Rollout of Digital Radiology Tool Supports Australias Largest Public Healthcare System

A patient’s medical imaging history is an important piece of the puzzle for clinicians when it comes to delivering healthcare.

When that history is stored independently at different hospital sites and kept in paper form, the full picture of a patient’s history can be hard to see.

This was the starting point six years ago for NSW Health, Australia’s largest public health system, which supports more than 8.1million* people through 17 Local Health Districts (LHDs) and three Specialty Health Networks (SHNs) across the state.

NSW Health needed a solution to future-proof and streamline medical imaging to deliver greater visibility and continuity of a patient’s care.

So began the journey to digitise over one billion existing images housed at public hospitals across NSW.

The Case for Digitisation Of Medical Imaging Services

Before NSW Health’s Radiology Information System and Picture Archiving and Communication System (RIS-PACS) was introduced, patients often had to repeat scans or bringpaper-based medical imaging histories to appointments.

Clinicians had to navigate a range of disparate and sometimes ageing systems, often making treatment decisions based on limited imaging history data.

eHealth NSW, as NSW Health’s digital centre of excellence, partnered with LHDs and SHNs to design and deliver the solution. LHD leaders and clinicians provided invaluable input to both design and implementation.

Core tosolution design was the need for integration with existing databases and systems including the Electronic Medical Record (EMR), Patient Administration System (PAS) and Enterprise Imaging Repository (EIR).

The solution design also needed to be future-proofed – enabling ongoing enhancements, an ability to scale to demand, and adapt as technology evolves.

Working closely with an external vendor, Sectra, eHealth NSW launched (RIS-PACS) in 2016.

A Digital Solution

RIS-PACS stores key information, digital images and results, which are accessible to hospital-based treating teams state-wide.

In simple terms, it means a patient’s journey can be tracked from image requisition, through to diagnosis almost instantly.

Representing one of the most significant digital changes to NSW Health infrastructure to date, RIS-PACS enables integrated imaging and archiving, while working seamlessly with different IT systems.

It provides a single source of truth for state-wide imaging information with increased data storage, heightened security and greater reliability.

Each patient is now linked to a single, secure record,giving clinicians fast and easyaccess to diagnostic reports and images.

The vendor neutral archiving solution design means clinicians can now retrieve images no matter what format they are in or which system they came from originally.

The capacity for RIS-PACS to integrate seamlessly with existing systems has reduced double handling or the need to manage multiple systems independently when documenting patient care.

This in turn has increased information sharing which is helping with interhospital transfers and providing a complete picture of the patient’s health status.

For patients, the burden of remembering to bring records and provide these physical copies at every point in their care has been removed.

Instead, patients now have direct access via a secure online portal to their images and reports and can avoid having multiple and repeated imaging.

The Story So Far

Since 2016 RIS-PACS has been delivered to 46*** hospital sites across nine LHDs.

In addition to building the imaging database for new scans, more than 20 million**** archived images have also been transferred into the system.

The rollout also coincidedwith COVID-19, which accelerated the provision of virtual support for the system. This included using remote access, portable IT hardware and comprehensive online training all tailored to site specific requirements.

A dedicated 24/7 support phone number was set up as well asremote vendor support via a single secure terminal that kept patient data safe.

Conclusion

RIS-PACS is expected to be operational at 55 public hospitals by late 2023 when it’s rollout Many clinicians have shared their experiences with RIS-PACS including:

“The RIS-PACS solution has made it easier for NSW Health services to share important information about patients' health. This means that doctors can quickly and easily access patient records, which helps speed up the process of diagnosing illnesses,” said Paul Green, District Medical Imaging Manager, Northern NSW LHD, NSW Health.

Overall, RIS-PACS has decreased the necessity for patients to have to undergo multiple scans. It also works together with other healthcare systems used by NSW Health to give doctors a full picture of a patient's health.

“The ability to look at data and images while you’re on the move is amazing, particularly on mobile devices for our on-call doctors. You could be an orthopaedic doctor, a plastics doctor, a neurologist; anybody who is on call and needs to see the images remotely,” said Associate Professor NarenGunja from Western Sydney LHD, NSW Health.

“We’ve never had this kind of flexibility with the ability to see everything—the entire domain’s worth of imaging. For clinicians, and especially for mobile clinicians, it is a game-changer—a new way of working,” he continued.

So far, RIS-PACS has been rolled out across 46 NSW Health sites, with more than 20 million imaging studies migrated to the new system. It is due to be completed by the end of 2023.