clinical workstations that still need to be locked down to the PACS and have various supplemental equipment requirements, such as high end monitors, optimized for image viewing.

Single sign on, multiple benefits

The basic web client runs on PCs—and there are more than 400 throughout the facility. For this, Gilbert and team designed the McKesson Radiology LITE deployment to work within the current AMC infrastructure. AMC employees use a single sign on (SSO) mechanism to access the system. Once authenticated (using a single login and password, as the name suggests), a toolbar appears and remains at the top of each workstation and the PACS is open and accessible via that toolbar. The PACS software installation was globally pushed out to all users on the system through AMC’s SSO.

“There are some serious benefits to doing it this way,” reports Gilbert. “From a resource perspective, nobody has to install the PACS web client one at a time. Conversely, if the users are installing it themselves, they may not be able to find it the next time they need it. And probably the biggest benefit is that we can make global changes or updates with just a couple of keystrokes.”

An icon for the McKesson Radiology sits right within reach on the SSO toolbar and as long as the user is signed on and authenticates entry into the SSO, the PACS is always available and with minimal effort, according to Gilbert.

“Additionally, there’s no guesswork involved in knowing exactly how many PCs have installed the software and where they are. I’ve heard other PACS administrators comment that they are able to run a program to ‘sniff out’ all of their web-based installations. We don’t have to do that. Our users don’t have to rely on a separate workflow to install and operate the PACS, and my team doesn’t take on any additional work to manage individual workstations that house it,” says Gilbert. “From a data security standpoint, managing the PACS through the SSO authentication provides a reliable sense of data security as well. The SSO authentication is required for access and we are able to maintain a record of user access.”

Enterprise PACS team

“The workflows we developed are tried and true and we’ve been running them for many months. It’s not something we hope will work, we know it does. Using our SSO, we enable more than 2500 staff members that are trying to access PACS for different reasons. We don’t need heavy clients for everybody,” concludes Gilbert, “and the AMC Information Systems team and Radiology developed a way to get them what they need by using what we already have in place.”

In addition to the resource benefits that Gilbert has experienced from the enterprise-wide deployment of the McKesson Radiology, he feels that AMC is able to achieve and maintain high standards in healthcare delivery because of the way the system is working.

“AMC has a level one trauma center and a stroke program,” Gilbert explains. “We are able to meet our time constraints because everybody has the access they need ‘round the clock. It's a tremendous benefit to have our PACS system set up the way we have it now.”