Edwin Fonner,
Jr., DrPH
Our isolated, rural, Great Plains region has out-migration, aging, mostly middle and lower-income people, and economic decline. Much of the region is classified as critically underserved for emergency medicine, primary care, radiology, and other specialty practices. Hospitals, mostly religious-sponsored or city/county owned, compete to stay profitable. Amidst growing volume in radiology, local delivery systems are fragmented, telecommunications outdated, and teleradiology capabilities are not used. These inadequacies impair diagnostic support and threaten the quality of care. A cornerstone for good healthcare is timely radiology services to support diagnoses and appropriate treatment decision-making. We are proposing to (1) upgrade telecommunications connectivity between healthcare providers in our region, (2) upgrade to digital radiography in outlying facilities, and (3) install a picture archiving and communications system (PACS) at Mercy Health Center in Manhattan (MHC). Here is a list of our project objectives:
Technical Objectives: Speed the transfer of clinical information and improve connectivity for physicians and clinical staff. Action items include:
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Computed Radiography Upgrades – Facilitate site upgrades at key referral hospitals for connectivity to a regional teleradiology system. Move to direct digital capture especially in computed radiography(CR), ultrasound and with other available modalities. Build on what’s already installed and promote an open DICOM architecture for flexibility in future investments. |
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Connectivity and Bandwidth - Move from standard phone lines to dedicated lines for faster transmission between facilities. Define telecommunications standards to ensure compatibility with MHC’s radiology information system and PACS. |
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Strengthen the Hub – Make necessary improvements to telecommunications and local area network to keep up with volume, avoid print for multi-slice images, and improve efficiencies in radiology. |
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Improve Viewing - Provide Web access for viewing images, upgrade workstations, and set standards for purchasing monitors to improve image quality at clinics, physicians’ offices and other receiving sites. |
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PACS - Purchase and install a PACS at MHC with access by Manhattan Radiology and other participating sites. Equip the system with sufficient storage to accommodate current volume (36,000 per year), growth in volume (+37 percent by 2010, possible outsourcing of Irwin Army Community Hospital’s volume, and storage for participating hospitals. |
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Information Systems Interface - Ensure an interface to electronic patient records stored in MHC’s health information system. |
Clinical Objectives: Shape a network of distributed expertise among clinicians in our region; reduce physicians’ need to travel and set the same standard of care that is available for urban counterparts. This may include teleradiology to specialists in urban areas for second opinions. Certain primary market sites identified below (where there are established relationships and sufficient demand) will receive services sooner than secondary market sites where there is more limited need for radiology support. [Back to Main Page]