1. An Overview of PACS-RIS Procurement Dave Plummer Department of Medical Physics and Bioengineering UCL Hospitals NHS Foundation Trust

2. IHE 20 October 2004Dave Plummer, UCL Hospitals

3. IHE 20 October 2004Dave Plummer, UCL Hospitals Procuring IT Systems 1. Identify the need 2. Survey the market 3. Prepare a business case 4. Obtain funding 5. Write a specification 6. Request tenders 7. Select supplier 8. Finalize contract 9. Purchase 10. Implement 11. Review POISE Procurement of Information Systems Effectively

4. IHE 20 October 2004Dave Plummer, UCL Hospitals Project Management  Use a recognized methodology eg PRINCE2 eg PRINCE2  Involve the full spectrum of users Right from the start Right from the start  Meet Regularly Don’t allow issues to go away Don’t allow issues to go away  Have a defined time frame  Have a defined end point

5. IHE 20 October 2004Dave Plummer, UCL Hospitals The Affect of NPfIT (in England)  RIS is not a ‘core’ application LSPs will provide RIS options but trusts are free to make their own arrangements. LSPs will provide RIS options but trusts are free to make their own arrangements.  PACS is now a ‘core’ component NPfIT does not permit open PACS procurement. NPfIT does not permit open PACS procurement.  The range of ‘viable’ products may now be more narrow.  Need to support integration to local clusters and the spine.

6. IHE 20 October 2004Dave Plummer, UCL Hospitals RIS and PACS  RIS is a database of radiology examination details  PACS is a database of radiology examination details

7. IHE 20 October 2004Dave Plummer, UCL Hospitals RIS and PACS  RIS is a database of radiology examination details including: scheduling, film management, report capture…. scheduling, film management, report capture….  PACS is a database of radiology examination details including: Images Images Integration to modalities Integration to modalities  In both cases the core data records are patients and exams.

8. IHE 20 October 2004Dave Plummer, UCL Hospitals Key RIS Functionality  Integration to external systems HIS (CRS) HIS (CRS)  Scheduling: Rooms & resources Rooms & resources  Examination details Request information, Exam details & Confirmation Request information, Exam details & Confirmation  Film management Tracking Tracking  Report Capture and presentation, dictation, transcription etc Capture and presentation, dictation, transcription etc  Dose records Support for IR(ME)R etc Support for IR(ME)R etc  Statistics: Examination numbers, Examination numbers, Equipment utilisation Equipment utilisation

9. IHE 20 October 2004Dave Plummer, UCL Hospitals Key PACS Functionality  Integration to HIS and RIS Modality worklists, Reporting lists, Prefetching Modality worklists, Reporting lists, Prefetching  Capture image from modality  Support radiographer QA/verification  Commit to secure storage  Make available for reporting display  Make available for review display  Make available for future visits  Support image sharing at cluster and national level.

10. IHE 20 October 2004Dave Plummer, UCL Hospitals RIS PACS Integration HIS RISBROKER MODALITY PACS

11. IHE 20 October 2004Dave Plummer, UCL Hospitals Desktop Integration  Close coupling of RIS and PACS applications  Ensures that RIS and PACS are in sync  Generally by establishing communications between two applications on the same computer.

12. IHE 20 October 2004Dave Plummer, UCL Hospitals RIS PACS Integration Desktop Integration HIS RISBROKER MODALITY Reporting Station PACS

13. IHE 20 October 2004Dave Plummer, UCL Hospitals Integrated RIS-PACS  Common patient and exam database  No confusion about status eg dictated/reported eg dictated/reported  Desktop integration should be inherent in the design.

14. IHE 20 October 2004Dave Plummer, UCL Hospitals RIS PACS Integration HIS RISBROKER MODALITY PACS RIS-PACS

15. IHE 20 October 2004Dave Plummer, UCL Hospitals Integrated RIS-PACS  May be appropriate solution if current RIS needs replacement.  Beware of potential gaps in functionality: Integration to external scheduling Integration to external scheduling Film management !! Film management !! IR(ME)R requirements IR(ME)R requirements Flexibility Flexibility  Some apparently ‘fused’ products are rather loosely glued

16. IHE 20 October 2004Dave Plummer, UCL Hospitals Beyond Radiology  Other Types of Images: Vascular Angiography Vascular Angiography Cardiac Angiography Cardiac Angiography Echocardiography Echocardiography Obstetric Ultrasound Obstetric Ultrasound Medical Photography Medical Photography Retinal Imaging Retinal Imaging Colposcopy / Cytology….. Colposcopy / Cytology…..  May be more of a RIS Issue than PACS

17. IHE 20 October 2004Dave Plummer, UCL Hospitals How IHE fits in  IHE specifies HIS/RIS/PACS integration. And has the potential to do much more! And has the potential to do much more!  No need to identify individual integration requirements  No need to provide an exhaustive list of functional requirements  List the integration profiles that you expect to be using and the actors that you want provided for them.

18. IHE 20 October 2004Dave Plummer, UCL Hospitals IHE Defines  Actors Abstract entities that are part (or all) of IT systems. Abstract entities that are part (or all) of IT systems.  Transactions Functional exchanges of information between Actors Functional exchanges of information between Actors  Integration Profiles Constraints on actors and transactions for performing specific functions. Constraints on actors and transactions for performing specific functions.

19. IHE 20 October 2004Dave Plummer, UCL Hospitals How to Use IHE  Be clear about the functionality needed  State in the requirement (and the contract) The Integration Profiles required The Integration Profiles required The Actors that will be in existing systems The Actors that will be in existing systems Any specific requirements beyond the IHE profiles Any specific requirements beyond the IHE profiles  Obtain a specific statement of: A commitment to deliver all aspects of the required functionality. A commitment to deliver all aspects of the required functionality. The integration profiles that each device supplied will be involved in. The integration profiles that each device supplied will be involved in. The devices (existing and supplied) that will be involved for each profile The devices (existing and supplied) that will be involved for each profile

20. IHE 20 October 2004Dave Plummer, UCL Hospitals Key issues in Procurement  Functionality  Training  Integration  Data Migration  Implementation  Make them all explicit in the contract.

21. IHE 20 October 2004Dave Plummer, UCL Hospitals Further Key Issues for PACS  Integration again Desktop, modality worklists, broker Desktop, modality worklists, broker  Capacity and Performance  Reporting functionality Screens, tools, workflow Screens, tools, workflow  Review functionality Web, user requirements Web, user requirements  Specialist Viewing Orthopaedics, Theatres … Orthopaedics, Theatres …

22. IHE 20 October 2004Dave Plummer, UCL Hospitals Summary  Understand Activity and Usage  Get a good team together  Analyze in IHE terms  Decide how you want RIS and PACS to relate to one another  Be aware of future changes  Use IHE in the specifications and the contract