Out of twelve hospitals in Extremadura, eight now work with the new GE Centricity RIS/PACS systems: the hospitals at Zafra, Llerena, Don Benito-Villanueva, Coria, Mérida, Plasencia, Navalmoral and Infanta Cristina in Badajoz. The organizers expect, that by mid 2007 all remaining hospitals in the region will become part of the Zurbaran project, including two new hospitals at Almendralejo and Talarrubias, which became operational in 2007.
The introduction of the new Centricity RIS/PACS system has changed the way hospitals in Extremadura manage and transfer radiological data. The principal advantage compared to traditional radiography is that digital patient data and images can be transferred electronically between medical staff and be readily available throughout the connected healthcare centres in Extremadura. Radiologists from different hospitals are able to access and share clinical histories, diagnosis and analysis of a certain patient. Previous studies can be compared with present ones at the time of diagnosis, either in emergency situations or in the case of a programmed consultation. This helps to provide more detailed background of the patient’s medical history, like previous treatments or injuries.
Imagine the following situation. An accident occurs at Llerena where a person suffers from a craneoencephalic trauma. The patient is taken to hospital in Llerena where a CT scan is performed. A neurologist in Badajoz, the biggest city in Extremadura, is able to consult the study within a few seconds after the scan was carried out. He will decide on the most appropriate course of action and treatment, for example, whether the patient should be evacuated by helicopter to another hospital where a more appropriate treatment can be administered. This method can save precious time in the treatment process of a patient and sometimes can help to save lives.
The Implementation Phase
From the outset of the project in Zurbaran, the main objective defined by the Health Service management was to streamline the organizational structure of the region’s healthcare services. As part of this process, information systems were closely reviewed and the area’s hospital information technology was identified as being in need of modernisation. Consequently, at the end of 2002, the SES acquired a RIS/PACS solution that would not only digitise radiology data within the hospital community but could also respond to future needs.
Among the top system requirements identified were the interoperability and integration to internal radiology departments in accordance with established standards like DICOM (Digital Imaging and Communications in Medicine) and HL7 (Health Level 7). At the same time the aim was to also integrate external systems, e.g. Hospital Information Systems (HIS) or Electronic Health Cards. GE Healthcare’s ability to comply with DICOM and IHE (Integrating the Healthcare Enterprise) standards was only one criterion why the company was selected to undertake the project. “We have many years of experience in RIS/PACS and always developed our products following the latest standards of IHE and DICOM”, said Juergen Reyinger, General Manager at GE Healthcare Integrated IT Solutions. “Centricity RIS/PACS is a modular, scalable and flexible technology that has proven its ability to connect large districts, like e.g. in the UK for the national program for IT (NpfIT), where we successfully implemented Centricity PACS in more than 70 hospitals, all connected to one centralized data centre”, explains Reyinger. Another advantage of Centricity RIS/PACS is that it can incorporate higher capacities as new necessities emerge and is therefore able to grow with the healthcare enterprise.
Advantages and Challenges
Due to its magnitude, the Zurbaran project required the participation of many professionals including radiologists, IT specialists and technicians as well as SES officials who were involved in adapting the region’s different health centres to the acquired technology and implementing the project’s objectives. The introduction of a new IT concept is always a challenge to the project management and medical staff involved. Radiologists and clinicians have to familiarise themselves with new tools and different workflows. Technical challenges like the integration of RIS/PACS to HIS also have to be overcome. Nevertheless, the implementation of the new technology was necessary and the advantages can be clearly seen. In the area of technical innovation, the region now operates with a state-of-the-art PACS system of superior quality.
Facts and Figures
The inhabitants of Extremadura benefit from this system, which is a pioneer on a European level. Since 2003, more than 600,000 digital radiological studies have been carried out. The success of the RIS/PACS project has led to the fact that Extremadura is seen as a model for other autonomous Spanish communities. Presently 86 per cent of the examinations are reported within 12 hours compared to only three per cent before the RIS/PACS introduction. The time taken to achieve a detailed diagnosis out of radiological data has been substantially improved and patient waiting times significantly reduced. Furthermore, the generated information may be reused or compared with previous studies. Within three seconds after having finalized a study, it is available to a radiologist for immediate diagnosis wherever he needs it. “Presently eight hospitals of the community are running with Centricity RIS/PACS without any problems. We count 450 RIS/PACS users, about 560 clinics, a production of seven million images in 2006, 600,000 studies and about seven Terabytes of stored information”, adds Juan Pablo Alejo, Subdirector de Sistema de Información del SES.
Work in Process
Image flow is continuous. Every single image is stored in a short-term archive, supported by a long-term storage solution that provides all necessary security parameters. It offers a high security standard and helps to avoid loss of image or data due to technical issues. The storage centre is situated at the central services of the SES in Mérida and is the technical heart of the Zurbaran project. During the last year and a half of functioning, more than 680,000 studies have been successfully saved. In addition, Extramadura offers a digital image service. Around 120 diagnostic modalities with conventional radiology images (e.g. bone and thorax), magnetic resonance, scans, mammographies, CTs, angiographies as well as digestive and urologic studies are accessible throughout the region. The project goes hand in hand with several important projects such as Zurbaran for RIS/PACS, Cornalvo for clinical analysis, Civitas regarding the Health Card, productivity, payroll, planned visits and much more.
Conclusion
Searching for films, loss of images, repetition of work or duplication belongs to history in Extremadura. As a result of Centricity RIS/PACS the region has now entered a film- and paperless hospital environment. The connection network between the linked centres goes up to 200 Gbps and thus is one of the most powerful networks in Europe with a better throughput than ever before. During 2006, the SES originated a committee of experts in digital radiology. The radiologists of the Extremadura health communities and the supervisors of the services of radiology are represented in this organisation. It aims at improving, promoting and studying the introduced technology. These efforts will ensure that future necessities of hospital information technology will be identified in the region to benefit the user and the population alike.
