PACS_Role_of_Digital_Imaging

PACS - The Role of Digital Imaging : 

PACS - The Role of Digital Imaging Project By, Bibin Chacko

What is PACS? : 

What is PACS? P icture A rchiving C ommunication S ystem

History of PACS : 

History of PACS Digital radiology introduced in the1980s First developed for US Army PACS was made commercially available in 1995 Now digital radiology is slowly replacing the traditional methods

PACS Introduction : 

PACS Introduction Main parts of the system Image acquisition Data acquisition Storage Display Main goals making imaging filmless Good availability of data and images

Enterprise-wide/Health economy PACS? : 

Enterprise-wide/Health economy PACS? “A set of technology components used together to capture, store, distribute and display any digital medical images, static or moving, and any associated media. The solution operates across multiple sites and multiple hospitals with consistent and seamless capture of, access to and use of digital images by any healthcare practitioner authorised to do so at locations where they undertake their clinical work, research or education.”

Typical Rural Radiology Environment : 

Typical Rural Radiology Environment The patient’s perspective: May have to wait for a radiologist consult while image is couriered to the radiologist. In general, is at the mercy of delays related to the physical media being shuttled between multiple locations. Patient may be transferred as an end result.

Typical Rural Radiology Environment : 

Typical Rural Radiology Environment From the radiologist’s perspective: Delay in reading films in emergency situations. Difficulty in meeting customer expectations.

Typical Rural Radiology Environment : 

Typical Rural Radiology Environment From the hospital / clinic perspective: Stuck in the middle between the patient and the radiologist. Images not always where they are needed, when they are needed resulting in inefficiencies. Costs associated with film, storage, courier services, etc.

Slide 9: 

HRM ACUTE TRUST – Core PACS Local PACS Store RADIOLOGY Scanner Monitor Monitor RADIOLOGY RIS Image acquisition viewing CR V DR

Slide 10: 

HRM ACUTE TRUST – Full PACS : Hospital Wide Local PACS Store MDT RADIOLOGY Scanner Scanner OUTPATIENTS WARDS A&E viewing image acquisition THEATRES Monitor Monitor RADIOLOGY RIS ONCOLOGY

Slide 11: 

HRM ACUTE TRUST – Stretching PACS : Hospital & Community Wide Local PACS Store MDT RADIOLOGY Scanner OUTPATIENTS WARDS A&E viewing image acquired THEATRES Monitor Monitor RADIOLOGY RIS ONCOLOGY PRIMARY CARE AT HOME/ REMOTE

Radiological Technologies : 

Radiological Technologies PACS RIS net – security Information Sharing National Spine Electronic Record Standards DICOM Teleradiology

Technical planning : 

Technical planning procurement Private public partnerships Changing workforce New Clinical models Building design Technology Change Whole system configuration

Slide 14: 

Scheduled Workflow Profile

Benefits of this approach : 

Benefits of this approach A more cohesive workflow process for transfer of information from HIS to RIS to PACS Smooth, reliable transfer of information between computer systems from different companies Patient journey can be more efficiently and accurately planned Mistakes can be more easily corrected

The future : 

The future This approach will extend beyond radiology to areas such as theatres and pathology The aims will be to facilitate patient workflow processes by improving computer systems interoperability a patient (user) driven approach

PACS Programme vision : 

PACS Programme vision Filmless (and ideally paperless) diagnostic services to be made possible in all health economies This should encompass Acute Trusts (where the bulk of diagnostic services currently take place) and other organisations where digital images are (or can be) created and/or used for clinical care education, planning or delivery.

Organisational Scope : 

Organisational Scope IN Hospitals Minor Injury Units Dental Practices Military Hospitals Specialists’ homes Anywhere for mobile practitioners OUT Prisons Private Sector Scotland Wales Northern Ireland

Image Scope : 

Image Scope Radiology Radiotherapy Computed tomography MRI Nuclear medicine Angiography Cardiology Fluoroscopy Ultrasound Dental Symptomatic mammography Non-radiological Retinal screening Endoscopy Colposcopy ECG Audiology Blood films Clinical photography Histology Dermatology Diagrammatic images Laparoscopic images Genetics Cytology Haematology

Slide 20: 

Hospital Hospital Hospital N3 Community Community Community Community Hospital Strategic Health Authority Intranet

A likely national architecture : 

A likely national architecture Cluster Health economy Hospital Trust National Spine Record Service Viewing Reporting Report and diagnostic image Viewing image PACS1 PACS2 PACSn Legacy ? New

What are the benefits? : 

What are the benefits? Access to specialist /2nd opinion Access to pathology & radiology opinion Single patient record – patient choice Reporting – flexible capacity Quality – all images always available

What are the benefits? : 

What are the benefits? Training academies / distance learning Home working Hospital @ night Cost saving – fewer patient transfers Primary care development Reduce car parking Lower outpatient attendances Monitoring of chronic diseases Requires – New ways of working

Slide 24: 

POTENTIAL BENEFITS OF STRETCHING PACS BEYOND RADIOLOGY & INTO THE COMMUNITY Patient/user/financial/quality/efficiency

Slide 25: 

Various Network Technologies, Bandwidths and Typical Transfer Times

Problems with Outsourcing : 

Problems with Outsourcing Lack of continuity – IT systems No training input Poorer equipment utilisation Access of clinicians to reports Duplication of work – protocols, reports, etc Transmission of data – images, reports Governance (teleradiology) Complexity of work (that left takes longer)

Emerging Technologies – Mobile PACS : 

Emerging Technologies – Mobile PACS Hand-held devices like tablet PCs, palm tops and wireless information appliances are predicted to become widespread as a technology by CIOs in their organisations Clinicians are more mobile than ever before & need pervasive access to relevant patient data in a timely manner Clinicians need to collaborate even while they are not physically present in their hospitals or at their medical offices “Creating an efficient Mobile workforce solution is more than placing the enterprise’s applications on the web”

Emerging Technologies – Mobile PACS : 

Emerging Technologies – Mobile PACS Usage scenarios –surgeon can explain to patient in ward, consultation & collaboration between specialists in hospital, remote consultation…. Remote access outside the hospital network needs 3G mobile technology which is imminent in India

Every healthcare organization could build its own PACS solution, but… : 

Every healthcare organization could build its own PACS solution, but… they would miss the opportunity to share the risks and costs associated with maintaining common elements of a PACS environment. they would need to build their own methodology for connecting the radiologist to their site. the radiologist would likely have multiple means of accessing multiple locations and need to learn multiple PACS environments. the radiologists would likely miss the opportunity to share resources such as on-call duty with other radiologists.

Slide 30: 

“A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty.” Sir Winston Churchill

Thank you : 

Thank you PACS NEW WAY TO CARE