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TPD’s Review of the RIS/PACS Relationship
By The PACS Designer
As hospitals try to get more efficient, it would be a good time to review what the Radiology Information System (RIS) and Picture Archiving and Communications System (PACS) can bring to the institution when it comes to efficiency.
First, let’s review the imaging piece, which is PACS. The main purpose of the PACS is to digitize image files for easier access and increased image sharing. While a PACS is a significant change, it does start to improve processes through more rapid access to image files. The PACS also encourages the sharing of image information with other departments.
Next, the acquisition of a PACS can be a significant draw on financial resources, as it will require workstations for each radiology department member, and other need-to-know individuals who require image file access privileges.
Weighing the cost against the benefits of a PACS, the institution can reduce film and chemical costs with a PACS, and also improve process flow for patients through quicker access to image files. These improved results have to be weighed against the financial outlay that has to be made to bring digital imaging to Radiology.
Now, adding a RIS to a PACS can further improve the scheduling of patients for Radiology procedures. The RIS allows efficient scheduling to take place through its automating of the scheduling software. The software can also highlight potential bottlenecks to alert staff to a looming problem.
The RIS lets everyone know what each radiologists workload is, and how fast equipment can be used to take advantage of each equipments efficiency features.
Another benefit of adding a RIS to a PACS is the bi-directional flow of patient information after procedures are completed and sent back to the RIS for staff review and planning.
In summary, a RIS/PACS configuration can bring great value to the Radiology imaging process, and help reduce costs overall after careful redesign of existing processes.
Awards For Sale?
By Randall Swearingen
KLAS recently named its “Top 20 Best in KLAS Awards: Software & Professional Services 2009” report. Before I list my concerns, you need to understand a few basic points about KLAS.
Their main award is the “Best in KLAS” award. It is supposed to be awarded to the vendor with the highest customer satisfaction scores in a given category (i.e. the best vendor). To be “Best in KLAS”, there has to be a minimum of three non-asterisked vendors in a given category. Vendors are asterisked when they have less than 15 customer surveys because KLAS doesn’t consider the data reliable. In addition to their “Best in KLAS” award, KLAS also has “Segment Leader” awards for those vendors whose categories don’t qualify for “Best in KLAS”.
It is important to note where KLAS gets their revenue because it seems to indicate a conflict of interest between serving the healthcare industry and serving the healthcare vendors. One source of their revenue is from selling their reports to hospitals, clinics, consultants, vendors, etc. Since hospitals and clinics can get free reports by completing just one vendor survey, very little revenue comes from them. The bulk of KLAS revenue comes from vendors. Vendors pay KLAS to survey enough of their customers to get the asterisks removed their products. That isn’t cheap.
KLAS further encourages vendors to pay to have the asterisks removed from at least two of their inferior competitors so that they can be eligible for “Best in KLAS”.
KLAS also charges vendors an annual fee to view KLAS data (including their own). The fee is calculated as a percentage of that vendor’s annual revenue. Thus, larger companies pay more than smaller companies to view KLAS data.
Of course most vendors elect not to pay KLAS, which is why most products are asterisked in their database. But, those who do pay and who are awarded “Best in KLAS” play the award up big time in ads, trade shows, etc.
See the conflict of interest yet? Isn’t the purpose of KLAS to identify and reward the best vendors on the basis of customer satisfaction? Not based on how much a vendor pays?
Back to this year’s report. As a radiology information system vendor, I went straight from the e-blast to review the radiology winners. The “Segment Leader” in the Radiology Ambulatory category this year went to a vendor who happens to be asterisked. Upon reviewing the report, I contacted one of my customers, who has a KLAS account, and asked them to compile some KLAS data for me. Turns out that the winning vendor had scores that were slightly better than those of Swearingen Software.
I then turned my focus to the Radiology Small category. Swearingen Software had the highest scores in the Radiology Small category in all three sections (PRIMARY INDICATORS, DETAIL INDICATORS, and BUSINESS INDICATORS) but the “Segment Leader” award was given to a vendor whose scores ranked seventh out of the10 vendors in all three sections! If you have a KLAS account, you can easily verify all of this information. In the KLAS e-blast, they did not disclose how the “Segment Leaders” were selected or that it doesn’t necessarily go to the vendor with the highest scores.
I felt compelled to dig deeper, so I asked my customer to review the “Segment Leader” section of the report and look for any clues that might explain this action. My customer informed me that upon close inspection of the Top 20 KLAS report on their Web site, a small note is shown below the “Segment Leader” chart which states: “Other solutions must have at least two products that meet the KLAS minimum for statistical confidence in order for a product to earn category leader status.” (That means having a minimum of two non-asterisked products somewhere in KLAS).
OK. So let me get this straight. It’s possible for a vendor to have two non-asterisked products (even if they are the absolute worst scores in their respective categories) AND they can have the absolute worst score in a different category AND they can still win the “Segment Leader” award for that category. Remember, vendors have to pay to get their asterisks removed. Hmmm. What happened to the concept of the award going to the vendor with the best scores?
Simple questions: who monitors KLAS? Who audits them? What independent source verifies their data to make sure it is accurate and fairly represented since they seem to have influence over some buying decisions? Answer: nobody.
I think the “Best in KLAS” award should be renamed to the “Deep Pockets” award. It would be more fitting.
Randall Swearingen is founder and CEO of Swearingen Software, Inc. of Houston, TX.