Kickapoo Indian Clinic

PACS, CR, Film Printer and RPMS Integration

Faced with the need to increase workflow at their growing clinic and improve the service for their referring physicians, in 2008 the Kickapoo Indian Clinic in McLoud, Oklahoma installed a Carestream PACS, CR and Dryview film printing system from InTelemed. Diane Van Curen, Radiology Director at the clinic, did extensive research on PACS and CR system prior to making her decision.  She spoke with Christin Crosswhite at the Oklahoma City Indian Clinic and heard about her satisfaction with the Carestream PACS and CR system installed successfully there and invited InTelemed to provide a solution for the Kickapoo Clinic.  In addition, Diane received strong recommendations about Carestream and InTelemed from Indian Health Services, so her decision was easy. "I really liked the Carestream system, and the positive experience of other IHS facilities gave me peace of mind that this was a good soluiton" said Diane.

Upgrade Radiology Network

The project was to rework their internal network so that PACS could stand alone from the hospital network.  This way problems that might occur on the clinic network did not affect her ability to process patients.  However, she still needed the ability to connect to the clinical network for RPMS integration and so that physicians could review reports and images from any of the 10 exam rooms throughout the clinic.  This was accomplished by installing a Sonicwall firewall and a seperate DSL line just for radiology.  The Sonicwall was used to connect the radiology LAN to both the clinical network and the public Internet.  Rules could be enforced in the Sonicwall to isolate traffic between the networks and only allow specific users to access the radiology network.  At the same time, InTelemed worked with the IT department at Kickapoo to reorganize the computer room, moving the servers into a portable, lockable rack that has better security, is better organized and can be more easily managed and expanded.

Install CR

The next step for Kickapoo was to install a Kodak CR-825 and a Dryview 8150 film printer.  This allowed Diane and her staff to become familiar with the CR system prior to implementation of the PACS system.  "I am very glad we installed CR first and PACS later," says Diane. "It gave us the opportunity to become familiar with CR before learning PACS."

PACS

The finalt step was to innstall the Carestream PACS system, RIS broker, CD burner and clinical review stations.  The PACS server was a multi-processor DELL system with over 4 terabytes of storage.  It would also act as a web server, allowing physicians to review the images from home or any clinical workstation.  The RIS broker would connect their RPMS RIS system to the CR-825 and the newly installed Kodak LS-75 film digitizer.  This way the techs would not need to enter patient information manually, which speeds workflow and helps eliminate errors.  The digitizer is used to send prior images to the off-site radiologists for comparison purposes.

Automated CD Burning

Diane opted for the high end Carestream automated CD burning system.  "I wanted to create a professional image for our clinic by providing patients with CD's that contained our logo and the patient name on the CD cover" says Diane.  "I also did not want to babysit the CD burner.  When a tech decides to burn a patient CD, they just do it from the web browser, then walk over to the CD burner a few minutes later and the CD with the patient name and our logo is resting in the output tray, ready to pass on to the patient. We can focus on patient care, not babysitting a computer."

Workstations

As part of the project, InTelemed, working with the clinic IT staff, installed wall-mounted dual monitor workstations in each exam room.  The wall mounts allowed the monitors to act like "view boxes" for the physicians and did not take up valuable cabinet space.  While examining the patient, the physician can easily look up images and consult with the patient minutes after the exam is complete.  "Patients and our doctors really like this" says Diane.

Future Plans

In the future Diane would like to replace her exam room with a DR system, but for now the CR is working quite well and allows the clinic to move into the digital age, eliminate nearly all film costs, and speed exam results to their referring physicians.  "Our doctors are very happy with the system and the fast reports they now receive" confirmed Diane.  "We have been very pleased with the Carestream system and the project management provided by InTelemed."