In early 2006, just before a new diagnostic imaging system went into operation in the three FirstHealth hospitals, Richmond Memorial radiologist John Stevenson, M.D., was confident that it would “dramatically improve the quality of radiology images and improve our efficiency tremendously.”

David Furie, M.D., a radiologist at Moore Regional, predicted the new system would “increase our capability so much that it’s almost like going from playing LP vinyl records to carrying iPods in our pockets.”

Now that the new technology has been at work for a while, radiologists aren’t the only ones who are sold on it. According to Dr. Furie, physicians both within and outside the hospitals have found it “overwhelmingly helpful in forming a diagnosis and guiding decisions about patient care.”

The technology that has literally changed the face of imaging is called PACS—for Picture Archival and Communications System. It replaces the films produced by imaging studies—X-rays, ultrasound, CT and MRI—with high-resolution images on computer screens.

Before PACS, radiologists viewed films on light boxes and then put them in file folders to be stored. If a referring physician or another specialist needed to see the films, they had to be mailed or delivered by courier.

The new system has streamlined the whole process. PACS captures images digitally, distributes them to physicians virtually anywhere via the Internet and stores them as electronic records that can be instantly retrieved whenever they are needed.

Computers with special PACS software have been installed in the three FirstHealth hospitals. Radiologists can use them to manipulate images electronically—enlarging specific areas, enhancing clarity, rotating an image to provide different views, and creating three-dimensional images of organs, bones and blood vessels.

“For example, we have software that lets us look down the center of cardiac or pulmonary vessels to find abnormalities,” Dr. Furie says. “We can take an MRI image, make it 3-D, rotate it and find small areas of abnormality that we might not have been able to see before. All of this increases our ability to detect significant disease.”

In the FirstHealth hospitals, physicians can look at PACS images at workstations on patient floors and in the emergency departments, operating rooms and intensive care units. Physicians can even access the images on the computer in their office, whether they are across the street or miles away from the hospital. They no longer have to go to the hospital to view a patient’s films with a radiologist.

“They can be sitting at their desk and looking at the images on their PC while the radiologist in the hospital is viewing the same images,” says David Quinlan, FirstHealth’s PACS administrator. “If another specialist needs to be looking at an image at the same time and discussing it with the radiologist and the referring physician, they can do that, too.”

Dr. Furie played a leading role in selecting the PACS system that FirstHealth uses. He thought it was important that PACS images be accessible to the entire medical community, including local physicians in private practice, and not just in the three hospitals.

Unexpected benefit
According to Dr. Furie, a somewhat unexpected benefit of PACS is that radiologists seem to be seeking each other’s opinions more often than they did when they had to be standing side by side looking at the same piece of film.

“Now, it only takes a phone call to a colleague at another workstation, and then we can view the case simultaneously and discuss it,” he says. “Patients benefit from the interpretive skills of the entire group.”

The ability to collaborate at a distance has proved especially helpful to the two Pinehurst radiologists who take turns covering Montgomery Memorial Hospital four mornings a week.

“It is really nice that they can pick up the phone and call another radiologist in Pinehurst and say, ‘Would you look at this with me and tell me what you think?’” says Leslie Champion, director of imaging at Montgomery Memorial.

When there is no radiologist on site in Troy, Champion says, a radiologist in Pinehurst can instantly view images from new diagnostic studies.

“Before, we sometimes had to package up the films and make a trip to Pinehurst that very day,” she says. “That was hardly efficient. Now, we are very efficient.”

Dr. Stevenson at Richmond Memorial agrees that a big advantage of PACS is that “we aren’t having to track down films or send them from place to place anymore.”

“This is the first time a major modality is really impacting how we do our job,” he says. “It is greatly increasing our efficiency.” Now, as soon as a diagnostic study is done, the images are ready for viewing. There is no waiting for a film to be printed.

“Our turnaround time is decreasing because of the instant availability of cases to be interpreted,” Dr. Furie says. “That is another way this system is benefiting referring physicians and, ultimately, their patients.”