This organisational set-up and diagnostic practices relied on an IT system to route, archive and manage the department and associated tasks. Karen Hawkins, PACS Manager for the hospital, had previously used a combination of a Radiology Information System (RIS) and a PACS (Picture Archiving Communication System) to document and support a patient’s radiological journey through the hospital system. For 10 years, Karen had used McKesson TC-RAD with Philips/Sectra PACS but, due to the RIS’s withdrawal from the market, then following a successful tender process, appointed Philips to provide the sole-vendor RIS/PACS system – XIRIS RIS and iSite IntelliSpace 4.1 PACS. Whilst XIRIS, a web-based infrastructure with a useful flagging feature, was more intuitive than the previous application, it was Philips iSite IntelliSpace PACS which truly rewarded Karen’s team with a significantly improved system which allowed rapid image access, user-friendly presentation of images and overall more efficient patient care. Although IntelliSpace presented clinical imaging success, there were some drawbacks to the RIS which affected the department. Michelle Stevens, Superintendent Sonographer for the hospital and regular user of the system, comments:
“We found our legacy RIS to have limitations which were not in line with the development of our department and the statistics functionality could not fulfil our requirements”.
Noble’s also had support challenges and the tiered structure of day-to-day radiology tasks led to clinical practices taking longer than needed. Karen comments:
“Unfortunately, we spent twice as long on each task as we had to cross-reference to our more reliable PACS, Intellispace”.
When Philips announced the cease in development of XIRIS in 2012, Noble’s sought to replace the RIS with immediate effect. Delighted with the functionality of Intellispace, Karen identified that the site required both applied RIS functionality and an application which supported the extended features of the PACS. In addition, the NHS England Five Year Forward initiative of a 2020 Paperless NHS was made even more pressing locally when the Isle of Man Government opted to bring the deadline closer to 2018 as part of its Digital Strategy. This created a new urgency to make Noble’s Hospital further digitalised and reduce the quantity of paper records within a small timeframe.
Capitalising on the experience with XIRIS, Karen identified the functional criteria for the new RIS solution. She took the specification from the previous tender and emphasised the areas for improvement, added new functional requirements which had arisen and sought IT and clinical insights from the project team. Along with a user-friendly interface and worklist structure that was easy to navigate, a statistics feature was needed to provide Karen with real-time departmental data to manage the team and operations effectively and an applied booking system, for both exams and patients, was required for a seamless clerical procedure. In addition, Karen needed the system to be easy to use, flexible for users with configurable permissions to ensure that radiology staff could make edits to records and reports where required.
Noble’s Hospital saw two RIS vendors who were advocated by the prime contractor Philips as integrating with their new release of PACS –IntelliSpace 4.4. One vendor, Soliton IT, came to the forefront of the RIS offering with their pioneering Radiology+, which met Karen’s functional criteria and could be deployed by a team of specialists with specific migration and integration proficiency.
Radiology+ now has 85 users across clerical, IT and radiology functions within Noble’s Hospital with plans to enhance the application with additional nuclear medicine workflow functionality.
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