Case study: Local experience setting up the NHS-UoE networking in the new Clinical Research Imaging Centre Elizabeth McDowell CRF IT Manager, Edinburgh

What will this talk cover? What is CRIC? Network design Workflow Data storage and archive Challenges Opportunities

Clinical Research Imaging Centre (CRIC) 320 slice CT scanner 3T MRI Scanner (whole body) 128 slice PET/CT scanner Cyclotron Image Analysis suite Joint partnership between University Hospitals Division of NHS and University of Edinburgh http://www.wtcrf.ed.ac.uk/CRIC/CRICdefault.htm MRI and CT mid-year. PET/CT and Cyclotron end of year Scottish government gave NHS money for PET/CT scanner, Uni secured funding for MRI scanner and building works, and RBS charitable arm funded the CT scanner. Website set up recently by Julian Sparrow, the IT support for the CRIC

CRIC – NHS and University IT Working Together Formed Memorandum of Understanding (MOU) between us which states what we want to achieve in terms of IT which party is responsible for doing what Hold infrequent but focussed IT meetings to resolve issues QUESTION TO AUDIENCE: How many from mixed NHS/University environment? We need to work together to achieve requirements. MOU signed off by Martin Egan, NHS eHealth Director and Professor Dave Newby, Director of CRIC, CRF and NHS R&D NHS and University worked together to come up with and agree solutions.

NHS manage firewall between scanners and NHS and research data stores Network Diagram

Workflow Developed together during IT meeting. Basic diagram, but from this we determined that every scanner booking, research or NHS, must go through TRAK NHS patient info system for 2 reasons: 1) TRAK holds NHS patient bookings, which we have to ensure don’t clash with research and RBS bookings, so all bookings have to be in one place Secondly, 2) A part of all scans will get reported back to the NHS for a complete patient record. Interesting, this means all of our research patients will have to have a CHI number, though we could use a dummy CHI or dummy patient to reserve the booking slots for test objects. ‘Logical firewall’ represents that NHS honorary contracts that must be held for anyone working with identifiable patient data within the CRIC.

Workflow Detailed workflow diagrams Viewing workstation location We have further developed our workflow diagrams, which we will review at a Clinician-focussed meeting tomorrow. Mention one part of detail… David R creating automated system for anonymisation of DICOM images. Difficult to anonymize the scanner files as there are so many of them, and they are buried a gargantuan folder structure. Interested to hear Alison’s talk on data de-identification and linking QUESTION: How many of you anonymise images? What do you use to anonymise them? An issue to resolve is location of the viewing workstations. NHS IT do not want to risk potentially grind network to halt by sending large image data files. But clinicians want to be able to view files from wherever they are located (cardiology, radiology, etc). Hope to resolve in tomorrow’s meeting.

Data Storage - Research Research scans to Edinburgh Compute and Data Facility (ECDF) SBIRCS and new VET CT scanner and PACS may share same storage solution Non-DICOM data(spectroscopy, etc) will be stored at the CRIC local data server until we figure out how to anonymise it! *start* We wanted our data storage to be off-site, and managed by University storage experts. Issue with standard dicom (small files) vs. enhanced DICOM (large files) format, as can’t efficiently be stored in same place. We have our next big meeting with the data storage gurus on Friday, and I know they plan to present a NAS (Network attached storage) solution, with separate servers for small and large files. solves problem, but makes this invisible to the user.

Research Data File Structure Agreed data file structure, which will be automatically generated. PROJECT SUBJECT ID (GUID) STUDY DATE SERIES NUMBER Image UID raw data read only copied to data analysis folders e.g. E06389/GUID/20090120/1/128.216.177…DCM Study ID GUID is a 36 character unique identifier that represents a booking for a patient. GUID will be generated by the CRIC patient booking system when the patient booking is created. Folder structure will be created on ECDF storage system, ready for images to be routed into them, after anonymized.

Data Storage - NHS NHS plan to store data on a local NHS ‘archive’ server in CRIC Radiologists report and then send select images on to the National PACS Cost prohibits storing all files on NHS National PACS as large volumes of data are expected, especially from CT scanner

Data Storage - Archive NHS. University. National PACS Archive in Livingston. All scans will have a small part of them sent to the archive. Only 100Mb connection at present until N3 network is upgraded. University. An archive service is being considered by the UoE Library services. Anonymised data only Moved to archive when the study complete. Data associated with research studies and publications is required to be kept for 15 years. Does anyone know typical retention for NHS scans?

Challenges Getting the right people together to attend key meetings and resolve issues Storage capacity difficult to estimate Scanners use different formats of DICOM Anonymising data for research Double data entry for patient bookings Clinicians and researchers are unsure of scans they are going to do as they haven’t had access to do many of these types of scans or modalities before. Only a few of these scanners in the world! Large number of Small files/a small number of large files of standard and enhanced DICOM can’t be stored efficiently in the same place Anonymising – not easy and no standards exist for doing this Eliminating double data entry into TRAK and CRIC scheduling system for research patients. Ted Boyle suggested that as our patient data is held on the NHS side, we can link to TRAK via ODBC to get patient booking details.

Opportunities for Imaging New state of the art facility for doing clinical and research work SINAPSE forum to develop good practices and standards in IT for Scotland’s Imaging facilities Opportunity to review your processes while doing this Scottish BRAIN IMAGING CENTRE SBIRCS been very helpful and involved in bringing experience and ideas to the development. They say CRIC has given them opportunity to review their systems and infrastructure they have in place, to improve processes.

Questions? Elizabeth McDowell Elizabeth.mcdowell@ed.ac.uk 0131 537 3353