Pauls Valley Hospital
CR, PACS and HL7 Integration
When 64 bed Pauls Valley General Hospital decided to implement a fully digital radiology department, the first company they contacted was InTelemed. As a long time vendor for Pauls Valley Hospital, InTelemed maintained their hospital firewall and radiology department LAN, and also maintained their Kodak digitizer and helped with teleradiology issues that might arise. Says Mike Welborn, Radiology Director “I have worked with James Pratt (owner of InTelemed) for years and was very comfortable with InTelemed’s technical ability. Since they started carrying the full Carestream product line, and I have always had good luck with Kodak products, I decided that InTelemed would be the first company I called when we decided to install PACS and CR.”
Although InTelemed was the first company contacted by Pauls Valley, they were not the only one invited to discuss PACS and CR with the radiology staff and hospital management. Pauls Valley also looked at products from Imageon, Agfa, and GE. After extensive product demonstrations and discussions, Pauls Valley Hospital chose the team of InTelemed and Carestream Health for their project.
“I was happily surprised the pricing was very competitive with all the other products we looked at” says Welborn. “The product functionality and ease of use far surpassed anything else we tested. Both the PACS and CR was very easy to use and had the backing of one of the largest companies in medical imaging. We felt comfortable with InTelemed, so the overall package of a worldwide imaging leader, a solid local company and a great product made the choice easy for us.” Pauls Valley ultimately installed two Kodak CR units, a Kodak Dryview film printer and a full Directview PACS system with a 5 megapixel diagnostic displays, CD burner, paper document scanner, film digitizer, PACS archive, HL7 integration and off-site disaster recovery to Carestream’s Hosted Information Service in Rochester, NY.
Revamping IT Infrastructure
Like many small and mid-sized hospital and clinics, the implementation of PACS was also a prime opportunity to revamp their IT infrastructure. Based on recommendations from InTelemed, a phone closet/storage room was converted to a secure computer room with special cooling and controlled access. Racks were installed not only for the PACS server, but for other servers used throughout the hospital. InTelemed installed a new high performance Sonicwall firewall and a new Cisco router for the radiology T1 line. This was all integrated with the current hospital Internet connection, with rules applies to control traffic between the hospital LAN and the radiology LAN. Several gigabit switches were installed in the computer room and the radiology department so that plenty of local bandwidth was available for moving the large image files around the network. All new PACS server and workstations had gigabit Ethernet cards installed so that response time would be extremely fast. “Image display is almost instantaneous inside the hospital” claims Welborn. “Our local physicians really like the performance of the system.”
“I hate to see hospitals install a brand new PACS system on an antiquated internal network” says James Pratt, President of InTelemed. “It is critical that the local physicians and staff embrace the system, and putting in a new PACS on an old, poorly designed infrastructure can wreak havoc with the project acceptance. We have an extensive radiology IT background and the implementation of a new PACS system is the perfect time to revamp some of the IT infrastructure in the hospital. I believe that it should be done right the first time so that the system is installed smoothly and the medical staff has confidence in the new system from day one.”
Project Management
As part of the implementation, InTelemed acted as project manager and coordinated work done by not only Carestream, but also the hospital’s local IT vendor, the Hospital information system vendor, and the radiologists IT personnel. “I hate when vendors point fingers” says Pratt. “Our role is to take responsibility for the project and ensure that our customer’s expectations are properly set, then those expectations are met by all parties involved. If a problem arises we just roll up our sleeves, gather the affected vendors and customer personnel, and figure out how to solve the problem.”
Installation
Installation of the PACS system took four days from the time the equipment was uncrated until the time Pauls Valley Staff was using the system for patient care. “Planning is critical to a smooth project implementation” says Pratt. “I would rather spend extra time up front doing thorough planning than disrupt the workflow at our customer site with installation that takes weeks or months.” Application training occurred the week after installation, with follow up sessions a few weeks later. “The system has been very easy to use and well accepted by our medical staff” says Welborn. “Implementation was surprisingly smooth, even considering the integration with our HIS system. We did have a few issues arise, but those were quickly handled by InTelemed.”
Now that the system is fully operational and well accepted by the medical staff, Welborn claims even the most computer unfriendly physician now likes the system. “We seldom print film anymore. Our physicians really like the ability to pull up images from any computer in the hospital. We have dedicated imaging display stations in our department, ER and the physician lounge, but really any PC works fine and the doctors like that ability.”