Hosted RIS: An Efficient Alternative

When Vanderbilt Imaging Services LLC, the freestanding outpatient radiology practice associated with Vanderbilt Medical Center, Nashville, Tenn, opened its doors in 1999, the center decided to implement an alternative to the traditional RIS configuration: a hosted RIS. The benefits of a vendor-hosted RIS solution include increased reliability, powerful business-continuity/disaster-recovery capabilities, and decreased costs.

"We had been using a stand-alone billing system and a stand-alone RIS, which meant we had to do double order entry, which left more opportunity for error than an integrated system. Now, we'll have a seamless, single point of data entry." —Jeffrey Landman, MD

Ten years later, Vanderbilt Imaging Services, which has expanded to five centers across Tennessee, is in the process of moving from its legacy RIS vendor (which went out of business) to the hosted RIS solution offered by FUJIFILM Medical Systems USA Inc, Stamford, Conn. Available through the company's Synapse Managed Services business, the FUJIFILM hosted RIS solution incorporates the key features that Vanderbilt had come to rely on from its legacy RIS, while adding integrated billing, rapid deployment, and increased system availability. Jeffrey Landman, MD, CEO of Vanderbilt Imaging Services, explains that the initial decision to go with a hosted RIS solution was an easy one. "It was easier to maintain, so we didn't have to put as much effort into it, and it was less expensive than having our own solution in-house," he says. "We're now changing vendors to get even more functionality and integrated back-end billing." The transition to FUJIFILM's Synapse® RIS will take place during April and be completed in early May. One advantage of switching to the new RIS will be an increase in staff efficiency, Landman says. "We think that we'll wind up saving some staffing in the back office owing to the integrated billing piece," he notes. "We anticipate a big increase in terms of personnel efficiency, and though it will take us a little more staffing in the front office, all in all, we also anticipate a slight increase in savings in terms of personnel." One way that the system will optimize staff efficiency is by helping Vanderbilt's radiologists to manage their workflow better. "They'll get a better look at the worklist in terms of the status of studies, which I think is very helpful," Landman says. "Knowing when a study has been dictated, and who it's been dictated by, is important. We had that functionality on the previous system, but in this system, it's in real time, which will be more helpful to us." The real increase in efficiency, however, will come with the integrated billing feature, which Landman says was a key factor in Vanderbilt's decision to move to FUJIFILM's RIS solution. "We had been using a stand-alone billing system and a stand-alone RIS, which meant we had to do double order entry, which left more opportunity for error than an integrated system," he recalls. "Now, we'll have a seamless, single point of data entry." Without transitioning to a new RIS, Vanderbilt would have had to shoulder the burden of integrating its system. "We're avoiding the costs of HL7 integration now," Landman notes. The hosted RIS configuration also offers benefits in terms of business continuity and disaster recovery—redundancies that are often too expensive for a freestanding imaging center to implement. "Disaster recovery and redundancy weren't the driving forces behind our decision, because we have pretty robust systems at Vanderbilt Medical Center," Landman notes, "but we like the way the FUJIFILM system is deployed, and we like having multiple points of disaster recovery, should we need them." Data security was another key factor. "We are very particular about keeping our data secure, and we're confident about how our data will be handled," he says. Additional cost savings will accrue from outsourcing not just the data center, but the IT infrastructure required to operate a robust RIS solution. "With the hosted solution, you pay as you go, and the nice thing about that is that you get the benefit of all these hardware and software upgrades, which otherwise can really start to add up," Landman notes. "Before you factor in the maintenance costs—along with the facts that you have to manage your IT staff, you have to have the right hardware, and you have to make sure your redundancies and other aspects of the system are dependable—it may seem cheaper to have an in-house RIS. Day to day, however, this is a much less expensive way to manage the system." Vanderbilt Imaging Services has always allowed its referring physicians to access its RIS, but with the implementation of the FUJIFILM hosted RIS, the center will gain a very crucial feature that it didn’t have before: online scheduling. "We allow our referring doctors access to our RIS so they can see images and reports," Landman says, "but there's a tool, with FUJIFILM's RIS, where we can actually allow physicians access to our scheduling database. Then, they can schedule appointments online, at their convenience." The feature, which Vanderbilt plans to pilot over the summer, will set the center apart from its competition. "I can't say for sure, but of the five other competitors in our market, I don't think anybody else has this," Landman notes. "We hope it will be a powerful marketing tool." FUJIFILM's hosted RIS configuration allows practices to extend this capability to as many referring physicians as needed, without additional costs. The rapid deployment offered by FUJIFILM was also an important selling point. "We've had a weekly conference call, for the past two months, where we've worked out issues and done demos of our data," Landman says. "The system will go online in early April, and we'll roll it out to the entire enterprise over the course of a month." Vanderbilt has sent superusers to other facilities to learn how the system works. "There will probably be three or four superusers who will train everyone else," Landman says. "When we first go live, we'll have some vendor support before we're on our own." Though transitioning to a new vendor can be a challenging proposition, Landman is optimistic about the change. "There's always a moment of hesitation when you want to change a system," he notes. "You want to make sure it's a seamless transition. There are always issues you worry about, but I think we've addressed them all.” He concludes, "We're moving from three separate solutions to one, which will make us more efficient than ever before. The bottom line is that day to day, this is an easier way to manage our RIS."