The TriHealth healthcare network had multiple picture archiving and communication systems (PACS) spread across departments and locations, making it difficult for clinicians to quickly access patient images.
TriHealth implemented the Watson Health enterprise imaging suite to centralize image storage and integrate with the electronic health record (EHR) to provide a comprehensive patient view from any location.
Eight million imaging examsadded to the vendor-neutral image archive
Allows clinicians to quickly access imagesin patients’ longitudinal records to review their full imaging history
Lets hospital data administrators manage imagesacross PACS, specialties and sites, regardless of source or format
Business challenge story
Manage imaging studies across the enterprise
TriHealth has experienced significant growth over the last several years. However, as it expanded, each new physician practice, hospital and outpatient center brought its own technology, including its PACS for radiology and cardiology, for example. Although these imaging systems allowed physicians in each location or department to view imaging studies such as mammograms, X-rays, CT scans, cardiology imaging, MRIs and more, the PACS systems remained siloed and segmented, impeding patient care.
For example, a patient might receive an imaging study at a cardiologist’s outpatient office that would generate a radiology referral for a more comprehensive imaging study. But the radiologist would only have access to the follow-up study he or she conducted and not the original ultrasound or nuclear cardiology study. For the radiologist or other specialists to see prior imaging studies, the referring doctor would often have to put them on a CD for the patient to physically carry to the specialist.
“It was particularly frustrating to not have access to images that were from your own health system,” said Dr. David Huelsman, a physician and radiologist at TriHealth.
It wasn’t just a matter of better access to historical imaging studies. Physicians who ordered studies would often face long wait times for the results. In addition, they were often limited to retrieving images from a local workstation connected to a standalone PACS. This meant that when a patient’s studies were stored in multiple PACS or at different sites, it was difficult to review them at one time to gain a comprehensive patient view. Finally, TriHealth faced challenges in storing and archiving the large image files; once archived, the imaging studies were difficult to retrieve.
Dr. Huelsman is the radiology department director at one of TriHealth’s five hospitals. He is also the radiologist representative on the TriHealth Physician and Clinical Informatics Committee. “It was through those two roles that I quickly became the physician champion for an enterprise imaging project at TriHealth,” he says.
As it sought to improve clinicians’ access to patient imagery, TriHealth looked for a vendor-neutral archive with a zero-footprint universal viewer that would allow physicians and radiologists from across the system to access images from any location, in any format, from nearly any device. But simply upgrading technology was not enough. TriHealth wanted a solution that would help it tackle future issues, including its growing patient populations and an ever-expanding workload for radiologists.
Improve access by centralizing images
After an extensive RFP process that included system demonstrations from several imaging solution providers, TriHealth adopted the IBM Watson Health Imaging solution to centralize the storage of patient studies, provide physicians easy access to current and historical data previously disbursed across the network and facilitate image sharing within the organization. TriHealth selected Watson Health Imaging because it offers a full enterprise imaging solution integrated with AI.
“The AI piece is what cinched the deal for us — the way IBM and Watson Health Imaging saw the future of radiology meshed with our vision,” says Dr. Huelsman. “In my practice, a long-term vision is really important to understanding … where we’re going to be in 10 years. And having partners who share that long roadmap is really important to me as a practicing radiologist.”
The collaborative, patient-centric medical imaging system includes several key components that help TriHealth facilitate image management, sharing and analysis throughout its healthcare network. The IBM® iConnect® Enterprise Archive provides the AI-ready foundation of the system that lets TriHealth store and access images from a centralized, vendor-neutral archive (VNA). The Merge PACS™ AI-ready workflow platform simplifies how physicians read and access imaging studies across the healthcare organization. The solution helps streamline workloads, delivering the right study to the right reader at the right time. The IBM iConnect Access zero-footprint universal viewer facilitates real-time image sharing and exchange by web browser. It communicates with the electronic health record (EHR) to help provide a longitudinal patient view.
“The images are right there at your fingertips wherever you are,” says Dr. Huelsman. “Referring physicians love it because they’re able to show images to the patients. They’re not chained to a computer workstation. They can use their phone, their iPad. Wherever they are, they have access to the images at any time.”
TriHealth also plans to implement the IBM Watson® Patient Synopsis solution, a radiologist-trained AI tool that simplifies data extraction, pulling relevant patient information from the EHR in seconds — including current illnesses, medications and medical history. The tool offers accessible patient summaries that offer a clearer, more comprehensive patient view to help inform care decisions that get patients onto the road to recovery faster.
