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Canada’s first VNA installed in Peterborough

By Jerry Zeidenberg

PETERBOROUGH, ONT. – What may be the first comprehensive Vendor Neutral Archive in Canada is currently being installed at Peterborough Regional Health Centre, just east of Toronto. The $2.5 million implementation not only replaces an eight-year-old radiology PACS, but it will provide storage and advanced reporting tools for cardiology studies, as well as DICOM and non-DICOM images from all other ‘ologies’ in the hospital, such as pathology and dermatology.

Large repositories for diagnostic images have been established in Ontario and other provinces, but they tend to house only images in the DICOM standard format, from radiology departments. The system at Peterborough Regional Health goes far beyond this, and it will connect to the Meditech electronic patient record system that’s used in the medical centre.

“Accessibility to images is going to be vastly improved for all clinicians,” said Lorel Morrison, director of diagnostic imaging at PRHC. “The tools the system offers, and the speed it works at, dwarfs what we currently have.”

Morrison noted that the system will also offer remote viewing for clinicians, who will be able to tap into the system from wherever they may be.

“On-call physicians may be home, or at the cottage on a boat, and they can still view patient images,” she said. “They can access the images on their phones or tablets, and they’ll even be able to use the system’s suite of tools. That’s something we didn’t have before for remote viewing.”

The solution includes Fujifilm’s Synapse Mobility Enterprise Viewer, which has been approved by Health Canada for diagnostic use. The system uses zero download technology for remote viewing, meaning that images don’t remain on the remote device – a boon for security. As well, no extra software needs to be downloaded with web browsers, which greatly reduces pressures on staff to manage the myriad smartphones and tablets that are used by clinicians.

With Fujifilm’s Synapse Cardiovascular, clinicians will also be able to call up ECGs, with tools to keep tabs on patients and to make decisions.

This remote-viewing feature means that on-call physicians may be able to provide instructions sooner, enabling treatment to start much more quickly.

Synapse Mobility also has a collaboration tool, enabling clinicians to simultaneously view images with their peers at other hospitals, to discuss cases and treatment options. This is a feature that many of PRHC’s physicians asked for when the project was in the initial stages.

“Our physicians are able to look at images on their screens while discussing them with, for example, specialists in downtown Toronto,” said Morrison. “We can send a secure link by email, and the images will open on their computer screens.”

This kind of collaboration is in great demand, and the new system will make it much easier to accomplish.

The new Fujifilm solution is being provided through its Canadian partner, Christie InnoMed. Peterborough selected Christie InnoMed from nine vendors who responded to the original Request for Proposal.

Last year, Fujifilm purchased U.S.-based TeraMedica, a VNA developer with a large installed based in the United States and abroad. The TeraMedica technology is at the core of the Fujifilm solution.

When the hospital was in the decision-making stage, it assembled a team of 40 clinicians from across the facility to evaluate options and make suggestions about the features that were most useful and desirable.

There are quite a few components to the Christie InnoMed solution. Included in Fujifilm’s Synapse suite are Synapse VNA, Synapse PACS, Synapse Cardiovascular with OPEN ECG, Synapse 3D for advanced visualization, Synapse Mobility Enterprise Viewer offering a patient centric access to all types of images on a single workstation, Cadens Colon virtual colonoscopy, and Crescendo Systems front-end dictation and voice-recognition for fast transcription. These components are all running on a virtual VMWare solution.

The major parts of the system are scheduled to be installed by June. “It’s a very fast implementation,” said Morrison.

She noted that the Synapse VNA will help organize the clusters of images that are quickly growing throughout the hospital.

There are currently many pockets of images that are collected but not archived in any systematic way.

For example, there are many ambulatory clinics in the hospital that like to take jpg images using digital cameras. “If a patient came back, some time later, and wanted to see his wound care images, chances are they just wouldn’t be there,” said Morrison.

However, using the new system, the images can be stored in Synapse VNA. They will be linked to the patient record using a header with demographic information.

This process can be used with all sorts of images that are proliferating, in surgery, endoscopy, and others. Morrison mentioned the example of pathology, which in addition to slides, is using a lot of digital photography, as well.

“In pathology, we take a lot of pictures to look at lesions. The new system will make it all available electronically.”

She observed that ultrasound usage, too, is quickly growing, with point-of-care ultrasound becoming popular with physicians, especially in the ER. “In the past, these ultrasound images have rarely been stored. But in the future, the new system will allow them to be stored with the right patient identifiers.”

With the Synapse Mobility Enterprise Viewer’s patient centric access, the system will give clinicians – and patients – a much more accurate view of medical histories.

Automated tools will call up associated images, so that physicians can view the information need all at once. “If the patient is coming in for a cath procedure, the system will call up all the previous X-rays and CTs,” said Morrison.

There will also be tight integration with the Meditech electronic health record. A single button in the EHR will launch the imaging system, so that clinicians can access the images they need without logging into a separate system.

Morrison said as well as all the software systems and tools that are being implemented, there is also a major hardware upgrade going on as part of the project.

Not only will clinicians benefit from the new software capabilities, which will enable them to obtain more information and make better decisions than ever before, but the new hardware will run it all at very fast speeds. “The speed of it all is very impressive,” said Morrison.

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