PACS implementation at the Countess of Chester
Transcript of PACS implementation at the Countess of Chester
PACS implementation at the PACS implementation at the Countess of Chester Countess of Chester
Dr R Etherington, Clinical Director, RadiologyDr R Etherington, Clinical Director, Radiology
M Cosens, PACS Project ManagerM Cosens, PACS Project Manager
•2 sites
•110 Consultants
•130,000 Rad exams p.a.
Plan A 2004/5
• Kodak CR
• Kodak RIS (mandatory)
• ComMedica PACS
Plan B 2006/…
• Kodak CR
• HSS RIS (additional cost)
• GE PACS
• 100% deployment by end 2007
Countess Plan B
• Agreement for MEDITECH RISand GE PACS May 25, 2006
• Go Live July 24, 2006
Why MEDITECH’s ‘legacy’ system?
• Can deliver all 3 current CfH requirements for Radiology– PACS– Choose & Book– Electronic Reporting of Diagnostic Wait Times and Activity
• Front End Integration for whole hospital• Trust control of RIS information and management• Future UK Govt strategy re chosen applications
still unclear• No need to buy and implement another RIS
Business Case Benefits
Lower radiation doses through no repeat exams. Cleaner, safer working environment for Radiology staff. 100 sq m x-ray file room in CoCH general wing freed up.
(Worth £250k.) Saving on purchase and printing of conventional film Saving on future purchase and maintenance of film
processors, including environmental surcharges Saving on 7 whole time equivalent film filing clerk jobs X-rays available as soon as they are taken:
simultaneous access enables swifter diagnosis, decision on appropriate care, and formal reporting
no more lost or mislaid films - significant saving on clinicians’ time and fewer phone calls
Benefits Baselining
• Diagnostics impact almost all clinical care
• PACS – benefit needs extracting Streamline patient flow and work processes Opportunity to re-deploy space more effectively
• IT enabled change
• 3 + year programme
PACS baselining audits - examples
Audit of films pulled for MDT Meetings Jan - April 05 - Percentage of missing Films
0%
5%
10%
15%
20%
25%
30%
35%
Lung
Chest
Paedia
tric
Urolog
y GI
Gynae
Lym
phom
a
Vascu
larTot
al
Benchmarking:Radiology turn around times
Av. Ordered to Signed (days)
0
2
4
6
8
10
12
14
16
18
20
J un J ul Aug Sep Oct Nov Dec J an Feb Mar Apr May
Months
Ave
rage
in D
ays
2002/ 2003 2003/ 2004 2004/ 2005 2005/ 2006 2006/ 2007
Av Taken to Signed (days)
0
1
2
3
4
5
6
7
8
9
J un J ul Aug Sep Oct Nov Dec J an Feb
Months
Ave
rage
in D
ays
Av Taken to Signed by Patient Type (days)
0
2
4
6
8
10
12
14
J un J ul Aug Sep Oct Nov Dec J an Feb Mar Apr May
Months
Ave
rage
in D
ays
EM
GP
IP
OP
Admin staff costs
30000
32000
34000
36000
38000
40000
42000
44000
Apr-06 May-06 J un-06 J ul-06 Aug-06 Sep-06 Oct-06 Nov-06 Dec-06
Films and chemicals
5000
10000
15000
20000
25000
30000
Apr-06 May-06 Jun-06 Jul-06 Aug-06 Sep-06 Oct-06 Nov-06 Dec-06
Waiting times by Modality
0
5
10
15
20
25
Months
Num
ber
of w
eeks
MR
CT
US
BE
• Paperless reporting from worklist on PACS
• Speech recognition
or
• Stand alone digital dictation
Radiologist reporting
Taken to Signed average
0
1
2
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Feb06 Mar06 Apr06 May06 Feb-07 Mar-07 Apr-07 May-07
Month
Ave
rag
e w
ait
in D
ays
Speech Recognition
Non - Speech Recognition
PACS Go Live
Draft to Signed average Feb-May 2007
0
0.5
1
1.5
2
2.5
Feb Mar Apr May
SR users
Non SR users
Percentage reported via Speech Recognition Feb-May 2007
46485052545658606264
Feb Mar Apr May
Countess queries
• Community links: electronic referral in / reporting out – demand for PACS?
The way ahead?
• Deliver integration to non-Radiology PACS
• Pioneer Government-stated wish for interface with private sector
• Deliver current government reporting and implementation requirements
• Respond flexibly to changing scene in the government approach to delivery of the National Program for IT in England
?
…Discussion