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RECORDS, DATA & DOCUMENTS
Tomosynthesis is replacing traditional mammography at many hospitals Improving access to imaging
Kaye Bonython, head of imaging informatics at HCA Group, discusses how using a new VNA solution has signifi cantly improved access to imaging for the organisation’s clinicians. David Stevenson reports.
C
linical access to patient images has often been challenging and sometimes only
possible from specifi c locations given the size and complexity of pictures.
But HCA, the world’s largest private hospital group, which runs 28 hospitals, clinics and outpatient centres in London, Kent and Essex plus The Christie Clinic in south Manchester, is well on the way to delivering improved access to imaging in digital health records for patients undergoing breast cancer screening.
Using a new Vendor Neutral Archive (VNA) solution, as distinct from a traditional picture archiving and communication system (PACS), HCA has been able to provide clinicians with easier access to advanced imaging, such as 3D breast tomosynthesis imaging.
Kaye Bonython, head of imaging informatics at HCA Group, told us: “The need arose to take the route of bringing in a new radiology modality – tomosynthesis 3D breast imaging – which is replacing the normal mammography machines.
“Clinical benefi ts include signifi cantly improved results in the reduction of false negative and false positive reports. So, we wanted to be gold standard and move to tomosynthesis for our breast imaging.”
Data challenge
In the past, though, such fi les were held in disparate PACS or archive systems, but HCA’s view is that “it shouldn’t matter if a patient has an image acquired at site A; it should be viewable and accessible to those who have rights to view it across all its enterprise”.
That, however, proved a substantial challenge, especially as the images and fi le types that come from the tomosynthesis units are not standard, compared with other imaging modalities.
“These current images are not currently 60 | national health executive Nov/Dec 14
viewable through your standard PACS, so it would mean a requirement to go to a dedicated station,” said Bonython. “But with the help of Perceptive, we already had existing 3D management software that helped us and was integrated to the PACS system.
“The workfl ow now is that the images are acquired on the machine, and then sent off to the VNA. The radiologist can use the modality specifi c station on site, but it now means any radiologist can go to our PACS system, which will look to the VNA, fi nd the images and launch them through the management software we have integrated in the system – meaning we have images available across our enterprise.
“From an end-user perspective, doctors don’t want to know where the data is held – only that it is accessible. By having this situation in imaging, though, we found a great way of bringing in, on a small scale, what VNA will do for us, in the future, across the whole enterprise.”
NHE was told that the project, which has centralised the imaging process, and provided signifi cant benefi ts to clinicians already, cost around £2.5m to implement.
Clinical archive
Talking about the commissioning, integration and testing of the VNA solution, Mark O’Herlihy, director of healthcare at Perceptive UK and Ireland, told us that the process was done in a matter of weeks, with all the teams meeting regularly to ensure the project was kept on schedule.
He added that the fi rm provided HCA with a clinical archive, for the active archive, “so it is where the data is going to and being stored. It isn’t being stored in another application, it isn’t a back-up, it is an active archive”, noted O’Herlihy.
“We looked at their existing assets and viewing
technology and we plugged them all together and created a middleware platform for them to move data around – based on the needs of the clinician not the organisation.”
This was made easier by the fact that HCA’s devices supported the DICOM medical imaging standard, one of the three core healthcare industry standards used by Perceptive. But O’Herlihy added that even if the technology hadn’t supported DICOM, “we had toolkits that can bring these devices in and standardise the data. This allows the customer to access the information from multiple sources”.
More than 140 UK hospitals are using Perceptive’s VNA technology, with Nottingham University Hospitals NHS Trust saving £1m by localising its data as opposed to hosting it in a centre off site.
By improving the acquisition, storage and distribution of 3D breast imaging at HCA, the private hospital group now intends to move forward with an enterprise-wide solution, initially for all imaging but then for all documents it stores, to improve its digital health records.
Bonython, who is immensely proud of the work already undertaken at HCA, and the team eff ort to integrate the VNA solution quickly and effi ciently, added: “It gives our clinicians a more holistic view of patients, improving care and record keeping whilst giving patients the fl exibility to choose the screening centre and treatment facilities that are right for them.
“It will act as a gold stand- ard for breast cancer screening, enabling ear- lier detection and better treatment plans.”
Kaye Bonython
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