Inland Imaging, based in Spokane, Washington, employs more than 600 people, including 65 radiologists and 8 vascular surgeons, in its three business units operating in Washington, Idaho, Oregon, and Arizona. Inland Imaging Associates is a radiology reading service. Inland Imaging LLC runs diagnostic centers in four states. Inland Imaging Business Associates provides information technology services to the rest of Inland Imaging and external clients.

In 2001, the use of electronic medical record (EMR) systems by referring doctors began to increase, and Inland Imaging saw an opportunity to differentiate itself from competitors. Inland saw how everyone would benefit by enabling doctors to order external radiology services directly from their EMR systems, and receive reports back from Inland directly into those EMRs. After trying different technology approaches to this integration challenge that were too expensive, too slow, or too limited in functionality, Inland turned to the InterSystems Ensemble® rapid integration and development platform.

Integration time cut in half

Integration with Ensemble ties customer EMRs directly into Inland’s scheduling and reporting systems via HL7 messaging. When a physician enters the order for radiology services into the EMR, the order flows to Inland’s scheduling system and Inland calls the patient to schedule the exam. The resulting report, along with links to the related images, is sent electronically back to the requesting EMR, where it is available for physician review.

Ensemble is so pivotal to our growth plans that it has essentially become the hub of our IT enterprise.

Brian Napora, Director of IT development
Inland Imaging

Integration eliminates inefficient manual handling of faxed, phoned, or emailed orders and reports, and the risk of data entry errors. It also increases the physician’s efficiency, as it eliminates the need to log on to systems other than the EMR to see the relevant radiology information, or go searching for a paper report. “Before Ensemble, it took 6 to 9 months to integrate a new customer into our systems,” explains Brian Napora, director of IT development at Inland Imaging. “With Ensemble we bring customers online in 3 months or less.”

  • Rapid Integration
  • HL7 Messaging
  • Greater Business Efficiency

Selecting Ensemble

In searching for a new integration platform, Inland Imaging wanted to go beyond just interfacing, to a product that could enable new business opportunities. The company’s incumbent product “Passed messages around,” says Napora, “but we needed message persistence and the ability to do more complex manipulations on message data.” Inland found the features it needed in Ensemble. Inland chose Ensemble after an internal proof-of-concept project showed that Ensemble provided several advantages, including:

  • Message persistence in its embedded object database
  • Business intelligence and reporting capabilities
  • Flexibility and programmability that overcame previous limits on the types of solutions Inland could create
  • Proven reliability and scalability based on technology found in InterSystems Caché, the leading database in clinical healthcare applications
  • A comprehensive set of capabilities beyond messaging that includes business process orchestration, business activity monitoring, dashboards, workflow, business rules processing, portal development, service-oriented architecture support, and rich Web interfaces

Rapid integration and business process improvement

Rapid integration with Ensemble is critical to Inland’s business as it allows the organization to meet its aggressive goals for growth, and customer satisfaction. For example, to win new business from a local hospital, Inland needed to quickly integrate its systems with the hospital’s EMR. But the demographic data came from two different systems, and the data had to be collected, matched, and combined before insertion into the referring EMR and Inland’s systems. “Before Ensemble it would have taken two or three of our programmers to complete this work in a timely fashion,” notes Napora. “With Ensemble it took just one programmer, and it was completed much faster.”

Going beyond messaging, Inland is using Ensemble and its advanced business process technology in a core application that drives Inland’s radiology workflow. “Ensemble is so pivotal to our growth plans,” explains Napora, “that it has essentially become the hub of our ITenterprise.”

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