Dr. Huelsman appreciates the synergy between the iConnect Enterprise Archive — which uses the high availability and liquidity of data in the VNA to deliver the value of AI insights — and the Patient Synopsis tool. “The iConnect Enterprise Archive has given us a great foundation where everything’s stored and accessed the same way,” he says. “And then we can just seamlessly integrate the AI tool on top of that.”
To help ensure a successful solution implementation, TriHealth developed a full governance structure comprising executives, clinical leaders, a clinical action council, an information systems (IS) council and a senior executive leadership team. By working collaboratively among departments, including IS, to identify key challenges and needs, and by having a shared mission within the organization to improve patient care, the hospital system was able to undertake this significant technology implementation. According to Dr. Huelsman, it was critical to keep communication strong through the entire process and prepare for the next phase, when TriHealth is ready to upgrade the environment.
Lay the AI foundation for radiologists
After implementing the enterprise imaging solution from Watson Health Imaging, TriHealth migrated more than eight million image studies to the iConnect Enterprise Archive platform. These studies are also available for access within the TriHealth EMR, which allows radiologists, hospitalists, cardiologists and other providers to pull up a patient’s historical records and results along with the images. Clinicians can compare image studies quickly through a longitudinal patient record that provides a holistic view of the patient’s history, facilitating decision-making for future care.
Thanks to the centralized VNA and the iConnect Access universal viewer, radiologists can now read any study from any location and even from remote locations. This feature proved valuable during the height of the COVID-19 pandemic when, due to decreased imaging volumes, many radiologists across the system were working remotely. When a referring physician needed an image read, the remote radiologists, including Dr. Huelsman, could step in and read them from any location. “I didn’t need a VPN, so it didn’t take me five minutes to log on. I just logged on to the website, the zero-footprint viewer, and I’m already looking at the images.”
Dr. Huelsman has high expectations of how the AI-enabled Patient Synopsis tool will integrate with the already installed, AI-ready iConnect Enterprise Archive Platform to benefit the TriHealth system in the future. “Even if it’s the greatest AI tool, if it’s not well integrated into the workflow and the PACS, the radiologists are going to hate it,” he says. “That the Patient Synopsis AI is a simple mouse click is what really sold us and made us feel that IBM Watson Health Imaging was the partner we wanted as we jumped into the pool and headed into the future.”
When TriHealth implements the Patient Synopsis solution, its radiologists’ skill and experience will be augmented by IBM Watson AI technology. For example, because the solution simplifies data extraction, it can help minimize medical errors resulting from overwork or burnout.
“It’s not that AI is going to replace radiologists,” says Dr. Huelsman. “It’s that radiologists using AI are going to replace radiologists who don’t.” He notes that, like other healthcare systems, TriHealth wants to provide better care and a better patient experience while keeping costs low. “You can’t do that without harnessing technology,” he states. “Let the machines do what they’re better at, and let the humans do what we’re better at, and do it seamlessly.”
A shared vision and philosophy for innovation have driven the project from the RFP stage to the present time for both IBM and TriHealth. Both believe in using technology to save people’s lives, and in working closely together to bring the vision to fruition. In addition, Watson Health Imaging is focused on standards-based interoperability through vendor-agnostic adoption of new technologies, interoperability standards and Integrating the Healthcare Enterprise (IHE) profiles as a cornerstone of its solutions.
Dr. Huelsman concludes: “We’ve only scratched the surface of the potential of the IBM Watson Health tools. So we’re happy about the present and excited about the future.”
Established in 1995 as a partnership between Good Samaritan Hospital and Bethesda Hospital, Inc., TriHealth (external link) is a full-service, not-for-profit health system that serves the Cincinnati, Ohio area. Through five hospitals and more than 130 sites of care, TriHealth provides a wide range of clinical, educational, preventive and social programs. It is the fourth-largest employer in Cincinnati, with approximately 11,500 team members.
About Watson Health
Watson Health is a data, analytics and technology partner for the health industry. Supported by the innovation of IBM and intelligence of Watson, we are committed to helping build smarter health ecosystems. Through the combination of our deep industry expertise in health, data and analytics, actionable insights, and reputation for security and trust, Watson Health is working together with its clients and partners to help them achieve simpler processes, better care insights, faster breakthroughs and improved experiences for people around the world. Learn more at ibm.com/watson-health.
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