Gwinnett Medical Center (GMC) is a not-for-profit healthcare network providing high quality facilities and services to Gwinnett and the surrounding community. With roots that go back over sixty years, GMC now includes two hospitals plus additional supporting medical facilities, with more than 4,100 employees and over 800 affiliated physicians. The hospital provides care to over 400,000 patients.

GMC has joined over 1,200 other hospitals in the 100K Lives Campaign to publicly commit to implement changes in care that have been proven to prevent avoidable deaths. In addition, GMC works with the Institute for Healthcare Improvement to rapidly test and implement meaningful, sustainable change within various healthcare areas.

For two of the last three years GMC has been designated a Distinguished Hospital for Clinical Excellence by HealthGrades, an independent hospital rating company.

The Project
GMC implemented the McKesson Picture Archiving System (PACS) to speed the acquisition and distribution of electronic medical images (e.g. MRIs, X-Rays) and patient records, thus enabling care givers to diagnose and treat conditions more quickly. To ensure that medical image data and electronic medical records are securely indexed, preserved and accessible in accordance with federal regulations, GMC implemented the HP Medical Archive Solution (MAS), a specialized content archiving appliance.

Previously, x-ray films  costly and time consuming to process  were stored in manila folders in a film library. Once filed, studies were often misplaced. And retrieving studies from the library could take hours, delaying diagnoses and treatment. With McKesson PACS and HP MAS, these issues were eliminated.

The PACS and archiving systems have delivered outstanding health and business outcomes:
 Reduced time to capture medical images and make diagnoses by an average of 20 minutes per study
 Helped achieve patient care quality in the top 5 percent in the nation, as ranked by HealthGrades
 Increased productivity of radiologists, who each save three hours per day through immediate access to electronic medical images
 Provided care giver access to x-rays and scans within minutes. Physicians no longer have to wait 15 minutes per study for films to be developed.

GMC implemented the McKesson PACS system and HP MAS to reinforce its focus on patient wellness and ensure compliance with federal data protection rules. These technologies, essential to achieving clinical excellence, underpin the following improvements:

 High Availability and Performance. The HP web-based archive solution provides performance reports and automated alerts that help optimize medical record availability and allow clinicians to continue reading images and treating patients. Gwinnett has eliminated service calls from physicians reporting slow access to images.

 Data Protection. Gwinnett is now better prepared for disaster recovery through real-time data replication. 

Using the HP MAS, Gwinnett stores two copies of image data, one at each of the hospitals two main data centers. The expandable archive with its grid-based architecture provides long-term storage for more than 350,000 imaging studies, or 11 to 13 terabytes of data, year over year. This scalability allows GMC to comply with federal regulations that require medical image and data retention for a minimum of seven years and up to 21 years. The solutions functionality also helps GMC comply with HIPAA privacy rules and implement policies for availability, confidentiality and integrity of records stored for decades.

 Efficiency. After migrating its entire cardiology and radiology image archives to the central HP MAS, Gwinnett was able to reduce its resources for managing and storing data by 25 percent. Gwinnetts data center operators now spend less time managing and storing DVDs and more time on business-critical operations. 

 Reduced Costs
   o The hospital no longer prints film, saving $775,000 per year.
   o GMC recouped its investment in HP MAS and McKesson PACS in just three years. 

 Productivity of Radiology Practice. Ready access to medical imaging saves GMC radiologists over three hours per day. Instead of waiting for films to be developed and hung for reading, radiologists now have immediate access to x-ray and MRI images and can read and dictate reports on the spot.

Previously, image capture and delivery on a rush order would have taken ten minutes. Now, in a normal use case, an x-ray or MRI is instantly transmitted to a radiology technician and, with a click of the mouse, the image is released to the radiologist.

Yes

Yes

The McKesson and HP solutions directly contributed to GMC being named a 2009 Distinguished Hospital for Clinical Excellence by HealthGrades. The designation is given to the highest scoring of the nations full service hospitals. In addition, the PACS and archiving platform have provided the following new advantages to clinicians and patients:

 Faster Time-to-Treatment. The key to the successful treatment of any illness or injuryfrom heart attacks to broken bonesis speed to treatment.

With McKesson PACS and HP MAS, GMC is able to capitalize on electronic patient information including radiology PACS (e.g. X-Rays, CAT scans, MRIs) and cardiology PACS that now can be captured and retrieved quickly and easily.

Instead of waiting 15 minutes for a single film to be developed, radiologists and attending physicians can access x-rays and scans, captured in digital form, within minutes. The time to capture images and make diagnoses has been reduced by an average of 20 minutes per study.

In one instance, a patient with a leg injury was brought to radiology for an x-ray. In the short time it took the patient to return to his hospital room, the x-ray had already been read by a radiologist and the results delivered electronically to his nurse.

