Facilitating mobile technologies and telemedicine
With many of the original glitches resolved, the main focus for technology has become a matter of figuring out how much information can be put in the hands of the physician and the referring physician and the quality of that delivered information.

"Those images are often used by the referring subspecialist as they attempt to determine the appropriate treatment path," says Long. "I think that if you go back in time, PACS were designed more around diagnostic use, but the real key now is tying in the diagnostic process with the treatment process."

Better access is essential, but just as important is the user-friendliness of the technology.

"The worst thing that can happen is to spend all this money deploying a system only to have the physician say, 'It's too hard to use. I don't like it. Give me the film,'" says Long.

And the area where Health IT stands to expand the most is in smaller facilities and rural community hospitals.

"Really health care starts in your small community hospital, and they don't have a large IT department," says Lenny Reznik, director of the Enterprise Image and Information Systems division of Agfa Healthcare. "It's pretty much just like any small business that you might find in the United States. They certainly have computers, but they are really dependent on the system being easy to use."

The RIS now has a hand in the automation of diagnostic modalities, such as digital radiography. Many systems can pull information about the patient and preload settings that have a direct impact on image quality. The RIS is also an important guide for the radiologist reading the exam.

"In order to diagnose you have to know about the patient's history, previous examinations and the results of those examinations and most of that information is stored within the RIS system," says Long. "The RIS is really where the patient level information is stored and managed."




As part of the newfound focus on electronic medical records, facilities looking to invest in HIS and computerized physician order entry (CPOE) technologies are set to receive stimulus money as provisions in the American Recovery and Reinvestment (ARRA) Act and the associated Health Information Technology for Economic and Clinical Health (HITECH) Act rollout. The newest technologies are going wireless and on the web, allowing physicians to gain mobile access through tablet PCs and even cell phones. The iPad may just be the next step.

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