Digital imaging may have been born in radiology but its future lies in mainstream hospital IT. Many Most Wired hospitals have found it expedient to integrate PACS with the hospital electronic health record, the benefits of which include single sign-on, giving physicians one point of access to complete patient medical records.

"Having imaging studies available through the EHR allows for efficient physician workflow," says Jake Kempen, vice president of clinical services at Aspirus Wausau (Wis.) Hospital.

Imaging studies at Aspirus are held and viewed on PACS. Links are provided in the EHR to PACS images to make it easier for clinicians to view studies. All reports are part of the EHR.

Kempen says physicians want all patient information available on one system so they aren't required to log into separate systems or multiple PACS to view images. All radiology and cardiology imaging at Aspirus is now digital, and Kempen says Aspirus is monitoring digital pathology technology development, with an eye toward future acquisition.

At Akron (Ohio) General Health System, diagnostic-quality images are delivered throughout the enterprise via RIS/PACS. "By providing images and reports that are posted to the EHR within seconds of completion, clinicians can have diagnostic information at their fingertips to expedite the delivery of care," says Dave Fiser, vice president and chief information officer.

Images and reports are made available anywhere in the hospital, to clinics and physician offices or home workstations. "The physician EHR access is coordinated through a physician portal, which enables local and remote access to all EHR components, including PACS," he says.

Remote access is particularly appealing to smaller, rural hospitals. "This is a huge advantage, especially in our rural area," Kempen says. Being able, for instance, to see CT studies from another hospital in the emergency department while a patient is in transit allows Aspirus to be better prepared when the patient arrives, Kempen says.

There is little question that digital imaging translates into better, faster patient care. Study turnaround times are improved. Retakes, due to image under- or overexposure, are no longer necessary. Fewer retakes mean less radiation to the patient. Films no longer are lost and film-related costs are eliminated. Study quality is enhanced and results can be viewed remotely. Multiple providers can view studies simultaneously.

There also are enterprise cost efficiencies and other advantages to digital imaging. "The business case is not only quality care, but digital imaging is more efficient," says William Young, CIO at Berkshire Health Systems in Pittsfield, Mass. Fewer repeats and less time to produce images lead to quicker throughput. At Berkshire, all imaging modalities in radiology are digital and integrated with both PACS and the EHR.

Digital imaging also may translate into shorter lengths of stay. "While we have not completed a study on the relationship between the use of digital imaging and correlated length of stay, we are confident that digital imaging helps move patients more safely and efficiently through the process," Young says.

Fernando Martinez, vice president and CIO of Jackson Health System, Miami, agrees. "Patient length of stay is reduced because of improved turnaround time from acquisition to report and reduction of retakes because of lost or unavailable films," he says. Jackson uses an enterprisewide PACS solution that captures diagnostic images in radiology, cardiology echo and cath labs, obstetrics and dentistry. Structured reporting has been implemented in cardiology. Other modalities use structured templates.

Clinician satisfaction with digital imaging is no longer in question. The use of voice recognition software with immediate radiologist report sign-off has decreased report turnaround to minutes instead of hours or days. "Emergency physicians and referring clinicians say this change has had a huge positive impact on their practices," Kempen says.

Berkshire has similar physician experience. "All of our physicians would agree that, at first, digital imaging took some getting used to, but the quality, quickness and the overall satisfaction with digital imaging is overwhelmingly positive," Young says.

Douglas Page is a freelance writer in Pine Mountain, Calif.