1. STRATEGIC PLAN FOR UPGRADES IN RADIOLOGY FOR REGIONAL HEALTH HOSPITAL BY: LADINA METZLER

2. WHY IS AN UPGRADE NECESSARY? * Recent merger with University Hospital More Physicians Increase in patient volume Increase Volume in Radiology Exams * Second CT scanner Large Data Sets * Current system is failing Delays in Workflow Patient Waiting Time Radiologist at Pauses Technologist Frustration Referring Physician Complaints Unable to view exam images Delay in results

3. PACS TEAM PACS Administrator (Coordinator) Chief Radiologist Director of Radiology Lead Technologists IT Supervisor and Staff members Chief Financial Officer & Assistant Nursing Supervisor Medical Site Director

4. RETURN OF INVESTMENT Value  Improved workflow in radiology  Improved clinician satisfaction  Ability to view images and reports from any site at any time Monetary Return of Investment in 3 years  COSTS  Equipment  Data Storage  Software  Training  Construction  Migration of Data

5. RETURN OF INVESTMENT WITHIN 3 YEARS REVENUEYEAR 1YEAR 2YEAR 3YEAR 4YEAR 5OVERALL TOTAL VOLUME50,00052,50055,00057,50060,0005% INCREASE EACH YEAR Revenue per $485$510$535$560$5855% INCREASE Procedure EACH YEAR Total gross revenue $24,250,000$26,775,000$29,425,000$32,200,000$35,100,000$147,750,000 ExpenseOne TimeRecurring Equipment $45,000,000 Hardware $30,000,000 Software $2,400,000 Training $100,000 Interface $125,000 Renovation $325,000 Migration of data $132,000 Service Contract $250,000 TOTAL EXPENSE$78,082,000$250,000 $79,082,000 ROI($53,832,000)($27,307,000)$1,868,000$33,818,000$68,668,000

6. REQUEST FOR PROPOSAL Description of Regional Health Hospital 150 Bed Rural Hospital Recent Merger with University Hospital Medical Office Building Consists of Emergency Department 24/7 Surgical Suite Outpatient Imaging 2 CT Units Open MRI 2 General DR Rooms DEXA Ultrasound *Film Screen Mammography *Digital Mammography Spring 2016 Needs Assessment of PACS/Radiology 2 Radiologist Workstations 1 Dedicated Mammography Radiologist Workstation 16-32 GB RAM storage Increased Bandwidth Fast RAID Storage Secure Image Transmission meeting HIPAA Guidelines Incorporate CT Dose reporting to ACR Critical Dose Reporting Completion within 5 months

7. IT IS VITAL TO INVEST IN AND UPGRADE RADIOLOGISTS READING ROOMS

8. SITE VISIT TO ANYTIME HOSPITAL Goals and Objectives  PACS system operates smoothly  Studies and reports accessible within EMR  Evaluate workflows  Steps in sending images  Radiologist will evaluate workstation and manipulation of images  Downtime procedures  Remote accessing of vendor for problems/support  Interoperability/sharing of images

9. TRAINING Staff training will be by super users  One month to 2 weeks before “go live” date  Before and after work session  Competency checklists Radiologists will have one to one training  Vendor to provide trainer on site for 3 weeks

10. WHY NOT INVEST IN A NEW PACS SYSTEM FOR REGIONAL HEALTH SYSTEM? An Upgraded PACS system will: Increase Radiologist Workflow Increase Technologist Workflow Improve Physician Satisfaction Accommodate Large Data Sets Decrease Patient Wait Time Monetary Return Within 3 Years THE IMPLEMENTATION OF A NEW PACS SYSTEM IS A VITAL NECESSITY FOR THE DELIVERY OF QUALITY AND EXCELLENT MEDICAL IMAGING. Transfer High Resolution Mammo Images

11. Agency for Healthcare Research and Quality. (2009, July). Staff "super users" who train others on clinical information systems help shape positive employee attitudes. par 3,Retrieved from U.S. Department of Health and Human Services: http://archive.ahrq.gov/news/newsletters/research-activities Brainstetter, B. (2009). Practical Imaging Informatics. Leesburg: Springer. Erie County Medical Center Corporation. (2013). p 3, par 2, Retrieved from http://www.ecmc.edu/about/governance MacDonald, D., & Neville, D. (2010). Evaluating the Implementation of Picture Archiving and Communication Systems in Newfoundland and Labrador-A Cost Benefit Analysis. Retrieved from Journal of Digital Imaging, 23(6), 721-731. http://101007/s10278-009-9212-x Mancino, P. B., & Russo, T. A. (2007). What You Need to Know Before Purchasing a PACS. Retrieved from Garfunkelwild: http://www.garfunkelwild.com RFP for RIS/PACS. (2015).sections 1 & 6, Retrieved from Linked In Corporation Web Site: http://www.slideshare.net/Carestream/rfp-for-rispacstemplate Xthona, A. (2000, November). Designing the Perfect Reading Room. par 24, Retrieved from Imaging Technology News: http://www.itnonline.com/article/designing-perfect-reading- room Slide 2 Image:http://www.singingwiththespirit.com/wp-content/uploads/2013/03/hospital.jpghttp://www.singingwiththespirit.com/wp-content/uploads/2013/03/hospital.jpg Slide 8 Image: http://www.bing.com/images/search?q=adjustable+table+for+radiologist+workstation&view=detailv2&&id=6D9C27A7A9CD380E1C180DF13F73A7C6 B90961BB&selectedIndex=0&ccid=J%2bJis28l&simid=608038533774837436&thid=OIP.M27e262b36f25191ab93cd1434e918f77o0&ajaxhist=0 and https://s-media-cache-ak0.pinimg.com/originals/9b/e0/2a/9be02ad844eabefb235779cebeef346c.jpg REFERENCES