Upstate Carolina takes turnaround times into the end zone

Of all scenarios in radiology that call for lightning-fast turnaround times coupled with absolute accuracy, few present the pressure of serving as the radiology group on call for in-season sports-injury studies.

During a full-contact field practice on a Friday afternoon, a football player at a major university—one of the radiology group’s biggest and most important clients—takes a hard hit and hobbles off the field. The team doctor transmits x-ray images from the locker room to the radiology practice and calls for a stat report to help him decide whether to clear the player for tomorrow’s big game. He might mention that the sidelined athlete is a marquee attraction and that tens of thousands of fans will be in attendance.

Jason Kelly, MD, president, 27-radiologist Upstate Carolina Radiology, in Spartanburg, S.C., takes it from there.

“You can’t send your dictation over to a transcriptionist and then wait for it to come back on Monday,” Kelly says. “Unless you want to sit there and type the report with all else you have going on, I don’t see how you could meet this kind of demand without voice recognition.”

Big-time sports medicine may be an ideal example of drop-what-you’re-doing-and-do-this radiology, but, says Kelly, it’s not the only case for which voice recognition is a radiological must.

In addition to staffing the radiology department at Spartanburg Regional Hospital, Upstate Carolina Radiology sees patients at two additional hospitals in the region and provides remote interpretations for seven physician-office clients.

“Teleradiology is competitive,” he says. “The referring physicians can go with whomever they want, for the most part. You strive to offer good customer service whether you’re talking about hospitals or teleradiology; you have to have people who are sensitive to the customer-service aspect of the business if you’re going to be working in teleradiology.”

A key component of that service level is rapid turnaround times, Kelly adds. “I just don’t see how you could do it without voice recognition.”

A-list voice ability

When it became clear that Upstate Carolina’s old PACS was approaching the end of its life cycle, the unanimous first decision was that voice recognition capability would be a prerequisite feature of the replacement PACS.

The group looked at three or four choices and agreed on Viztek’s PACS, which included a voice recognition capability in the purchase price, as the most cost-effective, yet capable, option on the table.

Just six weeks out from go-live, Upstate Carolina Radiology gives its installation of Viztek’s PACS high marks—and the system’s integrated voice-recognition component is proving a particular radiologist pleaser, not just for the group members doing sports medicine and teleradiogy, but for all 25 practice members.

“I would give the voice recognition feature an ‘A’ because it actually does just as well as the hospital’s [solution],” Kelly says.“In fact, in some cases, it does even a little better.”

Asked to name the single best improvement enabled by the voice-recognition component in Upstate Carolina Radiology’s new PACS, Kelly doesn’t hesitate. “Our main gain is in fidelity,” he says. “There’s a lot of confidence that the reports we transcribe are actually going to match up with the patient who was scanned. We’re finding how much voice recognition really does help with that.”

He notes that the new PACS features a header that auto-populates the report with patient identification information, enabling the radiologist to instantly check that information against the images. “You know you’re dictating into the correct patient report. That’s number one,” Kelly says.

In addition to the benefits derived from a tight integration between PACS and speech recognition, the system’s capability to auto-fill laterality for extremities adds a much-appreciated quality check, Kelly adds.

“Sometimes we’ve had situations in the past where we’ve had to correct left-hand versus right-hand in reports,” he explains. “So far, with voice recognition, I haven’t yet found a case where it’s wrong on laterality. If it says right shoulder, it’s a right shoulder. That’s a big help.”

Better for business

Word-of-mouth directed Upstate Carolina Radiology toward Opal-RAD, to begin with. The recommendation came from a major client that had been using the system for several years. The opportunity to integrate its PACS with the system of a major client, an orthopedics group, also played into Upstate Carolina’s decision.

The integration of Upstate’s PACS with the orthopedic group’s PACS proved a little tricky, says Kelly, but Viztek staff worked closely with Upstate, both onsite and remotely, to assure all moving parts were successfully synced and radiologists were appropriately trained.

In the end, says Kelly, picking the right PACS—including prioritizing voice recognition as an integral part of the selection—is as much a business decision as a clinical one.

“A radiology practice has to be run as a business,” he says. “Physicians aren’t always considered business savvy, but with reimbursements continuing to decline, you really have to watch the pennies.”

In radiology, he notes, practices do well to look at their net gain. “You might have a vendor whose product would get an ‘A’ on both voice recognition and on integration with their [PACS] product,” he suggests. “But if they’re going to charge me $5 per study for something on which I’m only getting reimbursed $30 per study, that’s taking quite a chunk of my profit.”

Considering both performance and cost of the new PACS, Kelly is pleased with the value of his new image management platform.  “In Opal-RAD we have a good product that serves our needs, and the needs of our referrers and their patients, very well,” he says.

It also came loaded with an accurate must-have feature: voice recognition.