NS upgrades PACS, implements leading-edge capabilities

Nova Scotia has upgraded its picture archiving and communication system (PACS) across 40 locations, modernizing the hardware and software and providing the latest innovations in digital storage of medical imaging.

Moreover, the enhancements give radiologists new tools and will get them “future ready” for developments such as artificial intelligence (AI).

All of Nova Scotia’s hospitals, including IWK Health, which delivers care to women, children, youth and families of the Maritimes, are now equipped with Agfa HealthCare’s Enterprise Imaging solution.

Nova Scotia prides itself on having implemented one of the country’s first province-wide PACS, something it did in the early 2000s. Since then, it has continued to upgrade its PACS. This latest deployment of the Enterprise Imaging solution is the most recent step in staying at the forefront of medical imaging.

The new PACS is comprised of two applications:
First, the Enterprise Imaging solution, which is used primarily within diagnostic imaging, emergency departments, orthopaedics, and operating rooms. And second, the updated XERO clinical web viewer, which is used in many departments for viewing medical images.

“Ensuring continued integration within our existing and future digital environment was one of our main objectives,” noted Sandra Colavecchia, director of Enterprise Imaging with Nova Scotia Health’s Information Management and Technology Team (IM/IT).

Cardiologists have already been using the previous iteration of the PACS to store and access their images, something that will continue. At the IWK, the system will remain in place for the storing and viewing of images for Fetal Assessment Treatment Centre (FATC), ophthalmology, dentistry, and women’s health gynecological laparoscopy exams.

“The new platform,” said Colavecchia, “is the foundation of a provincial enterprise imaging strategy, which includes enabling the future storage of images from other clinical disciplines outside of the traditional areas of radiology and cardiology.”

Agfa’s Enterprise Imaging platform offers artificial intelligence features, such as triage reading prioritization, image pixel analysis, and the sharing of results of AI algorithms throughout the imaging process. However, these tools have not yet been implemented.

Lisa Shoniker, regional vice president sales for Agfa HealthCare Canada, said “the Enterprise Imaging platform is a single database which helps simplify the IT infrastructure by eliminating the overhead of routing, synchronization and replication.”

After careful design and planning, the actual deployment of the new systems – Enterprise Imaging and XERO – occurred quickly, taking just five months from February to July 2023.

Colavecchia said the implementation was completed quickly because of the knowledge and skills of the I.T. and radiology teams. “We have a very strong team of PACS administrators, many of whom have been here since the original PACS implementations (in the early 2000s). They have a comprehensive understanding of departmental workflows.”

“The new system continues to allow radiologists to function as needed across the province. They can access the images and information they require, no matter where the patient exams were taken,” said Scott McKenna, CIO, Nova Scotia Health and IWK Health. “It’s an end-to-end replacement and improvement of our hardware and software.”

McKenna added that the project went quickly and smoothly because it had buy-in from the clinical areas. It also had effective leadership from Dr. Judy Rowe, radiologist and physician lead of DI Informatics and Support Services within Nova Scotia Health’s Central Zone. “She played a leading role.”

For her part, Dr. Rowe said, “The upgrade from Agfa Impax to Enterprise Imaging is an important piece of the digital transformation strategy. It helps consolidate the patient record and allows radiologists easier access to the relevant imaging history of the patient, which is critical to optimal care.”

The previous imaging system enabled radiologists in different locations to collaborate on the same patient exam. The new system is taking that functionality even further.

As an example, using Enterprise Imaging, the clinicians can share the mouse while viewing the same study, which improves that ability for collaboration in a virtual environment.

DI departments in Nova Scotia conduct about 1.5 million exams each year. “It’s a monumental project,” said McKenna. “It’s expected to help the province more effectively manage the growing demand for diagnostic images now and in the future.”