Dr Laurence Sutton.

Consultant Radiologist

Calderdale and Huddersfield NHS Trust.

National Clinical PACS Lead NE Cluster

PACS the facilitator of change.New ways of delivering

Diagnostic Imaging Services.

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CfH

PACS

The information VisionNHS

CfH

PACS

to have relevant diagnostic images and associated data available and useable in a timely manner at the point of care for all clinicians, irrespective of the location and timing of the care being provided. This would apply to any aspect of care delivery requiring images and associated data and would integrate relevant diagnostic images and data seamlessly with wider pertinent clinical information.Further, to have relevant diagnostic images and associated data available and useable for all clinicians to support service improvements in care delivery, service planning, research or education.”

PACS Programme:NCRP Vision for Future

Development.

• Sets out the Vision for PACS.

• Steps required to realise the Vision.

• Supports the wider strategy for Diagnostic Imaging across the NHS.

NHS

CfH

PACS

Diagnostic Imaging ServiceReform.

National Diagnostic Imaging Board.

Dr. Erika Denton.

NHS

CfH

PACS

Diagnostic Imaging Service Reform

Vision Enablers.NHS

CfH

PACS

•Workforce Modernisation.

•Independent Sector Capacity

•PACS

•Service Transformation.(ISIP)

Diagnostic Imaging Service Reform

Vision Enablers. Service Transformation.

(ISIP)Integrated Service Improvement Programme.

NHS

CfH

PACS

a methodology to enable local health economies, including all relevant service partners, to plan service change collaboratively to optimise efficiency, value and quality.

Diagnostic Imaging Service ReformPOLICY DRIVERS.N

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CfH

PACS

•System Reform and Patient Led NHS

•Patient Pathways.

•Patient Choice.

•Workforce Reform.

•Organisational Changes

•ISIP

•Best Use of Capital Resources

•Payment By Result.

Independent Sector (IS) Diagnostic Imaging (DI)

• Additional Services 2006.

• Increase overall capacity.

• Pleurality and Choice.

• Waiting Times for DI.

• DH Target 18 weeks. (R to T).2008

• Waits for imaging < 1 month.

• Target 13 weeks all DI March 2007

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CfH

PACS

Shorter Waiting Times.Referral to Treatment.

• Increase Primary Care Access.

• NHS and NHS Contracted IS

• Imaging prior to first OP appointment.

• Evidence Based Guidelines.(Choose and Book )

• Increased Volume Imaging.

• Increased NHS Capacity.

• Optimised NHS Capacity.(Choice of scan)

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CfH

PACS

Shorter Waiting Times.Increased Volume of Imaging /1000

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CfH

PACS

Current Projected Scan/yr

MRI 18 35 1.8M

20%

CT 40 55 2.5M

NUS 100 120 4.6M

Shorter Waiting Times.Workforce Planning.

• Deliver increased volumes.

• 4 Tier Structure.

• Radiology Academies Focus of Training Initiatives to support workforce.

• NHS CfH PACS Programme

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CfH

PACS

Full National PACS March 2007.To facilitate:

• Flexible Workforce.

• More Efficient Workforce

• Radiology Networks.

• Remote Reporting.

• Teaching, Training and Research.

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CfH

PACS

National Infrastructureversus

Increased Diversity of ServiceProvision

NHS

CfH

PACS

•Standardisation

Infrastructure

•Shift from Secondary to Primary Care

•Split between Image acquisition and

Reporting

•Commoditisation of

DI services.

•Pleurality and Choice

National Infrastructureversus

Increased Diversity of ServiceProvision.

The Technical Challenge

• The challenge is to develop a Nationwide Technical solution that will support the requirements of Patient Choice, Shift in where healthcare is delivered and maintaining the Integrity and availability of the Patients’ Imaging Record.

NHS

CfH

PACS

National Infrastructureversus

Increased Diversity of ServiceProvision.

The Professional Challenge (1)

• The challenge is to maintain the Clinical Integrity of Diagnostic Imaging Services through evidence based practice and improved communication between Radiologists and the Referrers.

NHS

CfH

PACS

National Infrastructureversus

Increased Diversity of ServiceProvision.

The Professional Challenge (2)

• The challenge is to acknowledge the benefits that PACS with integration with other clinical IT systems now provides for significantly improved productivity and quality of reporting.

NHS

CfH

PACS

National Infrastructureversus

Increased Diversity of ServiceProvision.

The Professional Challenge (2)

• ‘We can no longer hide behind the inefficiencies of Film.’

• ‘Next Day doesn’t cut it anymore.’

Steven C Horri. MD

NHS

CfH

PACS

The Technical Challenge.The How Questions!? And More!

NHS

CfH

PACS

•When can I see Images from another organisation?•When will there be a truly pan Health Care Community PACS?•How will Image Data and associated Data be updated and Validated?•How will Data Retention Policies be managed in an a digital environment?

The Technical Challenge.The How Questions!? And More!

NHS

CfH

PACS

•Is it worth connecting my Legacy PACS into the cluster data store.•How will I know which images to report if I’m working remotely from the point of acquisition?•How do I know that an Image report has been read and acted upon.•Will I see all the patients prior images?

The Technical Challenge.The How Questions!? And More!

NHS

CfH

PACS

PACS CENTRAL TECHNICAL TEAM AND DESIGN STEERING GROUP