We needed a way to consolidate this image data and make it universally available across our distributed network of hospitals.”
- Dan Baldock, Senior VP and CIO, Banfield Pet Hospital
Banfield Pet Hospital was challenged by all of its digital x-ray and ultrasound images stored locally at each of 500 disparate locations across the country. They had no way to share those images among all of the 780 Banfield pet hospitals. There was no backup or disaster recovery plan in place, so the medical data was at risk of loss if a hard drive failed. Telemedicine (getting a second opinion from a radiologist working remotely) was slow, expensive, and many veterinarians were not taking advantage of the service to improve patient care. “We needed a way to consolidate this image data and make it universally available across our distributed network of hospitals,” said Dan Baldock, Senior VP and CIO of Banfield Pet Hospital.
Banfield Pet Hospital is a network of 780 veterinary hospitals located throughout the United States. Banfield partners with PetSmart, the nation’s largest pet-related retailer, and operates pet hospitals inside PetSmart stores.
First Step: Centralize and Protect Digital Images
To solve these challenges, Banfield implemented a centralized PACS system (Picture Archiving and Communication System) at its headquarters in Portland, Oregon. They selected the open source software ClearCanvas as both the back-end archiving system and as the front-end viewer. Banfield had the support of the team at ClearCanvas and leveraged their existing in-house resources and expertise to develop and deploy the system. The only additional staff they needed to hire was a single PACS Administrator to aid in the setup and ongoing administration of the system.
Banfield set up the infrastructure for all 500 digital x-ray and ultrasound machines across the country to transmit images over a WAN to their centralized servers for long-term storage. They set up redundant, mirrored server and storage infrastructure with daily and monthly backup processes to protect the data. In addition, once that data was centralized, they implemented a disaster recovery plan for failover to a remote site in Arizona. Now the medical imaging data (x-ray and ultrasound images) is protected and readily accessible.
Data centralization also allowed Banfield to implement nationwide image sharing. Many clients are very mobile across the country. The hospital has countless stories of truckers that drive nationwide with their pets or snowbirds that go south with their pets for the winter. Having the ability for images taken at any Banfield hospital to be viewed with the click of a button at any other Banfield hospital has improved dramatically the continuity of care their veterinarians could provide.
Second Step: Telemedicine
With the foundational PACS system in place, Banfield then implemented a robust telemedicine system. To do this, they custom-built a RIS system (Radiology Information System) to track the requests for telemedicine consults, allow the radiologist or other specialist to view the cases, and communicate the consultation results back to the requesting veterinarian and team. They partnered with various veterinarian telemedicine vendors, even designing a custom integration with one to send cases that could be read in their existing system.
By building this RIS system, they were able to improve the turnaround time of telemedicine consultation results getting back to the hospital to an average of 30 minutes for STAT cases (emergency cases) and 90 minutes for routine cases. Historically the turnaround time was hours to days. This made an enormous impact at the point of care for the veterinarians and their clients and patients to have a specialist give a second opinion as needed on a case to improve the treatment decision-making process.
In the end, Banfield was able to save millions of dollars in the first few years by selecting the ClearCanvas technology and leveraging their existing resources. Since the initial implementation, they have also expanded the PACS system to include digital dental x-ray images after adding 60+ digital dental x-ray units to its hospitals. The system was built to be very scalable so they could add different types of imaging equipment and allow for the growth of new hospitals. Banfield has been opening about 50 new hospitals per year and will continue to do so. They are also in the process of implementing another feature, DICOM CD burn, using another ClearCanvas product. “The solution we chose has really allowed us to grow in many directions,” added Baldock.
Next Step: Integration with EMR
The future for PACS, RIS, telemedicine and all imaging systems at Banfield Pet Hospital holds even greater promise. The next step is to integrate the imaging systems with Banfield’s proprietary EMR (electronic medical record system) called PetWare. The goal will be to integrate images that reside in ClearCanvas PACS and radiology telemedicine consultation results directly into the EMR. The solution will also allow them to integrate images into their client/patient portal system, so clients can view their pets’ images.
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