From the January/February issue of HealthCare Business News magazine
• System maintenance, including updates, upgrades, backups, failover, hardware refresh, and other efforts, are shifted away from radiology IT staff to the EMR team, reporting into the CIO/CMIO.
• The interface from the HIS/EMR to the RIS system has been eliminated, as the RIS module shares the same database table as the EMR, improving reliability and reducing complexity.
• Access to patient information and reading worklists are available within the same application, simplifying desktop integration.
Radiology staff spend less time on the IT aspects of the system and more time on system configuration and operations. This can often require a shift in departmental staffing profiles and job descriptions.
On the flip side of the benefits, radiology staff report there are tradeoffs, such as:
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• Overall planned system downtime, and the timing and scope of testing associated with an EMR upgrade, is decided by a team outside the department.
• Getting operational reports, while technically feasible, can often lag departmental expectations as they need to be developed by a central EMR team that is serving the entire enterprise. Radiology staff often cite a regression in insight into their departmental operations compared to when they had full and direct control of their data.
• System configuration changes, such as how the patient chart is presented, how worklists are configured, what data is stored in the system, and the list of procedures available to order, are all difficult to obtain in a timely fashion. This will vary based on the organization, their operating procedures for system changes, and the working relationship between radiology staff and the EMR team.
Often, the decision to use the reading worklist provided by the EMR’s RIS module, one provided by the PACS, or a stand-alone solution, is heavily debated. There are pros and cons to each, with the EMR-RIS option providing some operational and management benefits, and the PACS (depending on its capabilities) or stand-alone solution providing more flexible and sophisticated workflow orchestration, along with a superior user experience, in many cases.
Additionally, the EMR RIS is typically optimized to provide services for imaging exams performed within the enterprise (which relies upon staff accepting standardized workflows to gain the benefit). In many cases, the EMR RIS only allows orders entered directly and not orders placed by an external system, resulting in added data entry and delays. Radiology staff often have difficulty reading exams that were performed outside the enterprise or accepting orders from outside the enterprise and sending the results back to the system managed by an external organization, such as a referring physician group.