 Quality of Care. By migrating medical records and images to a centralized archive, care providers across GMC have a foundation by which to share files for collaboration on patient treatment. All lab results and imaging examscurrent and priorare now available on a physician portal. 

GMC radiologists and care providers can access imaging exams and patients records remotely (via SSL VPN) from any computer in any location, improving responsiveness to patient needs. 

In 2009, GMC was named by Forbes as one of the 200 safest hospitals in the nation.

 New Model for Cost-effective Care. Secure online access to medical imaging has enabled GMC to bring aboard a teleradiology partner for nighttime radiology services, which relieved the burden on staff radiologists. Because remote radiologists serve multiple hospitals, teleradiology is a cost effective alternative to keeping a staff of radiologists on call in the evenings.

 Expanded Services. Owing to improvements in efficiency and imaging throughput, Gwinnett was able to introduce a new Outpatient Imaging Center and increase hospital revenue.

HPs technologies have helped us provide faster time to diagnosis and treatment for our patients. In addition, we can recoup patient payments faster and we are now more protected, efficient and compliant.
- Rick Allen, assistant vice president, Information Systems, Gwinnett Medical Center.

When were dealing with patients, the PACS system provides a more accurate and timely diagnosis compared to the old film method. Its better for the patient.
- Richard Zellmer, M.D., Gwinnett Medical Center

The HP MAS interface is Web-based and easy to use. It provides graphs, charts, performance reporting and email alerts. HP MAS lets me know when something is going wrong so I dont have to worry about checking the storage grid or looking at logs. It saves me time.
- Clay Combs, lead network administrator/storage administrator, Gwinnett Medical Center

An early adopter of PACS and the first to implement HP MAS, Gwinnett is leading the way to a National Electronic Health Records system. The 2005 implementation of a central archive for electronic medical records and imaging studies has yielded exceptional health outcomes, as verified by HealthGrades, which placed Gwinnett in the top five percent in the nation for clinical excellence two times in the last three years.

The investment in technology to capture, archive and secure medical data and images created a daunting management challenge for the GMC IT organization. In a three year span, the hospital acquired:
 300 new servers, augmenting its existing pool of 50 servers
 100 terabytes of fiber channel SAN primary storage to supplement 1 terabyte of local attached storage
 20 terabytes of storage for disk-to-disk backups
 An LTO-2 tape library equipped with 700 tape cartridge slots for disaster recovery

Because Gwinnett chose open and flexible solutions that would be easy to implement and manage, a 20 percent increase in staffing (mostly allocated to Application Support) was sufficient to administer the massive growth in IT.

Healthcare is a market that operates on extremely thin margins. Every capital project competes for scarce funds. To secure capital, the medical archive project had to deliver greater health and business outcomes than investments in surgical equipment, MRI replacements and capacity additions. Improved quality of care, lower costs and revenue growth from an expanded imaging business made a strong business case for HP MAS.

A second obstacle to the projects success was the initial opposition of business stakeholders to duplicating medical records (and costs) in primary and secondary data centers.

When Hurricane Katrina hit the gulf coast in 2005, destroying the medical records of many in the region, the disaster drove home the importance of backing up and securing patient information. Without access to evacuee health and prescription information, community hospitals found it difficult to provide timely treatment to patients displaced by the storm. 

Hospital administrators took to heart the lessons of Hurricane Katrina and now fully embrace the IT organizations disaster recovery measures. GMC is presently establishing a tertiary off-site disaster recovery center to further safeguard medical records and assure high availability.

Exceeded

The success of PACS and HP MAS in improving performance within the radiology department led to other specialties at Gwinnett requesting the same service. The hospital therefore expanded its electronic archive to encompass imaging for cardiology, obstetrics (ultrasounds measuring contractions and monitoring fetal development) and sleep studies (measuring brain waves) as well as electronic medical records and nurses notes. Next, Gwinnett will digitize and archive pathology studies.

These major hospital applications archive data into the same central platform, improving care-giver access to patient information and reducing the cost to capture, transmit and manage data.

Gwinnett is among the countrys top hospitals leading the way to a National Electronic Health Records system  a first-term priority for the Obama administration. The Gwinnett system has already proven itself by streamlining healthcare workflows, cutting costs, reducing preventable medical errors and advancing clinical excellence. Gwinnetts success will likely influence other hospitals to adopt PACS and a central archive platform and hasten the creation of a National Electronic Health Records System. Such a system will provide patients and their care providers with ready access to life saving health information.

The PACS and archiving systems earned early acceptance within the radiology department, where the anticipated benefits were clearly understood, but other care providers throughout the hospital also embraced the solution almost immediately. The hospital began digitizing prior studies and pulling in new images in first week of implementation. By week two, stakeholders were retrieving medical imaging from the archive.