National Orthopedic Imaging Associates

Case Study: National Orthopedic Imaging Associates


     From its inception in 1984, National Orthopedic Imaging Associates (NOIA) has introduced new ideas about how radiology can be practiced and has pushed forward the development of teleradiology and Web technology. For the past twenty years, this Marin County, CA-based operation has focused on providing best-in-class musculoskeletal image interpretation services. Their expertise is founded on their team of sub-specialized sports medicine radiologists. Together and under the leadership of Dr. Jay Kaiser, founder and CEO of NOIA, these highly skilled radiologists provide world class service to their growing list of customers.

National Orthopedic Imaging Associates in Marin County, CA

National Orthopedic Imaging Associates in Marin County, CA

     NOIA is a highly-reputed, well-regarded practice within musculoskeletal radiology and orthopedic fields. The group provides comprehensive diagnostic reading that is performed only by sub-specialized radiologists. They are also available for real-time consultation and formal reports are normally delivered within 24 hours. The NOIA business office has extensive experience in inter-state licensure, credentialing, billing and other related issues. NOIA goes the extra mile by working with each of their network sites to leverage the NOIA name in their local marketing efforts in order to enhance musculoskeletal and spine referrals.

     In March of 2003, NOIA selected ScImage’s ForeverOnline configuration of its flagship PICOMEnterprise solution. This Web-based product utilizes an Electronic Patient Folder (EPF) to store all relevant patient information. Physicians are able to retrieve the data stored within the EPF, using either a study-centric worklist-type application called PICOM PowerList or a patient-centric MS Internet Explorer browser-based approach. Either way, the information is made available in the way that most suits the person accessing it.

     The practice also has a fellowship program in musculoskeletal and spinal imaging, and currently trains four fellows each year. With the PICOM common worklist, ease of image transmission facilitates real-time teaching to all of the practice’s fellows wherever they are located on the system.

     PICOMEnterprise’s ForeverOnline architecture is based upon a low-cost, high-availability solution that employs intelligent image routing to serve high-volume, centralized reading environments. This configuration of PICOMEnterprise combines a powerful multi-processor server with a highly scalable storage solution that eliminates the wait for image and information retrieval by keeping everything online, thereby increasing productivity in heavy workload environments.

     NOIA’s nine radiologists read primarily MRI studies but also multi-detector computed tomography (MDCT) as well. Dr. Kaiser stated, “Workflow was our biggest concern. When you are reading 200 cases per day, you cannot afford any decrease in productivity. ScImage was able to customize a solution that helped us increase our efficiency. The result is faster turn-around which makes for more satisfied customers and happier employees.” The Marin County, CA-based private practice radiology group initially serv-

iced 33 outpatient clinics in ten states in the U.S. and Singapore using ScImage’s PICOM solution to acquire, read, store and distribute approximately 200 radiology studies per day. The installation provides visualization and Worklist tools, PACS and teleradiology to this complex network of imaging centers and outpatient clinics throughout the U.S. and overseas.

     “We reviewed and test drove several solutions before deciding to go with ScImage’s ForeverOnline configuration,” stated Peter Osuna, director of IT operations. “We knew we needed a solution that could handle the kind of volume that our practice produces. More importantly, we wanted a solution that we could tailor to our needs. ScImage addressed all of our concerns and exceeded our expectations.”

     Growth was also a key concern for the busy teleradiology practice. NOIA knew they wanted to able to expand and grow their business. Because of its scalable design, ScImage’s PICOMEnterprise solution allowed the practice to start with its current sites and slowly add new customers. Since the PICOMEnterprise solution was first installed, the busy practice has added more than 15 imaging centers to its roster of clients. This brings their client list to more than 50 sites across the U.S.

     “We are pleased with the growth we’ve made over the last two years,” stated Dr. Kaiser. “ScImage has assisted us in growing our business over the last couple of years. When we first started with ScImage we were reading around 200 exams per day. Today we read close to 300 exams. They have given us the productivity tools that facilitate efficiency while preserving and enhancing subspecialty excellence of readings. In addition to the fact that our images are transmitted from a large number of centers with a wide geographic dispersion and utilizing many different scanners, the NOIA radiologists are located at four different centers around the San Francisco Bay Area and Phoenix, AZ. The PICOMEnterprise system allows the entire operation to function as if it was all located in one imaging center.

     “The other important aspect of our relationship with PICOM has been the reliability of the system and the ScImage support to minimize system downtime,” continued Dr. Kaiser. “Our system is complex, but our customers, including a number of professional athletic teams, expect and deserve rapid turnaround on readings, and using the PICOMEnterprise system has allowed us to meet their needs.”

PICOMenterprise eliminates the wait for image and information retrieval

PICOMenterprise eliminates the wait for image and information retrieval