For Western Reserve, offsite PACS servers provide onsite PACS excellence

The IT team at Western Reserve Hospital, a 105-bed, physician-owned institution in Cuyahoga Falls, Ohio, already had considerable experience with remotely hosted solutions. In 2015, the time came to consider a remote option for its new PACS.

Pam Banchy, Western Reserve CIO and vice president of clinical informatics and transformation, recalls how she saw the situation as both an unexpected change and an exciting opportunity. “We wanted our own independent PACS that would help us meet our business needs.”

With those aims in mind, Banchy made sure to have a remote option on the table as the hospital headed into the selection and acquisition phase of the PACS transition project. She knew that remote hosting of PACS had the potential to help Western Reserve’s IT operations reduce infrastructure costs, minimize technical complexity and staffing requirements, and optimize security and disaster readiness.

Working closely with a steering committee representing clinical and administrative stakeholders from throughout the hospital, Banchy considered McKesson’s Imaging and Workflow Solutions (IWS) team and their McKesson Radiology™ Remote Hosted PACS, a potential vendor for its new project.

“We went through rigorous due diligence, did our homework, a lot of research and information went into our assessment and decision,” Banchy says.

Following a site visit to a hospital in the New York City area that Banchy recalls as “impressive,” plus formal product demonstrations back home in Ohio, the Western Reserve team did indeed select McKesson Radiology’s Remote Hosted PACS.

Banchy signed the contract in January 2016, and the technology went live in mid-October. Today Western Reserve’s 30 radiologists—who collectively read more than 50,000 imaging exams per year—are up and humming with a PACS server running in Atlanta and connected to four diagnostic workstations in Cuyahoga Falls.

“The implementation went as expected,” Banchy says. “The radiologists felt the transition went very smoothly, and their referring physicians didn’t even know anything had changed. There was plenty of support on-site. So from a project management perspective, the implementation went well.”

All this and Workflow Intelligence too

Looking back over her priorities during the PACS selection process, Banchy underscores three requirements that always remained at the top of her list.

First, the new PACS had to be remotely hosted. “We wanted no hardware on our premises,” she says. Second, it had to integrate with Western Reserve’s existing imaging modalities, which include CT, MRI, ultrasound, radiography, fluoroscopy and nuclear medicine. (The hospital doesn’t currently offer mammography, but hopes to add the service line later.)

Finally, Banchy says, the new PACS had to offer radiologists integrated workflows, and McKesson Radiology’s Remote Hosted PACS incorporates Conserus Workflow Intelligence™. Conserus is a workflow rules engine that consolidates interpretation and quality tasks while supporting an enterprise worklist, critical results notification, STAT communication with the emergency department, radiologist peer review and business intelligence. McKesson Radiology also integrates with Nuance’s Powerscribe 360 dictation system and the zero-footprint McKesson’s Clinical Reference Viewer.

Banchy adds that the vendor that ended up as the second-place finisher had a lot going for it—but also a conspicuous shortcoming. “When we went to their data center, they told us we would have separate contracts with numerous sub-vendors,” she says. “I didn’t want that. I wanted turnkey. To me, remote hosting means I write one check to the vendor and that takes care of everything.”

Secure data and high speeds

In the months since going live in October 2016, Banchy has been pleased with the performance aspects of McKesson Remote Hosted PACS, including the security of Western Reserve’s data.

“Putting the environment in the hands of a qualified professional staff in a location that I know is sound from a security infrastructure perspective—and just having the confidence that they will capably support our end-users—gives me peace of mind,” she says.

Another early performance indicator of McKesson Radiology Remote Hosted PACS that has pleased Banchy is the speed and performance of the solution.

This is perhaps best reflected in the work of Western Reserve radiologists who rotate to Hawaii for two-week stints as a way to provide their services 24/7 to the hospital back home in Ohio.

“We know from a technology standpoint how big these image datasets are and how network traffic can really be an issue,” Banchy says. “And based on our end-user feedback, speed is something that has pleasantly surprised us. I thought we would probably have to go back and reinvestigate the design of the network to get the performance we need.” That, however, was not necessary.

“When we met with the McKesson IWS team to talk about this concern, they showed us how they calculated what the network needed to be,” Banchy says. “It was obvious they knew their stuff—‘this is the size of the image, this is the physical distance the data will have to travel’ and so on. I couldn’t argue with any of that, and the network is indeed doing what they said it was going to do.”

Which brings Banchy back to her first interactions with McKesson IWS.

“My team and I had not worked with the McKesson IWS implementation and support teams before,” she recalls. “Today I would say they are a skilled and talented group. Do I think I chose the right partner in McKesson? Absolutely.”