An Overview of PACS-RIS Procurement

1. An Overview of PACS-RIS Procurement Dave Plummer Department of Medical Physics and BioengineeringUCL Hospitals NHS Foundation Trust

2. Dave Plummer, UCL Hospitals

3. Identify the need Survey the market Prepare a business case Obtain funding Write a specification Request tenders Select supplier Finalize contract Purchase Implement Review Procuring IT Systems POISE Procurement of Information Systems Effectively Dave Plummer, UCL Hospitals

4. Project Management • Use a recognized methodology • eg PRINCE2 • Involve the full spectrum of users • Right from the start • Meet Regularly • Don’t allow issues to go away • Have a defined time frame • Have a defined end point Dave Plummer, UCL Hospitals

5. The Affect of NPfIT(in England) • RIS is not a ‘core’ application • LSPs will provide RIS options but trusts are free to make their own arrangements. • PACS is now a ‘core’ component • NPfIT does not permit open PACS procurement. • The range of ‘viable’ products may now be more narrow. • Need to support integration to local clusters and the spine. Dave Plummer, UCL Hospitals

6. RIS and PACS • RIS is a database of radiology examination details • PACS is a database of radiology examination details Dave Plummer, UCL Hospitals

7. RIS and PACS • RIS is a database of radiology examination details including: • scheduling, film management, report capture…. • PACS is a database of radiology examination details including: • Images • Integration to modalities • In both cases the core data records are patients and exams. Dave Plummer, UCL Hospitals

8. Key RIS Functionality • Integration to external systems • HIS (CRS) • Scheduling: • Rooms & resources • Examination details • Request information, Exam details & Confirmation • Film management • Tracking • Report • Capture and presentation, dictation, transcription etc • Dose records • Support for IR(ME)R etc • Statistics: • Examination numbers, • Equipment utilisation Dave Plummer, UCL Hospitals

9. Key PACS Functionality • Integration to HIS and RIS • Modality worklists, Reporting lists, Prefetching • Capture image from modality • Support radiographer QA/verification • Commit to secure storage • Make available for reporting display • Make available for review display • Make available for future visits • Support image sharing at cluster and national level. Dave Plummer, UCL Hospitals

10. RIS PACS Integration HIS RIS BROKER PACS MODALITY Dave Plummer, UCL Hospitals

11. Close coupling of RIS and PACS applications Ensures that RIS and PACS are in sync Generally by establishing communications between two applications on the same computer. Desktop Integration Dave Plummer, UCL Hospitals

12. RIS PACS IntegrationDesktop Integration HIS RIS BROKER PACS MODALITY Reporting Station Dave Plummer, UCL Hospitals

13. Integrated RIS-PACS • Common patient and exam database • No confusion about status • eg dictated/reported • Desktop integration should be inherent in the design. Dave Plummer, UCL Hospitals

14. RIS PACS Integration HIS RIS-PACS RIS BROKER PACS MODALITY Dave Plummer, UCL Hospitals

15. Integrated RIS-PACS • May be appropriate solution if current RIS needs replacement. • Beware of potential gaps in functionality: • Integration to external scheduling • Film management !! • IR(ME)R requirements • Flexibility • Some apparently ‘fused’ products are rather loosely glued Dave Plummer, UCL Hospitals

16. Beyond Radiology • Other Types of Images: • Vascular Angiography • Cardiac Angiography • Echocardiography • Obstetric Ultrasound • Medical Photography • Retinal Imaging • Colposcopy / Cytology….. • May be more of a RIS Issue than PACS Dave Plummer, UCL Hospitals

17. How IHE fits in • IHE specifies HIS/RIS/PACS integration. • And has the potential to do much more! • No need to identify individual integration requirements • No need to provide an exhaustive list of functional requirements • List the integration profiles that you expect to be using and the actors that you want provided for them. Dave Plummer, UCL Hospitals

18. IHE Defines • Actors • Abstract entities that are part (or all) of IT systems. • Transactions • Functional exchanges of information between Actors • Integration Profiles • Constraints on actors and transactions for performing specific functions. Dave Plummer, UCL Hospitals

19. How to Use IHE • Be clear about the functionality needed • State in the requirement (and the contract) • The Integration Profiles required • The Actors that will be in existing systems • Any specific requirements beyond the IHE profiles • Obtain a specific statement of: • A commitment to deliver all aspects of the required functionality. • The integration profiles that each device supplied will be involved in. • The devices (existing and supplied) that will be involved for each profile Dave Plummer, UCL Hospitals

20. Key issues in Procurement • Functionality • Training • Integration • Data Migration • Implementation • Make them all explicit in the contract. Dave Plummer, UCL Hospitals

21. Further Key Issues for PACS • Integration again • Desktop, modality worklists, broker • Capacity and Performance • Reporting functionality • Screens, tools, workflow • Review functionality • Web, user requirements • Specialist Viewing • Orthopaedics, Theatres … Dave Plummer, UCL Hospitals

22. Summary • Understand Activity and Usage • Get a good team together • Analyze in IHE terms • Decide how you want RIS and PACS to relate to one another • Be aware of future changes • Use IHE in the specifications and the contract Dave Plummer, UCL Hospitals