By John Freeland – Managing Partner, Freeland Systems LLC

Clinical cardiologists spend an average of 37.9 hours a week meeting with patients and another 16.9 hours filling out paperwork and conducting administrative tasks. That’s 54.8 hours of work each week, as noted by Medscape’s Cardiologist Compensation Report 2020.

These long hours, combined with irregular schedules and high-stress work environments, can result in exhaustion and low job satisfaction. Is it any wonder 44% of cardiologists describe themselves as “burned out”?

Jeffrey Shanes, MD, a semi-retired interventional cardiologist, understands the unique demands of the profession. With a career spanning more than 40 years, he’s worked in many types of clinical settings.

Dr. Shanes began his career in academia, teaching for more than six years. He then owned and operated his own private practice for nearly 25 years, followed by 4 years with a large cardiology group.

Just getting started

More recently, Dr. Shanes splits his professional time between serving as locum tenens interventional cardiologist in a number of U.S. hospitals and interpreting echocardiograms conducted by a mobile service provider.

Jeffrey Shanes, MD

The hours aren’t as demanding as they used to be, but the associated job responsibilities require him to stay connected. “I need to be able to access my echo cases while I am doing locum in various locations in the U.S.,” Dr. Shanes said. Travel restrictions during the COVID-19 pandemic have paused his locum tenens; however, thanks to the latest digital technology, Dr. Shanes is able to continue remotely reading echo studies safely from home.

In 2018, Dr. Shanes and his wife decided to move to Israel. He wanted to live closer to his four children and more than 20 grandchildren but wasn’t quite ready to hang up his stethoscope. Professionally, this presented a unique challenge. Dr. Shanes needed a way to stay connected from anywhere in the world.

Enter telecardiology. Thanks to advances in computer technology, including faster processors, advanced graphics, and better access to cloud services, remote reporting on echocardiograms is simplified. Modern tech also helps medical professionals effectively review clinical cases and report findings from alternate locations.

Change for the better

In order to continue working, Dr. Shanes needed a picture archiving and communications (PACS) solution. There are many modern, zero-footprint PACS platforms available, but after much research, Dr. Shanes selected Freeland Systems’ cloud PACS.

This feature-rich platform meets ICAEL, ICAVL, and ICANL standards and facilitates HIPAA compliant imaging, reporting, and archiving for physician’s offices, group practices, and hospital systems.

Additionally, Freeland’s PACS improves physician productivity, increases practice revenue, and automates clinical workflow processes, all while maximizing return on investment. It features built-in Intelligent Structured Reporting, with the ability to re-measure images, customize reports, and utilize search features.

When combined, these attributes make it possible for cardiologists like Dr. Shanes to work in virtually any location while collaborating with colleagues elsewhere.

User-friendly, no specialized equipment required

Initially, Dr. Shanes worried about a potentially steep learning curve, but after installing and using the software that changed. “It’s a very user-friendly system,” he said. “I have someone send me the patient records and echocardiograms via a secure server. Afterward, I upload this information into the Freeland system. I can access and open the images on my laptop and go right to work, which is really awesome.”

The set-up is convenient, too. “You can look at the echocardiograms and report simultaneously, whereas some systems require two screens. With the Freeland PACS you don’t need anything like that, it shows you the report and images on one display.” These advanced visualization features allow Dr. Shanes to post-process the images as necessary, as well as zoom in or out, with compatible plug-ins.

A powerful and customizable reporting engine

The Freeland cloud PACS also allows for more data-centric and structured reporting. This includes measurement calculations for length, volume, doppler velocity, line segment, MM distance, and more; one-button statement creation for Intelligent Reporting and Normal statements; and a customized look and feel.

“You can tailor-make almost anything for yourself. Besides the phrases already in the system, you can go ahead and add your own phrases. For example, instead of typing a particular comment that you like to say every time, you can put that phrase into the system under whatever category you want, and it will always show up there,” Dr. Shanes said.

For ordering physicians, this flexibility makes remote work much easier, allowing for tailored reports that adhere to a recipient’s unique needs. Dr. Shanes agrees, noting that “most importantly, I can customize anything I want.” 

Perfect tool for interoperability in modern EHR environments

Aside from its convenience and comprehensive diagnostic tools, the Freeland PACS makes it possible to collect patient information, create a report, and upload it to the patient’s electronic health record.

“Let’s say for example there was mild pulmonic regurgitation or little bit of tricuspid regurgitation, that would not be clinically significant” said Dr. Shanes. “Freeland’s PACS doesn’t fill in the summary until you click and select what to include. It allows you to make all the interpretations you want while avoiding extras that are irrelevant to the summary. If you accidentally leave something out, you can always go and look at the whole report again.”

Only after the clinical report is finalized does it get sent over to the EHR for other clinicians to access. This stepwise approach avoids medical errors or treatment complications.

Secure data sharing

Some hospitals, health systems, and physicians worry about transitioning to a cloud or zero-footprint PACS due to security risks, including the potential for HIPAA violations.

Dr. Shanes understands these concerns but is confident in the safety and reliability of Freeland’s PACS, “I know John Freeland and have been using his applications in one form or another for over 20 years. He built the company on a foundation of integrity. They are pioneers in medical imaging workflow. I have absolutely no qualms.”

Furthermore, Freeland’s cloud PACS has a built-in de-identifying tool that allows users to share data archives without fear. Users can even remove identifying information from images, DICOM SR and Encapsulated PDF, or referenced PDF repositories.

Regular updates for continuous improvement

Features are only one important aspect of a clinical application. To ensure client satisfaction and an improved experience, Freeland Systems continuously updates and improves their PACS. They do this in part by encouraging client feedback.

“Compared to major corporations, Freeland Systems is responsive,” said Dr. Shanes. “You can call them up to discuss the challenges you’re facing, and they listen and make changes.”

He continued, “I’ve contacted previous software partners before and they responded with, ‘yes, we see that’s a problem, we’re working on that, and hope the new revision will be out eventually.’ That’s how bad it is! Freeland Systems is just the opposite. They’re totally responsive. No matter your needs, they’ll make sure to fix it.”

Freeland cloud PACS allows for more freedom and flexibility

Less than two years ago, Jeffrey Shanes, MD, thought he might have to choose between his career and his family. By investing in the Freeland Systems cloud-based PACS, he’s able to continue working from anywhere while being semi-retired.

“The Freeland cloud PACS allows me to do all the things that I want to be doing. It allows me to continue my locum work; it allows me to live in another country; it allows me to go on a trip. With Freeland I can do whatever I want and no matter which computer I go to, I can always read these studies with the same quality.”

To learn more about the Freeland Systems cloud PACS and advanced workspace, click here.

About the author: John Freeland has been an industry pioneer and innovator of medical imaging technology for more than 25 years, most notably in cardiovascular informatics. He founded Freeland Systems LLC in 2004 to improve interoperability and standardized data transfer between imaging devices and clinical information systems. He is respected by and collaborates with major industry manufacturers and leading physicians to advance connected clinical imaging solutions that streamline patient diagnoses and treatment decisions.

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