Bon Secours Moves Images to Azure to Drive Costs Down and Speed up Delivery

By Dennis Schmuland MD FAAFP, Chief Health Strategy Officer, Microsoft US Health & Life Sciences Winnie Bernard, Enterprise Radiology Imaging Systems Manager, Bon Secours Health System Tammy Grausgruber, Enterprise Radiology Special Project Manager/Systems Analyst, Bon Secours Health System on July 21, 2017

In my last blog, I talked about how Austin Radiology Association moved their 3D tomography data storage platform to the cloud to radically expand their storage capacity and reduce costs. In this blog, you’ll hear Bon Secours Health System’s story of how and why they’re using NucleusHealth’s cloud-based image sharing service to drive their image sharing and delivery costs down and their delivery speed and referring physician satisfaction up. This blog is a transcript of my interview with Winnie Bernard, Bon Secours Health System’s Enterprise Radiology & Imaging Systems Manager, who tells Bon Secours’ journey to the cloud story.

Schmuland: To provide readers with some background on Bon Secours, could you briefly describe your role, the organization, and the areas you serve?

Bernard: I’m responsible for all enterprise radiology imaging systems at 15 Bon Secours hospitals. Bon Secours is a not-for-profit health system that owns, manages, or joint ventures 19 acute-care hospitals and numerous other health care facilities and services. Bon Secours’ more than 23,000 caregivers help people in ten communities in six states, primarily on the East Coast. Sponsored by Bon Secours Ministries, Bon Secours is known for providing compassionate and innovative care for the whole person and building healthier communities through our community outreach efforts.

Schmuland: In your move to the cloud, can you talk about your top challenges as well as the advantages you saw in moving to the cloud?

Bernard: Stewardship is a part of our mantra. People think straight away of cutting costs when you mention stewardship. But, for us stewardship also includes our time management and customer service. Our big three challenges are security, improving customer service for both clinicians and patients, and reducing costs, in that order.

The security of patient data is paramount to being compliant with all federal, state, and local regulations and laws. For example, unencrypted CDs, if lost or stolen, can compromise patient privacy – so they need to be eliminated.

When we looked further into what new things we could do with the cloud that we couldn’t do on-premise, we found several completely new opportunities to improve the experience for our patients and our referring clinicians. We found we could reduce our turnaround time in delivering images and reports to our ordering clinicians—which meant that the images they ordered would always be there before the patient returned. Our referring clinicians would also be able to access and view our radiology images within the convenience of their offices using any web-enabled browser. In the past, we’d send CDs out to our referring clinicians by mail. Not only did that delay delivery by a day or two but every now and then a CD would somehow get scratched—which required us to re-burn and send a replacement out via courier. That frustrated us and our referring providers.

In radiology, one of the high-cost areas for the enterprise is the cost of replacement equipment and the cost of maintenance agreements for our equipment. When equipment ages out and needs to be replaced, we always ask ourselves the stewardship question, “What’s the opportunity here to decrease the cost of equipment replacement and maintenance?” Even better if, at the same time, we can make the imaging experience better for the patient and their team of care providers. That opportunity came up last year when the time came for us to replace our CD burners.

This time around, replacing our CD burners was going to cost us far more than in the past because we needed to add encryption and key management capabilities – which was going to cost us 3-4 times what previous replacements cost us, not to mention increased maintenance costs and ongoing courier costs to deliver CDs. So, the savings alone were enough to justify moving our image viewing and sharing application to a cloud-based service.

Schmuland: Your move to the cloud seemed faster than most I’ve seen. How were you able move so quickly from CD-based image-sharing to a cloud-based solution?

Bernard: We chose a partner that was agile, compliant, and met our tough requirements. We looked at the options available on the market today, and after an extensive evaluation process, we selected RadConnect from NucleusHealth. RadConnect is a HIPAA-compliant, cloud-based image-sharing service that enables us to share and view diagnostic-quality images among our medical staff, outside clinicians, and even patients through just a browser on any web-enabled device.

