Prescribed Computing for Care Providers™

On-demand Technology Powers Virtual Teleradiology Business

Veteran radiologist launches new virtual radiology group practice, generating nearly $3 million in revenue in first year

In September 2008, Dr. Steven D. Johnson formed his own radiology group practice

called Voyageur Radiology, LLC. He chose 7 Medical Systems as his teleradiology

technology partner to enable radiologists in the group to work more efficiently, so

they could work faster and handle a larger workload. With the right technology and

automation in place, Voyageur would build a virtual team of radiologists, leveraging

resources, time and sub-specialty expertise—creating a pool of radiologists across the

nation able to serve hospitals and clinics, especially those in rural, underserved areas.

1st yearLaunched virtual radiology group practice using 7 Medical on-demand teleradiology technology

~$3 millionRevenue generated in first year

30 minutesAverage turnaround time onradiology reports

15-30 studiesRead (final reports) in an hour, depending on modality/study type

12 radiologistsWorking full-time and part-time

14 sitesHospitals, imaging centers and clinics served

7 statesCovered and aggressively growing

SUCCESS STORY

MINNESOTA

CASE STUDY

Prescribed Computing for Care Providers™

Voyageur Radiology, LLC9975 Dellwood Road NorthStillwater, MN 55082(612) 230-6750

www.voyageurradiology.com

Founder: Steven D. Johnson, MD

Radiologists in the Network: 12Locations Served: 14States Served: 7Studies per Month: 12,000Studies per Year: 144,000Residents in Rural AmericaServed: 120,000+

RADIOLOGY SERVICES

• Preliminary and final reads• On-site and off-site• Daytime and nighttime• Over-reads• Consulting services

AREAS OF RADIOLOGY

• MRI• CT• PET/CT• Nuclear Medicine• CR• Ultrasound• Mammography (BSGI)

VOYAGEUR RADIOLOGYFAST FACTS

DEMANDS OF A GROWING, AGING POPULATIONRadiology is a technology driven field. New technologies (ultrasound, CT, MRI and

nuclear medicine) coupled with an aging population are driving higher demand

for imaging services. People 65 years and older use imaging services three times

more often than the younger population. According to the U.S. Census Bureau, the

population projected to be 65 and older in the year 2020 is expected to reach 53

million, a 50 percent increase attributed directly to the aging Baby Boomer generation.

Making matters worse, the American College of Radiology’s Commission on HR

reports that the number of new radiologists is increasing by only two percent per year.

This gap between supply and demand represents a critical shortage of radiologists

necessary to serve the imaging interpretation needs of the growing population—an

issue exacerbated in rural, underserved communities that lack the means to attract a

high-caliber workforce.

THE CHALLENGEIn order to meet the radiology interpretation needs of the Baby Boomer population,

Voyageur’s radiology group practice needed to meet the following objectives:

• Finding a cost-effective technology solution for automating workflows

• Coordinating workflow with hospitals and clinics for orders, priors,

documents and reports

• Integrating to disparate RIS/HIS/EMR/PACS systems

• Managing radiologist workload, schedules and orders coming from multiple

facilities using different PACS systems

• Delivering fast report turnaround times to improve quality of service and care

• Meeting on-site, off-site, daytime, nighttime and over-read coverage needs for

hospitals and clinics in rural America

THE SOLUTIONVoyageur subscribed to 7 Medical’s X-HIS™ Radiology Suite, a full-service, on-

demand solution for managing a radiology practice, including Teleradiology worklist,

PACS, advanced visualization, and revenue cycle management related functions. Using

a phased approached, Voyageur first implemented the Xi-Imaging™ Suite, which

allowed virtual radiologists full worklist access along with dictation and advanced

visualization to read from any location. The revenue cycle management was then

implemented as phase two of the solution.

On-demand Lowers Barriers to Entry and Reduces Start-up Costs.

7 Medical made the teleradiology technology available to Voyageur on an on-demand

or software-as-a-service (SaaS) basis. “7 Medical’s on-demand model allowed us to

avoid the huge upfront capital investment,” said Steven D. Johnson, MD and founder of

Voyageur. “We didn’t have to incur the costs to build a system, implement it and integrate

it ourselves. Instead, we were able to purchase a complete turnkey teleradiology solution

as a service for a monthly fee based on what we use, and we can scale as necessary.

Without 7 Medical’s on-demand solution, we wouldn’t have been able to get our business

off the ground.”

With 7 Medical’s solution, all service, support, maintenance and upgrades, backup and

disaster recovery protection, and HIPAA compliance are included as a part of the service.

