Virtually every hospital Trust in the UK is exploring the use of picture archiving and communication systems (PACS) as a means of replacing their use of hardcopy images and film archives. The choice of available systems can be daunting, however, and while all of these systems offer the ability to more efficiently manage the storage and transmission of images, hospital staff today are looking for systems that enable true operational advantages in their daily routines. At the Rotherham General Hospital (RGH) Trust, the decision was recently made to implement a next-generation image and data management solution to streamline workflows on an enterprise-wide basis and fundamentally improve the organisation and use of radiographic information. Within three months of installation, staff from across the Trust began to report significant improvements to case reporting, image-based diagnoses and treatment planning.
The chose system used at the RGH (IMPAX from Agfa HealthCare) is a web-deployable PACS for radiology that receives, distributes, archives, and displays digital images, enabling healthcare enterprises to eliminate their reliance on film. Through a digital connection to imaging systems, departmental units and hospital information systems (HIS), users within the healthcare enterprise gain an integrated view of patient data from a single screen. This clinically-relevant display allows users to not only read and review patient images, but to digital manipulate and interact with them to enhance diagnostics, analysis and treatment planning, as well as improve interdepartmental communication and organisation. This can substantially improve daily routines and enhance clinical diagnostic capabilities, while reducing the likelihood of clerical errors and misplaced film packets.
John Beeston, General Manager Clinical Radiology and Medical Physics at the RGH, described how some of these advantages have, in a short period, positively affected workflows at the Trust, “With the new PACS in place, all patient images and data are now available in digital format, instantaneously across the whole organisation. This allows multiple users to access the same files and images simultaneously from any location. The immediate advantages of this are that reports are being generated and dispatched much faster than they were previously, helping us to increase our daily turnarounds.
“Hospital staff also no longer have the problem of missing or incomplete films packets, a common issue for larger Trusts. Just as important is the ability of the system to improve communication between staff and enhance case conferencing, which is now being done both more easily and for a greater number of cases. This enables physicians and radiographers to even perform consults over the phone while looking at the same images.”
In addition to having rapid access to radiographic images, the installed PACS provides reports, technologist comments and other patient information in a consolidated display. Physicians viewing these files can then easily correct and manage patient data and integrate this information into scheduled worklists and files for grand rounds. By facilitating daily routines in this manner, the system helps staff to improve patient care and streamline patient journeys.
As Mr. Beeston continued, “One of the areas where we've seen a clear improvement to turnaround is the A&E department where the return times for assessment using films there has dropped from over one week to less than two days. Although we're still gaining momentum with the system, we've also noticed improvements to other areas. A typical example of how patient journeys have been streamlined was a case in which a radiographer had received a GP referral for a suspected case of lung cancer. When the chest X-ray revealed a malignancy, the radiologist was able to immediately contact the medical physicians at the hospital and discuss the case details over the phone, while both were able to look at and review the X-rays and file information from the patient's GP.
“The patient was then admitted directly for treatment, which was easily coordinated between the radiologist, pathologist and medical physician. Previously, this scenario would have entailed a number of delays in communication as the radiologist would have to send the films with the patient to the hospital, the radiologist would then have to schedule a time to meet with the medical team, and so on. In this case, we were genuinely able to influence the speed of the diagnosis and treatment pathway and it's these kinds of efficiency gains that we're beginning to experience on a day-to-day basis.”
Annette Talbot, PACS Application Administrator, agreed with these comments having noticed the same effects in radiology and other departments. “Since the installation of the new system, the waiting room in the radiology department has become decidedly less busy. As we're not waiting for films to be developed or lasers to print, we're able to receive, image and dispatch patients on a much shorter timescale; the same is becoming true for other wards and departments. Patients have definitely noticed this, as they are surprised when they no longer have to wait for a film packet. Those who have been at other Trusts without as an efficient system have definitely noticed that they are getting better service and spending less time nervously waiting for results.”
To improve diagnosis and treatment planning, IMPAX includes a range of image processing