Little desktop integration and lack of VR causes ineffective process
Royal Bournemouth and Christchurch had depended on an Ascribe system, simply called “RIS”, to computerise the department’s radiology practices. Although the system provided some workflow options, it offered no desktop integration and was character-based in its form – resulting in a basic DOS-type programme that had little scope for integration with other departmental software. Ascribe’s system had no operational mouse navigation and, more importantly, no supporting VR (voice recognition) to support document production via a voice-to-text process. The lack of VR placed pressures on both radiologists and clerical teams whose sole method of generating reports was through dictating onto analogue mini-cassettes and audio-typing the tapes through desktop transcribers. This produced an influx of paper-based workload which was difficult to route and process from the dictated report to the finished typed document. Jon Teece, PACS & RIS Manager for the Trust, was involved in RIS and PACS appointment from 2003 and comments on the previous system: “Ultimately, the department’s Radiologists were removed from the RIS function in the very moment that the mini-cassette was handed over to the secretary, thus causing a disjointed workflow process where it was virtually impossible to prioritise urgent reports and monitor workflow.”
“The most positive feedback from Radiologists was the collective information available on the screen; patient history, previous reports and clear imaging were all available at a glance on one interface. This resulted in a quicker generation of reports for our department.”
Adoption of digital workflow brings improvements for radiologists
Royal Bournemouth and Christchurch NHS Hospitals implemented a series of additional software systems in an attempt to ease the strain on internal departments. They adopted an Aspyra PACS application (Med-View) and Soliton IT’s Workflow Manager to integrate digital dictation features and voice recognition capabilities into the radiology set-up allowing radiologists to manage imaging and generate their own typed clinical reports, hence removing both the reliance on analogue cassettes and burden on clerical staff. With document production radically improved, the Trust opted to further optimise radiology processes within their IT framework and, in 2008, the radiology department requested a new RIS platform to truly integrate elements of document management with PACS and imaging activities. Jon and his team had firm requirements for a new solution; scheduling was a key criteria to enable electronic patient, clinician and consulting room booking and eliminate the traditional day book – which in its hard-copy ledger and Outlook versions created an untethered approach with double-entries between paper and PC. Statistical features were also sought after, in order to generate department analytics for Trust reporting and monitoring of departmental productivity.
A new RIS – and excellent standards of VR
After evaluating a series of RIS vendors, Royal Bournemouth and Christchurch opted for Radiology+; a RIS system from UK-based RIS developer and Workflow Manager supplier Soliton IT. Radiology+ met Jon’s functional criteria for RIS improvements; it offered an excellent standard of VR with Nuance’s SpeechMagic; an “enterprise” server-based voice recognition application equipped for larger multi-user networks. This new capacity enabled departmental roll-out, optimum levels of accuracy and the accommodating of Radiology terminology through custom dictionaries. Additionally, the application’s “kiosk” function further optimised internal resources by offering a “self-check-in” facility during Trust extended hours and instances where staff availability was compromised. The Stats element proved equally useful with trends and forecasts populated for analysis to ensure that departmental capacity was always maximised and in-line with sector benchmarks. From an operational perspective, Radiology+ integrated well with the Trust’s replacement PACS platform from Carestream and offered critical future-proofing with the flexibility of add-on modules and, more importantly, additional development opportunities according to the Trust’s individual organisational and technical needs. This secured the application as an investable option for both the Trust and the NHS as a whole. Royal Bournemouth and Christchurch NHS Hospital Foundation Trust now has 630 users of Radiology+ and, along with Soliton IT, continues to have significant input into the continued development of the product.
