An Overview of PACS-RIS Procurement

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An Overview of PACS-RIS Procurement

• Dave Plummer
• Department of Medical Physics and
  BioengineeringUCL Hospitals NHS Foundation Trust

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(No Transcript)
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Procuring IT Systems

• POISE
• Procurement of Information Systems Effectively

1. Identify the need
2. Survey the market
3. Prepare a business case
4. Obtain funding
5. Write a specification
6. Request tenders

1. Select supplier
2. Finalize contract
3. Purchase
4. Implement
5. Review

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Project Management

• Use a recognized methodology
• eg PRINCE2
• Involve the full spectrum of users
• Right from the start
• Meet Regularly
• Dont allow issues to go away
• Have a defined time frame
• Have a defined end point

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The Affect of NPfIT(in England)

• RIS is not a core application
• LSPs will provide RIS options but trusts are free
  to make their own arrangements.
• PACS is now a core component
• NPfIT does not permit open PACS procurement.
• The range of viable products may now be more
  narrow.
• Need to support integration to local clusters and
  the spine.

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RIS and PACS

• RIS is a database of radiology examination
  details
• PACS is a database of radiology examination
  details

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RIS and PACS

• RIS is a database of radiology examination
  details including
• scheduling, film management, report capture.
• PACS is a database of radiology examination
  details including
• Images
• Integration to modalities
• In both cases the core data records are patients
  and exams.

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Key RIS Functionality

• Integration to external systems
• HIS (CRS)
• Scheduling
• Rooms resources
• Examination details
• Request information, Exam details Confirmation
• Film management
• