BROOKLYN 3 PACS USER GROUP Kevin WHITE Sun 1 st Sep 2013 Session 1 / Talk 1 09:00 – 10:00 Instigating the PACS USER GROUP PACSUG Presentation on Regionalization.

BROOKLYN 3

PACS USER GROUP

Kevin WHITE

Sun 1st Sep 2013

Session 1 / Talk 1

09:00 – 10:00

Instigating the PACS USER GROUP

PACSUG

Presentation on Regionalization

Regionalisation

Midland StyleBy Kevin White

Regionalisation Definition: The process of dividing an area into

smaller segments called regions. One of the more obvious examples of regionalization is the division of a nation into states or provinces. Businesses also use regionalization as a management tool and a way to make certain that needs unique to particular areas are met.

Read more: http://www.businessdictionary.com/definition/regionalization.html#ixzz2dIT8ahUo

Midland DHBs

Midland DHBs is made up of 5 District Health Boards• Taranaki• Tairawhiti• Lakes• Waikato• Bay Of Plenty

Midland PACS/RIS

Midland PACS/RIS is made of only 3 of the 5 Midland DHBs.• Tairawhiti• Bay Of Plenty• Waikato

Other 2 DHBs?

Why are there only 3 of the 5 DHBs involved in the regional PACS/RIS?

Politics!

Vendors

Main Vendor• Philips (iSite PACS)

Subvendor• Kestral (Karisma RIS)

Other Companies• Gen-I, Datacom, IBM, OrthoView, Sound

Business Systems (Dragon Naturally Speaking)

How does it fit together?

Philips won the tender to provide a 10 year regional PACS/RIS solution.

Philips contracted Kestral to provide the RIS.

Philips supplied OrthoView for the Orthopaedic Templating

Philips has contacted Sound Business Systems to supply the voice recognistion software.

How does it fit together? continued

PACS Servers (50+)• Main Location server farm is in

Hamilton.• Mirror server farm is in Tauranga.• Local cache servers located at Gisborne,

Whakatane, Tauranga, Taumarunui, Te Kuiti, Tokoroa, Thames

• Waikato Hospital is close to main location so currently doesn’t have local cache servers.

How does it fit together? continued

RIS Servers• All located in Hamilton

OrthoView• Managed by each DHB

Dragon Natuarally Speaking• Managed by each DHB

How does it fit together? continued

HL7 Integration• Regional HL7 Interface Engine (HL7Connect)• Through to each DHBs own Enterprise Interface

Engines. E.G Rhapsody and HL7Connect.• 3 Clinical Results Viewers• 3 Patient Management Systems• National Breast Screening Programme – Sectra• HealthLink – outbound reports• 3rd Party Reports from Comrad – inbound

reports via HealthLink

How does it fit together? continued

PACS Integration• Obviously modalities to the PACS• Transferring of studies outside of the 3

DHBs using a DICOM router managed by Bay Of Plenty DHB.

• PACS to image printers• PACS to DVD robots

How does it fit together? continued

Desktop Integration• iSite Radiology – Karisma• Karisma – Clinical Results Viewer• Karisma – Dragon Naturally Speaking• iSite Enterprise – OrthoView• iSite Radiology/Enterprise – Advanced

Visualisation Tools• Karisma - Sectra

What Works?

More and more doctors are working in multiple DHBs, this enables them to see images of one DHBs patient while being at another DHB.

Dramatic decrease in repeat studies due to patient being imaged else where and images not being available.

What Works? Story Hawkes Bay had a very sick patient. No

one in the lower North Island could help the patient. Images were transferred to the Midland PACS via the DICOM router. Within an hour an Interventionalist was viewing the images from home. A couple of hours later the patient was in a helicopter heading for Waikato Hospital. A few more hours later the patient is in the Interventional Suite having a life saving procedure. Patient went back to Hawkes Bay in a much better state.

What Works? Continued

No matter what politics exist (Some will be mentioned shortly) the patient is who needs to benefit from the system. We have seen many examples each week of this system effecting patients in a positive way.

What Works? Continued

Multiple PACS/RIS Administrators spread across a large area.• 6x PACS/RIS Administrators across 3

DHB share call. Lessens work impact on personal life. If all PACS/RIS administrators of 1 DHB are

away from work 1 day, life still continues.• 2x RIS Administrators

Dedicated administrators to understand RIS processes etc.

What Doesn’t Works?

3x Information Services (IS) Departments• If one IS department can not provide resource

with assisting an upgrade, it means no one gets the upgrade or the upgrade is delayed.

• Another words 2 DHBs are at the mercy of the weaker DHB. (Weaker doesn’t mean smallest DHB)

• IS Departments generally have great trouble helping each other. - Regional IS is being created to assist with resolving this.

What Doesn’t Works? Continued

Senior management not turning up to regional meetings.

The business in one DHB making a business decision that impacts all 3 DHBs.

Future

Have the 2 other DHBs onboard. Second DICOM Router to be located

at Waikato. More blurring of lines between the

Radiology and Information Services Departments

Thank you!

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07 579 8111