Picture Perfect

Gary Baldwin, for HealthLeaders Media, May 20, 2008

It was encouraging to see my May "Behind the Wires" magazine feature pop up near the top of our "most e-mailed list." In its fifth year, this profile series highlights the technology leaders—medical groups, health plans, and hospitals—who are making headway toward the often lofty goals of clinical IT. This month's feature covers Eastern Maine Healthcare Systems, a Bangor-based system with seven hospitals. It's an example of how often sprawling health systems are attempting to standardize clinical practices and documentation on a common platform. By the end of the year, Eastern Maine is on course to attaining the "one patient, one record" goal.

What the print magazine story, however, does not detail is the organization's efforts to reach beyond its own institutional walls. CIO Cathy Bruno described to me how the system is hosting a regional picture archiving and communications system for some 15 other organizations. The so-called "regional PACs" includes several small hospitals, some imaging centers, and a physician practice. Eastern Maine hosts the system, with the participating members paying for the service on a per-exam basis. According to Bruno, the members wanted to easily exchange images and reports, so the network was constructed to facilitate that. If an image is destined to be read by a certain radiologist, the system will direct the picture straight to the facility. And if a patient is referred to a given hospital, their images can follow along.

This is the type of set-up—in which clinical data traverses even "competing" organizations–that the industry so dearly needs. Not only does the model eliminate duplicate testing, it expedites clinical decision-making. The distributed cost model makes sense too, as I am sure the smaller facilities in the network could not have afforded—or necessarily needed—a PACs on their own. These systems are notoriously expensive. Despite that, they are becoming commonplace. Nearly 80% of the respondents to our 2007 IT survey have one in place, with another 13% planning to deploy within three years. I would be curious to know how many of the organizations are linked to a regional PACs, like Eastern Maine's. Probably not very many if my read on the marketplace is accurate. "The culture in Maine is not as competitive as in some other states," Bruno told me. "There are limited resources, so we cooperate as much as we can."

Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at gbaldwin@healthleadersmedia.com.
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