NORrad PACS ProgramNorthern Radiology – Picture Archive Communication System

Guy Guindon, Manager, Medical Imaging & Cardiopulmonary Department, NORrad PACS, Timmins & District Hospital

Kevin McConomy, Account Director, Client Relationship Management, eHealth Ontario

October 29, 2008

Kevin McConomy

NORrad PACS Program – Business and Benefits

NORrad uses Picture Archiving & Communication System (PACS) technology with the ONE® Network – a high-speed, high-capacity province-wide network by eHealth Ontario to view/move diagnostic images and reports securely between community and regional hospitals

Multi-year project to reshape radiology reporting services in northern Ontario

eHealth Ontario

eHealth Ontario (formerly Smart Systems for Health Agency) formed and funded by the Ontario government, is the enabling force behind a province-wide information technology infrastructure and services delivering e-Health

ONE® - Ontario Network for e-Health – Products / Services

A suite of products and services provide continuous connectivity across Ontario’s health care sector ONE Network

ONE Mail/Pages

ONE Hosting

ONE Portal

ONE ID

ONE Support

ONE® Network

What is itPrivately managed, high speed, high quality, highly secure network that offers connectivity to the health care sector

What it does for e-HealthFoundation for electronic information sharing of patient information

eHealth Strategy

eHealth identified as key enabler for system-wide transformation of health care in Ontario

eHealth Strategy is about improved health, health care, patient safety and quality care

eHealth will bring a shift from paper/film-based record keeping to fast efficient and secure electronic data sharing among authorized providers while safeguarding an individual’s privacy

eHealth will help health care teams collaborate in new ways to improve the continuum of care

Enables faster and more informed decision making, care plans and follow up

Groundwork for the eHealth Strategy

As part of the strategy, eHealth Ontario is looking to provide better patient/provider access to their diagnostic images

Focus is on moving diagnostic facilities away from film-based modalities

A centralized archive strategy will provide appropriate secure access to historical images anywhere in Ontario

In Northern Ontario, eHealth Ontario is assisting with the development of a regional DI archive call the Pan Northern Ontario PACS Project (PNOPP) The project will support NORad, through expanded

storage capacity, enhanced security and faster connectivity

Digital Imaging/Picture Archiving and Communication System (DI/PACS)

Guy Guindon

NORrad PACS - Vision

Improve patient care by providing 24 / 7 / 365 radiologist access to all member hospitals

Creating a virtual hospital

NORrad PACS – Removing Geography from Quality of Care Equation

Network 13 NORrad Partners Timmins Hearst Kapuskasing Smooth Rock Falls Cochrane Iroquois Falls Matheson Kirkland Lake Moose Factory

Englehart Hornepayne Wawa Chapleau Moosonee Fort Albany Attawapiskat Kashechewan

NORrad PACS – Overview of NORrad Network 13 Region

12 separately governed hospitals 17 Sites Timmins to James Bay Over 100,000 people Over 140,000 Procedures/Year Over 300,000 square miles Resource-based economy: mining + forestry Population older than provincial average 1 Radiologist

NORrad PACS – Challenges in North Eastern Ontario

Distance Weather Access Health Care and Physician

Shortages Availability of Diagnostic

Resources Sparse Population Poor Health Status

NORrad PACS – Why a Made-in-the-North Solution?

Patient care improvements locally / regionally Practical solutions to meet real needs Enhancing integration of care among hospitals Leveraging technology to overcome natural

obstacles Leveraging technology to create medical/fiscal

efficiencies Fiscally viable service Making better use of limited human resources

NORrad PACS – Health Care Benefits: Hospitals

Enhanced support for small hospital physicians Increased relevance of local and district hospitals Elimination of lost films, decreased x-ray film

storage and operating costs Transfer of diagnostic images to referral or

teaching hospitals to eliminate unnecessary patient travel

Avoids duplication of exams and reduces radiation exposure

NORrad PACS – Health Care Benefits: Physicians/DI Techs

Leverages physician shortage Reduces medical risk / professional isolation Provides virtual consulting relationship between

radiologists and referring doctors irrespective of distance

Facilitates retention of existing physicians Increased hospitals’ attractiveness to new

physicians Physician access to images/reports in their offices Supports northern medical school innovation

mandate

NORrad PACS – Health Care Benefits: Patients

Better patient care provided locally in distant communities

Improved access to local patient care Better outcomes Shorter lengths-of-stay and fewer admissions Fewer emergency evacuations Reduced travel to district and regional hospitals

NORrad PACS – Clinical Example of PACS

Moose Factory patient with bowel obstruction Patient x-rayed at Moose Factory hospital Local surgeon calls Timmins radiologist for diagnosis Diagnosis made Clinical consultation between radiologist and surgeon Decision made to treat locally Successful operative outcome Enhanced local physician support Unnecessary $5K emergency evacuation avoided Better care provided locally

NORrad PACS – Top 5 Challenges and Barriers

Provincial: Coordination with Provincial initiatives

District: MPI Solution Integration between multiple HIS/RIS systems Governance structure Politics

NORrad PACS – Timmins Network Current State17 hospitals in Network 13 All DI images from each site sent via WAN to TDH for reporting and storage Each site has between 6 months and 1 year of local online storage Each site has ability to access images from any other NORrad sites EMPI (Enterprise Master Patient Identifier) AGFA Solution EMPI created for automatic retrieval of relevant prior studies Complete and seamless integration between all sites Direct link to the North Eastern Ontario Regional Cancer Centre Established for benefit of patients referred to Sudbury for cancer careWeb 1000 VPN remote access permits consultation with specialists outside NORrad

group (e.g Toronto Sick Kids Hospital)Orthopaedic Template software allows orthopaedic physicians to make pre-operative measurements for hip

and knee prostheses digitally

PNOPP Partners

Phase 1

10 Hospitals

Phase 2

19 Hospitals

3 First Nation Nursing Station

Phase 3

41 Hospitals

1 Private Clinic

10 First Nation Nursing Station

NORrad PACS Program

Questions?Visit eHealth Ontario website and

sign up for our e-Newsletter atwww.ssha.on.ca

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