Orthopedists offer their advice for implementing a digital system

Issue: July 2006

When practices are choosing a digital imaging vendor, they often seek advice from others who already have a system in place. Orthopedics Today compiled some “words of wisdom” from surgeons well-versed in the process of vendor selection on how to survive implementation.

Consider the reputation of the vendor.

Peter R. Kurzweil, MD, of the Southern California Center for Sports Medicine in Long Beach, suggested that practices look beyond price and consider whether the vendor has staying power to support the product for several years into the future.

Peter R. Kurzweil, MD [photo]
Peter R. Kurzweil

“Consider what advanced applications the system has to offer and the possibility that you might be stuck with a system that will not grow with your practice,” Kurzweil told Orthopedics Today. “Orthopedic practices are changing. Your equipment should be able to change with you.”

Choose a vendor that offers a Web-based picture archiving and communications system (PACS).

Kurzweil suggested that practices look for as much online and spinning disc storage as possible. “This will facilitate getting old studies quickly,” he said. “Also, you need to size your archive to what you anticipate your volume will be.”

Employ an expert IT consultant.

Paul D. Hartleben, MD, a spine surgeon at Summit Orthopedics Ltd. in St. Paul, Minn., said an expert and trustworthy information technology (IT) person – either within the practice or outside the practice – is key to implementation.

“Going digital with an electronic medical records (EMR) or PACS system is a very big project,” Hartleben said. “It takes dedicated IT staff, a dedicated group of doctors and a large enough group that can afford to do it.”

Integrate the office digital imaging system with those in nearby hospitals and surgery centers.

“Unfortunately, many hospitals and surgery centers do not [yet] have the capability to connect to an outside PACS system,” Kurzweil said. “This will change with time, and our group is certainly encouraging this to occur in the ORs.”

He also said to ensure the system could meet the practice’s security and Health Insurance Portability and Accountability Act requirements.

Choose a vendor that already integrates with an EMR system.

Hartleben’s group chose their PACS vendor based on its integration with the EMR system their office already used.

“After using an EMR system and looking at all the peripheral software that goes along with it and all the things we want to record, it’s difficult if you buy from vendors that don’t integrate already,” Hartleben told Orthopedics Today.

Sample the program and visit practices with digital systems in place.

“Send some of the most technology-advanced partners out to the sites so they can come back with good advice,” Hartleben said.

Consider strategic alliances with another practice.

“You may not need your own PACS and may be able to achieve all you want by leveraging someone else’s investment,” Kurzweil said.

Have younger physicians work with the older physicians who may be hesitant.

In Hartleben’s group, older physicians nearing retirement were not as enthusiastic about switching to digital imaging.

“What helps is having the younger [physicians] work side by side [with the older colleagues] and show them the advantages [of the system],” he said. “I think that’s an obstacle and probably the hardest one to get [the systems] to be fully functional.”