Automated Workflows Key to Efficiency. 7 Medical’s solution is a single, integrated

technology platform for managing the radiology practice workflow. The X-HIS™

Radiology Suite saves time and money by automating the entire radiologist workflow.

As a turnkey solution, 7 Medical provides a clinical project manager and technical IT

experts to support installation and integration.

Prescribed Computing for Care Providers™

“7 Medical’s on-demand model allowed us to avoid the huge upfront capital investment. We didn’t have to incur the costs to build a system, implement it and integrate it ourselves. Instead, we were able to purchase a complete teleradiology solution from 7 Medical as a service for a monthly fee based on what we use, and we can scale as necessary. Without 7 Medical’s on-demand solution, we wouldn’t have been able to get our business off the ground.”

Steven D. Johnson, MD Voyageur Radiology, LLCX-HIS™

Radiology

Worklist

RIS

PatientHistory

Xi-View™Xi-View™ Pro

Dictation

PhysicianPortal

Orders auto processvia Web and mobile.

Patient documentscanning/association tocurrent worklist studies.

Order managementfor referring sites

and modalities in auniversal worklist.

2D/3D/4D thin-clientand Web viewer with cardiac,

oncology, and neurology,or use your viewer of choice.

Advanced voicerecognition provides

transcription, templating,and speech recognition

enablement options.

Referring physicians canview images and reports

from an easy-to-useonline portal.

Electronic Routing of Patient, Order and Report Information.

Voyageur uses 7 Medical’s X-Connect™ interface engine to integrate its telerad

system to a referring facility’s RIS/HIS/EMR. The interface engine receives standard

HL7 messages from RIS/HIS/EMR systems, translates the HL7 messages carrying

patient demographic (ADT messages) and order information (ORM messages) to

DICOM, and electronically sends these messages to the Voyageur telerad system.

Reports can be sent back to referring sites via email or fax. They can also be

electronically interfaced back to referring HIS/RIS/EMR systems through an

optional interface for ORU message types.

Intelligent Telerad Gateway Server. An Xi-Gateway™ server is installed at each

facility. The Xi-Gateway is the “smarts” of the system, providing intelligence and

rules for the routing and management of patient images from hospitals, imaging

centers and clinics to Voyageur radiologists for interpretation. The gateway is also

the communications link between referring sites and 7 Medical’s data center, the

hub of the teleradiology technology platform. Together, 7 Medical’s data center and

the gateway centralize and manage all digital images and communications from

multiple modalities and multiple locations into a single, integrated system.

Radiology Information System. Voyageur can offer referring sites access to

7 Medical’s X-HIS™ RIS, which makes order entry, management and dictation

easier on the radiologists by electronically sending order information. Once the

data is entered, the RIS auto-populates the worklist, dictation system and report

with order information, saving time and reducing data entry errors. For radiology

groups doing their own billing, patient and order information from the RIS can be

electronically interfaced to billing systems.

Document Scanning. Document scanning software allows Voyageur to receive

prior studies, reports and notes from referring physicians to accompany the current

study—even when no electronic order entry is available. Scanned documents are

matched to the corresponding patient study in the worklist. Facilities using RIS/HIS/

EMR systems can use the print command to create and attach electronic documents.

“Having one centralized worklist is orders of magnitude more efficient than trying to coordinate orders from several facilities and multiple systems,” said Dr. Johnson. “We’re able to reduce our turnaround time by 60% leveraging X-HIS™ and Xi-Imaging™ platform. We wouldn’t be able to accommodate those kinds of volumes without 7 Medical’s technology.”

“7 Medical takes care of the technology and revenue cycle management functions so we can focus on delivering core radiology services to patients. The teleradiology technology, workflow coordination and RCM services enable us to work more efficiently, read larger volumes and handle larger workloads.”

Xi-Virtual Worklist™: A single, centralized worklist shared by all radiologists.

Single, Centralized Worklist. The radiologist virtual worklist

automates radiology workflow by allowing Voyageur to manage all

orders coming from multiple facilities and modalities in a single,

integrated view—no need to bounce around between different

systems. “All the radiologists in our group work from one central

worklist queue, which makes us more efficient, and helps us

manage and track the status of all orders and where they are in the

process,” said Dr. Johnson.

“Having one centralized worklist is orders of magnitude more

efficient than trying to coordinate orders from several facilities

and multiple systems,” said Dr. Johnson. “We’re able to reduce our

turnaround time by 60% leveraging X-HIS™ and Xi-Imaging™

platform. We wouldn’t be able to accommodate those kinds of

volumes without 7 Medical’s technology.”

