Going Digital
- March 2006
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Accurate, timely diagnostic tests are vital to assist doctors in making the correct diagnosis, and as technology advances, managing hard copies of x-rays, CT and MRI scans, nuclear medicine images, ultrasound images, angiograms and more is time-consuming, costly and increasingly out-of-date.
To keep pace with advancements in the storage and viewing of radiology-based images, the Niagara Health System has invested in a Picture Archiving and Communications System (PACS). PACS is a computerized information system that receives and stores images and data from several systems, and shares the information with authorized users on computer workstations, regardless of where they're located. The NHS has chosen the Agfa Health Care PACS system.
"There are very tangible benefits for patients with this system," says Radiologist Dr. Amit Mehta. "Now, there can be delays for a number of reasons in getting a diagnosis quickly, but when PACS is fully implemented at our hospitals, we will see our turn-around time for reports decrease significantly. Our specialists and radiologists will have full and instantaneous access to any diagnostic tests on PACS from the NHS's seven sites. This is a significant step forward for patient care."
Essentially, PACS will eliminate the paper and x-ray film generated in a radiology department, says Hilary Evans-Redpath, Regional PACS Project Manager for the NHS. "Digital imaging is the gold standard in radiology, because the quality is high and the speed with which images can be retrieved is incredible."
By April, St. Catharines General Site will be online with PACS, and all diagnostic test results will be in digital image format, with the exception of mammography. "Our Mammography Departments will continue to print x-ray film because the technology to guarantee high-quality images of breast tissue is not quite there yet," Hilary says.
The primary benefit of PACS will be easy, convenient access to images for radiologists and specialists. Currently, only one set of diagnostic film is created per patient test, and sometimes locating that film file is difficult and time-consuming. With PACS, access will be instant – there will be no more waiting for film to be processed, sorted, filed and then delivered to the radiologist for review. "Specialists such as orthopaedic surgeons and respirologists also review diagnostic images and they will be able to review them when it's convenient to them, literally with the touch of a button," explains Bonnie Sipos, Regional Technical Director, Diagnostic and Laboratory Services.
The clinical computer stations being set up are two or three panel monitor systems, with additional 20" flat screens being installed in various clinical areas. "Altogether, we are setting up 14 clinical viewing stations at St. Catharines General in the Diagnostic Imaging Department, ICU, Oncology, ER, with flat-screens in our OR's and Fracture Clinic," Hilary explains. Authorized users will in fact be able to access images throughout the hospital on regular desktop computers as well. Later in the year, access to physicians will be further enhanced, as PACS is made accessible to doctors' offices as required.
A unique element to PACS being installed at the NHS is voice recognition software. By this spring, radiologists at St. Catharines General will begin using voice recognition software and will dictate directly to the computer, which will type the report on the screen. The radiologist will then review and edit the report, electronically sign his or her approval, and it will be attached to the electronic patient record and into the PACS system. "We are really pleased with the Agfa voice recognition package," Hilary says. "It's about 90% accurate, and manages accents quite well."
All this high-tech work takes time. Installation of electrical and network cabling, new computer systems, renovations, equipment and staff and physician training on the new system takes about three months per hospital. "We are hoping this process will speed up as we progress from site to site, and our goal is to be full integrated and operating at all of our seven sites by early 2007."
The long-term benefit to PACS is savings. "We have calculated that PACS will have paid for itself in about five years," Bonnie says. "Film and processing chemical costs, processing equipment repair and replacement costs, storage costs, and longer hospital stays for our patients due to delayed diagnoses are very tangible expenditures that add up to millions of dollars each year, just in Niagara. Having PACS in place is a step in the right direction to make us more efficient."