It started with a simple goal: to send radiology images to healthcare facilities throughout Montana in a manner that was cheaper and more efficient than using FedEx to mail CDs overnight. About 30 healthcare organizations in Montana joined the grassroots organization called the Image Movement of Montana.
The group needed a solution that would work not only for more tech savvy facilities with picture archiving and communications systems, but also for folks who don't have PACS and would need to access images on a PC, says Gayle Knudson, radiology manager at Great Falls Clinic and IMOM co-founder.
After looking at several different vendors' product demonstrations, the group chose to implement eMix, a new cloud-based technology to securely share radiology images and reports, from DR Systems. With eMix, providers can send full-res images to other hospitals, referring physicians, or even patients "using the Internet and a standard SSL connection with secure encryption," says Bill O'Leary, regional outreach and PACS administrator at Kalispell Regional Medical Center and IMOM co-founder.
I've read a lot recently how other industries are using cloud-computing technology to improve business processes. But this is one of the few healthcare examples that I've heard about. Here's a strategic look at how IMOM is using the eMix technology and why they determined cloud-computing was the solution for them.
How it works
Organizations pull up the image on their PACS that needs to be sent to a patient or another facility and send it with the eMix client that sits on their desktop. The image goes to an offsite eMix server in San Diego where it is temporarily stored until the receiving physician or radiologist accesses it. That provider, who is sent an e-mail notification, can choose to simply view the image on his or her desktop, burn it to a CD, or push it out to the facility's own PACS.
IMOM is currently beta testing the system at three diverse locations in Montana—Kalispell Regional Medical Center, a regional healthcare delivery system that uses a PACS from DR systems; Great Falls Clinic, a multi-specialty practice that uses a PACS from McKesson; and St. Luke Community Healthcare in Ronan, a critical access hospital that uses a PACS from Amicas Inc.
The challenge with some of the other proposed solutions was that they required the organizations to put in a server, a router, and VPN connections between several facilities. "They were all capital out of pocket upfront," says O'Leary. The eMix solution works because anybody can use it and there is no upfront cost. "The cost is when you download data," he says, explaining that the size of the data determines what your charge will be. Organizations can pay per image or they can set up an account to pay a set rate for say 40 gigabytes of transfer data per month.
The cost of sending 200 megabytes of data one time is less than $2 versus the $10 to $12 it costs to send an image on CD with FedEx, says O'Leary. He expects the technology will save his organization roughly 50% of its FedEx rate. Kalispell Regional, which is in a resort area, probably has one of the higher use rates of CDs than other facilities, he acknowledges.
Questions and concerns
But what about security and the capability of the technology to meet the needs of such a diverse set of providers? The concerns that many providers have about cloud computing is the security of patient information. eMix has security measures in place at its data center, such as limiting the number of people who can access data, biometric scans to confirm people's identity, and network level security between end users and the data in database and content servers.