In order for an imaging department, IT department, and hospital system to continuously provide care, the staff must remain relatively intact and unaffected by the outside world. This includes the intense focus on patient care required during the current Coronavirus and COVID-19 pandemic which is in full outbreak mode. This event is forcing everyone to work differently.
We wanted to provide a quick checklist of topics that many imaging providers are implementing to help address this COVID-19 pandemic. This list is not meant to be all inclusive, rather the intent of the article is to prompt additional thoughts and discussions on these topics.
Radiologists and Cardiologists should be reading from home to minimize exposure.
- Sufficient home bandwidth. 1gb connection is recommended.
- PACS network outside the hospital (VPN / SSL / extend the network to the client)
- Additional VPN connections may need to be licensed by the VPN provider.
- Potentially deploying SSL servers – if PACS supports it.
- You may need additional DNS entries to allow integration, authentication paths
- RIS/PACS workstation integrations (ex: PowerScribe, Epic, Cerner)
- High performance PACS workstation with video card matched to diagnostic monitors to ensure performance.
- Diagnostic monitors – must be calibrated and maintained. Do not use “Clinical Review” monitors. They don’t meet performance specs, nor calibration specs. They are dangerous. See my other post, Dangers in Radiology, for more information.
- Controlled reading environment at home. Quiet, comfortable, ambient light control – dark room.
- Don’t have the capabilities with your PACS? No worries, please keep reading.
Quickly deploy a Cloud PACS solution for remote reading solutions.
- Many cloud service providers can deploy their solution the same day.
- Many are paid per study sent, so you can leverage them as a downtime or backup solution.
- Flexible reading options:
- Send routine and less critical reads to the cloud for a reliable remote reading option.
- Critical reads (ER, ICU, Trauma) could remain on-site.
- Cloud PACS could be used to provide a quick prelim and all finals could be onsite.
- Integration with Dictation is also included.
- Quick deployment options are available for reporting, faxing, and documentation.
Implement image sharing solutions to keep patients from coming to the hospital to get their studies.
- Cloud based image sharing solution that allows the patient to receive data without coming into the hospital.
- Data resides outside the cloud for improved security – nothing is resting in the cloud.
- Multi-factor authentication is required.
- Patients should be allowed to access and request their imaging history on demand, through their patient portal.
Allow patients to cancel or reschedule their exams via their patient portal.
- Many systems do not allow patients to cancel or reschedule imaging exams via their EMR patient portal.
- This will free up scheduling phone lines, triage lines, and scheduling staff and in turn would reduce red tape.
- The schedule can always be reviewed and approved by a scheduler.
Engage staffing agencies at all levels.
- Engage Teleradiology and Telecardiology providers and use as overflow. There are many providers like VRad or Night Hawk that can accommodate most needs.
- Engage mobile imaging service providers. CT especially. Equipment failures happen, you need to have a backup solution.
- Rad Techs, CMA, CNA, LPN, RN, etc. – Most staffing agencies will reserve staff with a retainer. Hospitals should be doing this immediately.
- This will ensure that you are not left looking for staff!
Radiology and Cardiology leadership must be available 24 x 7.
- Direct reports should have multiple paths of access to contact the managers and directors. Cell phone, Spouse’s Cellphone, Email, FB messenger, FaceTime, Home address.
- Helpdesks must have updated contact information, and backup contact information.
- Leadership should have proficient knowledge and training on remote access to critical systems.
- Hospitals should provide communication devices including workstations, laptops, cell phones, pagers (yes even pagers) for home use.
Business continuity plans should be reviewed. NOW!
- When it rains, it pours. Make sure you know what to do when IT or PHONE systems are down and a high % of the staff is out sick.
- All departments in IT and Operations should be reviewing their plans and posting and printing them.
- Unfortunately systems go down, and accidents happen. Know what to do with IT contingency planning.
- Note: There should be no requirements on any individual person in order to run any particular plan. The plans themselves should include instructions and directions as to whom will be making leadership decisions.
- Everyone is responsible to know that there is a plan, and how to access the plan.
- The plan should be fluid, reviewed periodically, and updated often according to technical and operational changes needed.
We have talked to a lot of hospitals and imaging professionals over the past few weeks, and we have heard that these gaps exist in multiple organizations. We are certain that there are many other issues or concerns that could be added to this list. Feel free to add your thoughts and comments.
Thank you, and we pray that everyone is safe through this pandemic. Thank you for doing the amazing work you do to minimize the impact of this terrible virus.
Note: HealthCare Tech Solutions provides industry leading consultants on enterprise medical imaging IT and operational projects. We are careful not to take advantage of this situation, but are offering our services to assist with COVID-19 strategic planning, implementation, and support.