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

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

3. 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
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

4. 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.

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

6. 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.

7. 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.

8. 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.

9. 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/ /1/ …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.

10. 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

11. 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?

12. 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.

13. 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.

14. Questions? Elizabeth McDowell Elizabeth.mcdowell@ed.ac.uk