CIOs Must Match RIS Decisions With Facility Priorities

With Meaningful Use regulations yet to address images and provide clear direction, CIOs face competing priorities in making choices about institutions' Radiology Information Systems.

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Radiology information system (RIS) decisions are being pulled in three different directions depending on a facility's priorities, according to a recent KLAS report, "RIS in the Middle: The Integration Tug of War." Those directions include:

-- An integrated RIS/EMR strategy where data is housed on a common clinical platform -- An integrated RIS/(Picture archiving and communication system) PACS for the imaging department -- A feature-rich standalone RIS solution capable of being implemented and interfaced within the existing environment

Some in radiology believe that an integrated RIS/PACS setup is a silver bullet, marrying integration with end-user functionality, finds KLAS. On the other hand, IT administrators push for RIS/EMR solutions in order to build a patient-centric workflow across the organization. Both strategies have pros and cons, and both must still have an interface -- either the RIS/PACS to the EMR or the RIS/EMR to the PACS, the report finds.

On the inpatient side, "really the strategy that most folks are going with is an integrated platform or at least single vendor platform. That tends to be the most common trend, but it doesn't mean that standalone RIS aren't out there or integrated RIS/PACS with a different clinical vendor," said Ben Brown, general manager of medical equipment and imaging informatics at KLAS. "But most provider organizations prefer to have -- just from a patient-centric and quality-of-care perspective -- access and context to patient information. Prior history of other exams and integrated EMR/RIS with tight interfacing is the prevailing trend."

Community hospitals and ambulatory organizations tend to be a mixed bag of standalone solutions, integrated RIS/PACS, and integrated RIS/EMR, Brown found. Sixty-three percent of respondents indicate their RIS has the necessary functionality, but providers list four key functionality items on their RIS wish list:

-- Management reporting tools -- Flexible scheduling -- Rollout of promised mammography tools -- Critical test results management (CTRM) functionality

Among the twenty-three RIS solutions tracked in the report, Epic Radiant ranked number one for large hospitals (200+ beds) with an overall performance score of 82.0 out of 100. Siemens syngo Workflow and McKesson Radiology Manager ranked second and third, respectively.

Organizations offering RIS, PACS and EMR are GE, Cerner, McKesson and Siemens. Those offering RIS and EMR with no PACS are Epic and Meditech. "A top-to-bottom EMR/RIS/PACS strategy, not everyone has it -- Siemens and Cerner can tell that story; McKesson can tell that story -- some have tighter integration than others. Epic only has EMR and RIS, and Meditech has RIS and EMR as well."

Other vendors covered in the study include Avreo interWORKS and NovaRad NovaRIS, which tied for the highest score (83.3) in the community hospital market segment, with GE Centricity RIS-IC taking the third highest ranked position.

FUJIFILM Synapse Information System was the highest ranked ambulatory RIS system with an overall score of 87.8, followed by Swearingen Software RISynergy in second place and MedInformatix RIS in third.

And while the initial Meaningful Use regulations haven't addressed the world of images, Brown said that certainly won't last forever. "With Meaningful Use, and what will come out in Stages 2 and 3, I think integration and easy access to patient information, patient care and quality are all going to be drivers, so having an integrated system is where most people have their focus long term."
Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at [email protected]

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