Schmuland: What was it about RadConnect that you found so compelling, above all the other options in the market?

Bernard: First, RadConnect was the solution that best met the cloud privacy, security, and compliance criteria that our security committee required. RadConnect easily passed our security review because they ran their service on the Microsoft Azure cloud and they encrypted all images at rest as well as in transit. Second, what’s unique about the RadConnect solution is that it works without needing to download and install a browser plug-in of any sort. And third, NucleusHealth really listened and responded to us. We had a lot of one-of-a-kind processes and complex workflows that they had to handle uniquely. For example, we serve facilities that have non-standard PACS systems, which made the process of sharing images and information extremely complex even within our own organization.

What’s really impressive is now when a patient or physician needs an image set for an urgent reason, we can say “we can have that for you within the hour.” And even beyond streamlining the sharing of patient data, NucleusHealth also enabled us to pull together all that historical data with images and deliver a more complete patient imaging jacket to our referring providers.

Schmuland: At Microsoft, we’re seeing the term “digital transformation” being used quite loosely and are concerned that, if we don’t hold ourselves and our partners to a higher standard of the definition, the term will quickly degrade to a hollow corporate cliché. To keep this from happening, we’ve defined digital transformation in health as “technology-enabled care, health promotion and disease prevention that advances the triple aim.” Could you say that the NucleusHealth solution is enabling Bon Secours to achieve the triple aim—better health and better care at a lower cost?

Bernard: Yes, I would definitely say that this solution is enabling us to achieve the triple aim.

In terms of better health for our patients, we anticipate that patients will be treated sooner, care will be better coordinated, and we’ll see fewer negative outcomes since we can now deliver images in minutes rather than hours or days—when we had to express ship CDs across the country.

In terms of better care experiences and outcomes, I can cite a couple of examples. First, the mother of one of my team members has extensive small cell lung cancer…inoperable and no known cure. She finishes her last chemo treatment in 2 weeks. We could just sit and pray it comes back slowly but now with RadConnect we have a better way to find other options to possibly extend her life. What we’ve done is gathered and uploaded all of her studies from everywhere into RadConnect so that we can quickly cast our net across the country to find the specialty oncologist or clinical trial that might be able to save her. Having all her images and reports available in one place to securely share instantly means that her daughter will be able to focus her energies on her mom instead of spending hours gathering, shipping or hand-carrying CDs or heavy and cumbersome jackets of films.

Another example I can offer you is a recent patient who called us on his way to Washington State because he had forgotten to pack his CD. We used RadConnect to send the images electronically to the physician he was scheduled to see. That patient was ecstatic because his images were already there when he arrived.

In terms of reducing costs, we based our business justification on hard cost avoidance by eliminating CD-burning equipment, materials, and labor– which made it possible for us to move forward as an act of stewardship. The costs related to CD burning and processing add up quickly, especially when you calculate the costs across 15 hospitals. We could confidently project savings of over $300,000 per year, or about $20,000 per hospital. But even beyond our own hard cost savings, no more lost, forgotten, or damaged CDs means that patients will be able to avoid the cost, inconvenience, and radiation exposure of having to repeat imaging tests. If RadConnect can avoid the need to repeat even 1% of the 1.2 million imaging tests we do every year, we can reduce the cost of care for the community by over $2 million.

Schmuland: In an earlier conversation you mentioned that this move to RadConnect was a just a small first step in a bigger, longer term cloud strategy to drive costs down and the patient experience up. What’s next up in the cloud for Bon Secours?

Bernard: We see an even bigger long-term opportunity to extend our NucleusHealth partnership to cardiology and from there to other “ologies” like dermatology and pathology. We believe that we’ll see incremental improvements in care quality the more we can empower patients to share their images and results through a trusted and compliant cloud.

For more information on how health organizations are using Microsoft Cloud solutions, check out our cybersecurity in health e-book.

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