An inflexible legacy system puts RIS requirements out to tender
Amongst their clinical services is King Edward VII’s esteemed Imaging facility. The site’s Diagnostic Imaging Department is equipped with the industry’s most advanced technology to support their team of Consultant Radiologists. Offering MRI, CT, Mammography, Ultrasound and Fluoroscopy, the department boasts a series of hi-tech equipment to offer the best radiology service to mirror the hospital’s prestigious standard of healthcare.
Corey Frazer, Imaging Manager for King Edward VII’s, manages the Imaging and Diagnostic processes and remains constantly vigilant of modern technology within radiology disciplines. The department’s practices were supported by a Radiology Information System (RIS) and Picture Archiving Communication System (PACS) provided by Agfa. The Impacs solution was in place for 7 years and, although it provided process functionality, was considered inflexible and technically unreliable by the team. The program crashed frequently, offered a multitude of options which were not relevant to the department and, on a task level, took several minutes to register a new patient. The limited workflow meant that radiologists had a timely process to route and review exams and its dated infrastructure was technically fragile; the solution had no DR (disaster recovery) or back-up system which left the department vulnerable to technical failure.
As emerging technologies were becoming more available and proven in the industry, combined with the Agfa contract ending, Corey and the team sought new considerations for a replacement solution and the hospital went out to tender for a complete replacement RIS/PACS.
Solution criteria: a customised system for a unique site
Corey had firm requirements for a new RIS and PACs solution. He needed system reliability in terms of build, process and infrastructure; the hospital could not accept system failure or technical glitches. To accommodate the mobile nature of staff, the solution had to accommodate remote access so that consultants could access the system from any location. The workflow element was also important – availability, routing, quick reference and traceability of patient examinations and notes were vital in ensuring a quick response time to patients. From an organisational perspective, the solution had to accommodate the structure of the site; King Edward VII’s is a small 56-bed hospital and their workflow processes are different to that of a standard NHS Trust site and so a “one-size-fits-all” solution could not support the hospital when their radiology workflow is typically more streamlined. Due to the time in service of their legacy system, a replacement solution from a new vendor had to be simple to use and make for an easy transition for users.
King Edward VII’s reviewed many RIS and PACS vendors to seek a solution that would optimise their radiology functions, ensure task autonomy and allow technical flexibility. In addition, the hospital needed vendors that could be flexible in their approach and give the hospital the customised features it needed. Corey comments:
“It’s our system, our patients, our data. I needed to be in control of the installation and deployment. I needed a vendor who could be flexible and accommodating to this and a solution that offered fluidity”.
King Edward VII’s takes a format-agnostic approach with RIS and Deconstructed PACS
After assessing seven different suppliers, Corey and the team opted for a unique collaboration – Radiology+ from Soliton IT and a Deconstructed PACS (also known as VNA) from Vital Images. The combined technology was the first of its kind in a hospital site. As a RIS electronically manages radiology’s tasks, communications and analytics, the Deconstructed PACS handles and stores clinical images as a standard PACS would, but with the added and vital flexibility of recognising many picture formats in order that images can be accessed “vendor-neutrally” by other systems. This agnostic approach eases migration of systems and enables access to images across varying modalities.
King Edward VII’s investment into Radiology+ was supported by the workflow-driven structure of the application, which included all stages of clinical imaging functions: patient planning, resource management, results distribution and statistical analysis in a concise and content-rich interface. The additional workflow tools of Radiology+ allows not only the standard data collection of a RIS but also unique user configuration, data sharing and scheduling – the daybook feature was particularly welcomed by the department who could now view personnel and patient whereabouts and timings – all on a single interface which was important for a small department across several floors. The modular structure of the system gave the hospital future options of data/information sharing and the potential for strategic add-ons modules. Corey also saw aptitude with Soliton IT as a company; a team of in-house developers and support engineers who can configure the system and make it seamless to the unique organisational needs of the hospital. He comments:
“Both myself and the department had confidence that Soliton IT could make the RIS solution work for King Edward VI’s. They consistently displayed a can-do attitude to our bespoke integration requirements and worked with me directly in areas of data migration and deployment, with vigilance to the importance of our data and flexibility and how we wanted to manage it. We used to be a PACS-driven department – now we are RIS-driven.”
Corey’s selection was also based on the principle of flexibility and ease of use. Vital Image’s Deconstructed PACS offers consolidated access and management of enterprise imaging data for healthcare sites who do not want the financial investment into PACS, as well as providing the flexibility to view JPG, PNG, TIF and PDF files alongside the standard DICOM format. Driven by Radiology+, the system enabled 200+ users the ability to manage radiology tasks and move data freely among imaging systems with full viewing and archiving compatibility. Integrating seamlessly into the hospital’s PAS system Compucare, radiologists and system users now have simplified access to the complete patient imaging record and King Edward VII’s has the added safeguard of future proofing their clinical imaging processes by investing in a truly flexible integrated system.