Interior Health may be the only major jurisdiction in Canada that has created a region-wide PACS that consolidates the medical images of both hospitals and community imaging clinics.
It was no small task, as the project integrated PACS and RIS of two tertiary hospitals – in Kelowna and Kamloops – as well as 35 other acute care centres that do imaging, along with eight independent imaging clinics.
The unified network has resulted in substantial benefits for radiologists and patients.
“It doesn’t matter where the patients go, the radiologists can easily access their images and reports,” said Norma Malanowich, Vice President, Clinical Support Services & Chief Information Officer at Interior Health.
That translates into time-savings and access to more accurate information by allowing radiologists to see previous exams and make comparisons.
As well, noted Malanowich, radiologists can go from one hospital to another, and even to independent clinics, and still use the same PACS. They don’t have to learn new systems, or try to remember how to call up exams or use the tools from one system to another.
GPs and other clinicians can also access the system from any site across Interior Health, which reduces the need to order duplicate exams.
The regional PACS had its origins in 2004, when Interior Health was deploying a McKesson PACS. (The company is now known as Change Healthcare.)
Management at that time had the foresight to realize that it would make sense to extend the PACS to community clinics as well as hospitals, so that all images and reports could be captured and accessed.
“They knew from the start that there would be a hole in the data if the community clinics weren’t included,” said Tim Rode, Program Director, Medical Imaging.
The clinics account for 18 percent of the images in Interior Health – less than in many other jurisdictions, but still representing nearly one in every five exams.
It was necessary to provide an incentive for the independent clinics to come aboard, change their workflow and invest in the region-wide PACS. So Interior Health offered to pay the upfront costs of the PACS licensing and workstations. The clinics would only have to shoulder the cost of ongoing support and storage.
All the clinics jumped at the offer – with the exception of an MRI clinic in Kelowna that remains the only community clinic today that’s not part of the regional solution.
More recently, Interior Health has been shifting to a centralized storage model, where community clinic images can be housed in regional servers, note John Geistlinger, Corporate Director, Clinical Informatics. This means lower storage costs for the community clinics, but they’ve had to invest in faster online technology to upload and download images efficiently.
“After testing and seeing that it works, two of the largest community clinics are intending on moving to this model,” said Geistlinger.
Creating a region-wide PACS would be harder if they had to start today, as it’s likely that some community clinics would have their own PACS. That would require much more time, effort and money to integrate them into the IH PACS.
Still, Malanowich says, it’s a model that some jurisdictions in Canada might want to look at, especially if many of their community clinics haven’t installed PACS.
“It fits a rural environment,” she says. “And there are lots of places across Canada that have a similar mix of urban and rural hospitals and clinics.”
Interior Health continues to innovate. It has implemented voice recognition technology for dictation/transcription, and has extended the solution to radiologists in community clinics. The system has been a great success.
“97 percent of the radiologists have adopted it,” commented Geistlinger. “They don’t see a transcriptionist which has resulted in faster report turn-around times and lower costs.”
A patient portal has also been deployed allowing patients access to their imaging reports online. Over 30,000 patients are now enrolled and reviews are very positive, Geistlinger said.