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Instigating the PACS USER GROUP PACSUG Presentation on Regionalization

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

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Instigating the PACS USER GROUP PACSUG Presentation on Regionalization

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

  2. Regionalisation Midland Style By Kevin White

  3. Regionalisation • Definition: The process of dividing an area into smaller segmentscalledregions. One of the more obvious examples of regionalization is the division of a nation into states or provinces. Businesses also use regionalization as a managementtool and a way to make certain that needs unique to particular areas are met. Read more: http://www.businessdictionary.com/definition/regionalization.html#ixzz2dIT8ahUo

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

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

  6. Other 2 DHBs? • Why are there only 3 of the 5 DHBs involved in the regional PACS/RIS? Politics!

  7. Vendors • Main Vendor • Philips (iSite PACS) • Subvendor • Kestral (Karisma RIS) • Other Companies • Gen-I, Datacom, IBM, OrthoView, Sound Business Systems (Dragon Naturally Speaking)

  8. 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.

  9. 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.

  10. How does it fit together? continued • RIS Servers • All located in Hamilton • OrthoView • Managed by each DHB • Dragon Natuarally Speaking • Managed by each DHB

  11. 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

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  21. Thank you! kevin.white@waikatodhb.health.nz pacs@waikatodhb.health.nz pacsinfo@bopdhb.govt.nz pacssupport@tdh.org.nz 07 579 8111

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