Feb 22, 2015

Discussing OneDx with Joe Funaro, Chief Information Officer at Zwanger-Pesiri (DOTmed News)

Innovative and groundbreaking patient imaging is something that Zwanger-Pesiri Radiology in Long Island is fairly well known for. But they are also making unique strides in the way patients experience health care outside of the treatment room. 

DOTmed News spoke with Joseph Funaro, the chief information officer at Zwanger-Pesiri, to talk about OneDx; an OEM independent, browser agnostic, zero footprint referring physician portal that Funaro says has transformed the way his facility shares diagnostic information. 

DOTmed News: What exactly is OneDx? 

Joseph Funaro: It is a patient and referring physician portal. One part provides medical results in the way of a report and images for the referring doctor, and on the patient side if provides the same thing in a bit of a truncated view; with a more simplified report and images. 

We encouraged the developer to build a bunch of low tech / high tech communication tools into the product because we know there are a bunch of patients and referrers out there who are still not fully computer savvy. When viewing the report, a physician or a patient can choose to click a button saying "share this report." 

If they want to send the report to another doctor, they punch in an e-mail address. An encrypted key is built for them, and they share the results securely with the doctor. If they want to fax, they can do that through the system too. 

So, that's really it in a nutshell. 

DOTmed News: Can you talk a little bit about how OneDx compares to products that work similarly? 

JF: There are a multitude of products today that claim to be patient and referring physician products. A lot of them are solely browser based, a lot require little applets to be installed — whether it be Java or something like that. OneDx provides, in a single code-based fashion, a very familiar look across all platforms. 

You go to website, put in password and user credential, then you can instantly load the dashboard for the referring doctor and present to him all of the patients he sent to Zwanger-Pesiri Radiology. At that point he can either open the report or the images, right in the browser via HTML 5. 

DOTmed News: What benefits are associated with remote access for patients? 

JF: Let's look at the traditional way; what we're moving away from; Johnny Smith comes in for an MRI of his brain and now wants to communicate those results to his primary care provider. Well, maybe Johnny's on vacation and his doctor is in Florida. If we gave him a CD he would have to figure out on his own how to get the DICOM data set of the medical images and over to his doctor. With OneDx, when the exam is completed, the patient receives an e-mail saying the medical results are available for viewing, (provided they share an e-mail address with us). They go and register on our portal, and they get a list of all the exams they had done at Zwanger-Pesiri, even if it was from years ago. At that point they can share those results with their doctor wherever he may be, and that doctor will be able to fax them or email them to someone else to collaborate. There is even a video conferencing collaboration capability which allows a doctor and patient or two doctors to look at the images together, even if one is on Windows and another on iOS or Android. 

They are also integrating with some pathology labs on Long Island, so when a patient gets a PET/CT and we suspect cancer and send out a biopsy, the lab sends back a pathology report. Traditionally, we would dictate that into the radiology report but now we work with them through OneDx and they send secure FTP into a folder and we grab that exam and marry it to the radiology exam. 

Zwanger could be closed for the evening and the patient will still have full access to their medical history, can route it, share it, collaborate with a doctor, without us getting in the way. 

DOTmed News: Is this a PACS system? 

JF: It has the capabilities of a PACS minus the FDA approval of a medical device, but you can do window level measurements, one on two, two on two, film view... You can see comparisons, so if the referring doctor is seeing a herniated disc he can do a comparison with another MRI of the spine from another doctor it will show up as a comparison. That's a big benefit for both the referrer and the patient. 

DOTmed News: Is FDA approval on the agenda? 

JF: They could apply for FDA approval but there are so many PACS viewers out there already. I believe they can beat the competition by focusing on the sharing and the communication aspect. What he's working on now for us is something that reminds me of online banking. 

You have a profile where it sets up how you want to be communicated with, you are notified if your balance goes below X, someone deposits a check above Y, that kind of stuff. In that way, you need to be sensitive to the method in which referring doctors want to be notified. 

Let's say there's a critical finding and it's an emergency. The impression is cancer and you want to get them into the hospital right away. You want to be notified immediately on critical findings. 

If it's not critical, you think they have a sprain, maybe you don't want to get a notification and jump on right now, maybe you want to wait until the end of the day when it will come in with a couple other low urgency studies to review. Let the doctor customize how he chooses to be notified so the system doesn't become noisy. 

DOTmed News: Is there anything else you want to add to the conversation? 

We were dealing with a hospital where they were concerned about the product we were using a year ago for remote access into the images. We told them we were moving away from that and towards OneDx. They called a meeting, they had their HIPAA officer, security officer, compliance officer... there were about nine people in the room, you know, bureaucracy at its finest. They were all sitting around the table and all concerned about this product. 

They had a big monitor with a computer attached at the front of the room. I asked, is it safe to assume that it has all your security policies applied to it, and that if I tried to do something that was prohibited by the current policy that I would prevent me from doing that? They all immediately responded, "Yes." I said, "OK, let me try to open up OneDx. I went to the website and I placed in one of their doctor's credentials and immediately the viewer opens up, the list of studies they sent us were all in there, I didn't have to install anything or do anything, I got passed firewall and antivirus, and everything else. They were amazed. They didn't know how to proceed. We essentially walked in, zero foot-print, and the minute we closed the browser everything we did went away. They were pretty impressed. 



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