The introduction of the new Centricity RIS/PACS system has changed the way hospitals in Extremadura manage and transfer radiological data. The principal advantage compared to traditional radiography is that digital patient data and images can be transferred electronically between medical staff and be readily available throughout the connected healthcare centres in Extremadura. Radiologists from different hospitals are able to access and share clinical histories, diagnosis and analysis of a certain patient. Previous studies can be compared with present ones at the time of diagnosis, either in emergency situations or in the case of a programmed consultation. This helps to provide more detailed background of the patient’s medical history, like previous treatments or injuries.
Imagine the following situation. An accident occurs at Llerena where a person suffers from a craneoencephalic trauma. The patient is taken to hospital in Llerena where a CT scan is performed. A neurologist in Badajoz, the biggest city in Extremadura, is able to consult the study within a few seconds after the scan was carried out. He will decide on the most appropriate course of action and treatment, for example, whether the patient should be evacuated by helicopter to another hospital where a more appropriate treatment can be administered. This method can save precious time in the treatment process of a patient and sometimes can help to save lives.
The Implementation Phase
From the outset of the project in Zurbaran, the main objective defined by the Health Service management was to streamline the organizational structure of the region’s healthcare services. As part of this process, information systems were closely reviewed and the area’s hospital information technology was identified as being in need of modernisation. Consequently, at the end of 2002, the SES acquired a RIS/PACS solution that would not only digitise radiology data within the hospital community but could also respond to future needs.
Among the top system requirements identified were the interoperability and integration to internal radiology departments in accordance with established standards like DICOM (Digital Imaging and Communications in Medicine) and HL7 (Health Level 7). At the same time the aim was to also integrate external systems, e.g. Hospital Information Systems (HIS) or Electronic Health Cards. GE Healthcare’s ability to comply with DICOM and IHE (Integrating the Healthcare Enterprise) standards was only one criterion why the company was selected to undertake the project. “We have many years of experience in RIS/PACS and always developed our products following the latest standards of IHE and DICOM”, said Juergen Reyinger, General Manager at GE Healthcare Integrated IT Solutions. “Centricity RIS/PACS is a modular, scalable and flexible technology that has proven its ability to connect large districts, like e.g. in the UK for the national program for IT (NpfIT), where we successfully implemented Centricity PACS in more than 70 hospitals, all connected to one centralized data centre”, explains Reyinger. Another advantage of Centricity RIS/PACS is that it can incorporate higher capacities as new necessities emerge and is therefore able to grow with the healthcare enterprise.
Advantages and Challenges
Due to its magnitude, the Zurbaran project required the participation of many professionals including radiologists, IT specialists and technicians as well as SES officials who were involved in adapting the region’s different health centres to the acquired technology and implementing the project’s objectives. The introduction of a new IT concept is always a challenge to the project management and medical staff involved. Radiologists and clinicians have to familiarise themselves with new tools and different workflows. Technical challenges like the integration of RIS/PACS to HIS also have to be overcome. Nevertheless, the implementation of the new technology was necessary and the advantages can be clearly seen. In the area of technical innovation, the region now operates with a state-of-the-art PACS system of superior quality.
Facts and Figures
The inhabitants of Extremadura benefit from this system, which is a pioneer on a European level. Since 2003, more than 600,000 digital radiological studies have been carried out. The success of the RIS/PACS project has led to the fact that Extremadura is seen as a model for other autonomous Spanish communities. Presently 86 per cent of the examinations are reported within 12 hours compared to only three per cent before the RIS/PACS introduction. The time taken to achieve a detailed diagnosis out of radiological data has been substantially improved and patient waiting times significantly reduced. Furthermore, the generated information may be reused or compared with previous studies. Within three seconds after having finalized a study, it is available to a radiologist for immediate diagnosis wherever he needs it. “Presently eight hospitals of the community are running with Centricity RIS/PACS without any problems. We count 450 RIS/PACS users, about 560 clinics, a production of seven million images in 2006, 600,000 studies and about seven Terabytes of stored information”, adds Juan Pablo Alejo, Subdirector de Sistema de Información del SES.
Work in Process
Image flow is continuous. Every single image is stored in a short-term archive, supported by a long-term storage solution that provides all necessary security parameters. It offers a high security standard and helps to avoid loss of image or data due to technical issues. The storage centre is situated at the central services of the SES in Mérida and is the technical heart of the Zurbaran project. During the last year and a half of functioning, more than 680,000 studies have been successfully saved. In addition, Extramadura offers a digital image service. Around 120 diagnostic modalities with conventional radiology images (e.g. bone and thorax), magnetic resonance, scans, mammographies, CTs, angiographies as well as digestive and urologic studies are accessible throughout the region. The project goes hand in hand with several important projects such as Zurbaran for RIS/PACS, Cornalvo for clinical analysis, Civitas regarding the Health Card, productivity, payroll, planned visits and much more.
Conclusion
Searching for films, loss of images, repetition of work or duplication belongs to history in Extremadura. As a result of Centricity RIS/PACS the region has now entered a film- and paperless hospital environment. The connection network between the linked centres goes up to 200 Gbps and thus is one of the most powerful networks in Europe with a better throughput than ever before. During 2006, the SES originated a committee of experts in digital radiology. The radiologists of the Extremadura health communities and the supervisors of the services of radiology are represented in this organisation. It aims at improving, promoting and studying the introduced technology. These efforts will ensure that future necessities of hospital information technology will be identified in the region to benefit the user and the population alike.