The worklist provides all patient information, including current and

prior studies, reports, physician notes and scanned documents from

HIS/RIS/PACS systems. Worklist views are customizable and provide

one-click access to patient images and voice dictation. The Web-

based worklist is accessible anywhere, anytime through an Internet

connection.

Workflow Coordination. A critical component of the X-HIS™

Radiology Suite is workflow coordination. Workflow coordinators

are the human interface between referring sites and the radiologists.

“The workflow coordinators are a critical part of the process,” said

Dr. Johnson. “They monitor and manage the worklist to ensure

that orders are received complete with all of the images, order

information, priors and documents necessary for us to read the

studies. That allows us to focus on reading more studies.”

Xi-View™ Pro - Thin Client Viewer. Voyageur uses a 2D/3D/4D

Web viewer that supports a full spectrum of advanced visualization

applications and modalities. Thin client technology streams pixels

over the Web for instant viewing from any radiology workstation,

anywhere. Extremely fast processing techniques can display

a 2000-slice series in as little as three seconds. The X-HIS™

Radiology Suite is also flexible enough to work with a radiologist’s

viewer of choice.

Dictation with Advanced Voice Recognition.

To maximize efficiency, Voyageur uses advanced voice recognition

software for dictation. “The dictation piece was also key,” said Dr.

Johnson. “Patient and order information is pre-populated into

the report template, so there’s no need to re-enter or dictate that

portion. The voice recognition dictation system automatically

transcribes as we dictate, which makes the process faster and allows

us to speed up turnaround times.”

Physician Portal for Referrers. With 7 Medical’s physician

portal, referring physicians and staff can log in to see the status of

the orders and reports, eliminating the need for calls to Voyageur.

Referring physicians can also view digital images and related

diagnostic reports on any Web browser. Reports can be delivered

via secure email or fax. Workflow rules can be configured to send

notifications to referrers via email, fax and text messaging when

reports are ready for viewing.

Efficient Revenue Cycle Management. In phase two of the

project, 7 Medical implemented a revenue cycle management

(RCM) solution including coding, billing and collections. The RCM

solution is integrated to the X-HIS™ Radiology Suite so that patient

and order information are sent electronically between the telerad

system to the billing system. Tighter integration between the two

systems enabled Voyageur to further reduce business office/billing

system costs by an additional 20 percent.

Delivering Flexibility for Referring Sites. With 7 Medical’s

telerad technology in place, Voyageur was able to focus on

delivering quality diagnostic radiology and consulting services

to referring sites. All hospitals and clinics have to manage some

combination of on-site, off-site, daytime, nighttime and over-

read coverage. For rural facilities it’s even harder to attract the

high-caliber workforce available to their counterparts in large

metropolitan areas.

Physician Portal for Referring PhysiciansXi-View™ Pro - Thin Client Viewer

“Hospitals and clinics benefit from having access to our pool of

radiologists to cover and manage varying schedules and workload,

and all radiologists in our group have full access to our Web-based

telerad system from any remote location,” said Dr. Johnson. “In

practice, we’re seeing a mix of coverage needs, and we’re uniquely

positioned to provide some combination of on-site and remote

reading services, depending on what our referring sites need.”

THE OUTCOMEAmidst an economy when businesses are reporting lackluster

performance at best, Voyageur is enjoying a boom of unprecedented

demand and growth. The company closed nearly $3 million in

revenue in its first year. The 12 full-time and part-time radiologists

who joined Voyageur’s virtual radiology group practice in the first

year read 12,000 studies a month. Voyageur is providing reading

services to more than 14 hospitals, imaging centers and clinics in

the Midwest, serving the diagnostic radiology needs of communities

totaling more than 120,000 rural residents spanning seven states.

With the telerad technology, Voyageur radiologists enjoy flexible

schedules and are able to work on-site at referring facilities

and remotely. They are able to access the virtual worklist from

anywhere, anytime and take advantange of the 2D/3D/4D Xi-View

Pro thin-client viewer to provide the highest quality of service and

care to patients. The integrated voice recognition dictation system

enables radiologists to dictate and work faster. The entire telerad

solution enables Voyageur to deliver the fastest turnaround times—

an average of 30 minutes for a typical study, day or night.

“7 Medical takes care of the technology and revenue cycle

management functions so we can focus on delivering our core

radiology services to patients,” said Dr. Johnson. “The teleradiology

technology, workflow coordination and RCM services enable us

to work more efficiently, read larger volumes and handle larger

workloads—I can see how the X-HIS™ Radiology Suite has the

potential to help radiologists read more studies to help offset the

shortage of radiologists.”

CSVR063016

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To learn more about X-HIS Radiology Suite, call us today.800.440.7119, option 3 | info@7medical.com | www.7medical.com