Northwest Health | WINTER 2009 By Ellen Langley

It was no bigger than a button, but Chris Randolph saw it clearly on her daughter Cambria's CT scan. The white dot deep in her child's abdomen was a ruptured appendix. The 13-year-old had entered a Group Health Urgent Care Center in Seattle with a stomachache. Now she was facing surgery with pediatric specialists at another Group Health location.

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Enter Group Health's new picture archiving and communication system (PACS). Using this digital tool, the off-site surgeons studied Cambria's abdominal scans on their computers before the family even left Urgent Care. "The pediatric team was waiting to rush Cambria into the operating room the moment we got to the hospital," says Randolph.

PACS stores digital images from X-rays, CT scans, MRIs, ultrasounds, and other diagnostic modalities and transmits them so they're included in your electronic medical record and shared online among your physicians at Group Health medical centers. The images can also be stored on a CD to share with other clinicians involved in your care.

"This is an absolutely fantastic system that makes us better doctors," says Radiology Service Line Chief Bob Karl, MD. "Any Group Health radiologist can read images from any Group Health medical center, using any Group Health computer — or even from home, after hours. It helps us prioritize urgent cases and get results in time to make a big difference to patients, especially those in remote medical centers."

Diagnostic Images While You Wait

Most imaging results are reported within minutes, says Dr. Karl. "Patients don't have to get dressed and wait, or drive home, only to be called back for further treatment."

Personal physician David Kauff, MD, at our Downtown Seattle Medical Center, says "the beauty of PACS is how it allows integrated care in real time." Smaller facilities such as his can coordinate more quickly and seamlessly with larger specialty centers by using PACS.

Instead of waiting several hours or days for hard-copy images to wend their way through processing and evaluation, "we can take an image, get a prompt reading by an off-site radiologist, and then set up an immediate conference call with the right specialists. The patient is there in the room, and everyone is looking at the same pictures as we develop a treatment plan," says Dr. Kauff.

"When I treat people with sports injuries, I tell them that our streamlined approach is on par with the service available to professional athletes," he says. While PACS is available throughout the country, most physicians don't belong to a large multispecialty physician team like Group Health's. That, combined with Group Health's sophisticated electronic records system, makes PACS really shine.

Features That Help Doctors Help Patients

Family physician Barbara Detering, MD, recently saw a patient for pneumonia follow-up after discharge from an Emergency Department. "The original film was viewed by the urgent care physician, who didn't spot the pneumonia. The radiologist who read the film saw the pneumonia and circled it, so the patient and I could easily locate the subtle finding."

Another key feature of PACS is its capacity to consolidate the hundreds of individual images that make up a CT scan. The result is a clear, 3-D composite image that makes more visual sense to patients, especially when key areas are magnified to show greater detail.

"I love PACS, and my patients are really wowed by it," says Dr. Detering. Dr. Karl especially appreciates the voice recognition program that works with PACS. "I can dictate my findings into the computer while I'm looking at a patient's pictures. That voice recording is quickly converted to text for the electronic medical record."

Added Benefits in Complex Cases

Surgeon Amy Harper, MD, sees the benefits of PACS grow with the complexity of a patient's case. While her office is at Group Health Capitol Hill Campus in Seattle, and her outpatient surgeries are done there, she performs inpatient surgery on Group Health members at Virginia Mason Medical Center. "Virginia Mason has a PACS system that can interact with Group Health's PACS technology," she says. "No matter which operating room I'm in, my patient's digital images are up on a screen when I go into surgery."

Tracking changes over time is important in oncology, says Dr. Harper. "So having the patient's full image history at our fingertips is extremely powerful. Nothing beats the feeling my patients get when they see photographic proof that they are making positive progress."