| The VA Midwest Health Care Network, VISN 23, is one of the Department of Veterans Affairs 21 Veteran Integrated Health Service Networks. VISN 23 serves veterans residing in a seven state area through a system of community based outpatient clinics (46), medical centers (11), nursing homes (7), and residential rehabilitation treatment programs (4). The states in the VISN 23 service area include Iowa, Minnesota, Nebraska, North Dakota, South Dakota, and small portions of Illinois, Kansas, Missouri, Wisconsin, and Wyoming.
Since 2006, VISN 23 has used a centralized PACS solution to electronically integrate all diagnostic imaging studies (CT scanners, MRI scanners, Ultrasound Systems, CR and DR systems, RF systems, etc.) across the VISN. To be readily accessible to the care provider in effective development and execution of treatment plans, VISN 23 utilizes state-of-the-art diagnostic modality equipment, digital technologies, and advanced telecommunications. The system, costing over $9M, consists of approximately 15 servers and 270 clinical and diagnostic workstations. Currently there are over 14,000 PACS users in VISN 23, and approximately 300,000 imaging studies are generated per year. Our primary implementation team consisted of over 40 members representing Radiologists, Imaging PACS Specialists, Biomedical Engineering, IT, and other personnel.
The VISN 23 radiologists have become even more involved with the affiliated physician for clinical decision-making at the beginning of a patient episode (for example, a shared care-coordinator role). Through this relationship, radiologists will coach primary care physicians on appropriate utilization of imaging technologies. Radiologists, as relative generalists who are familiar with important facets of patient care over a broad range of specialties, are able to assist primary care physicians with the triaging of patients to appropriate specialists real-time. A challenge for this new PACS system is the ability to provide imaging services to VISN 23 facilities at all times. This includes planned system maintenance; technology failures, including power; networking; and PACS Server malfunctions.
Biomedical Engineering Services within VISN 23 provide or coordinate provision of medical technology support. Included in this support is performance assurance of workstation equipment, including calibration of display monitors. |
| Past calibration technology has dictated that Biomedical Engineering Departments scheduled Preventative Maintenance programs for monitor calibration of diagnostic and clinical displays. Should these displays drift out of compliance during these periods, they often went unnoticed until the scheduled date. VISN 23 has implemented a continuous electronic calibration monitoring system that detects out of compliance displays, then immediately notifies the technical group of the drift and potential malfunction. The technical group responds to the notification in a proactive, timely manner. The scheduled Preventative Maintenance now serves to assure the calibration monitoring is within specifications and to assess overall workstation performance.
This presentation will describe and demonstrate the calibration system used throughout VISN 23. This real-time monitor calibration system uses SSMP to conduct frequent queries and SMTP for real-time notification from a centralized location. With over 270 workstations in 5 different states, this system has provided benefits to both the physicians and the technical support staff. Those benefits will be illustrated. Remote capability for calibration of diagnostic PACS monitors allows for efficient support, enhanced patient safety, and overall better patient care. |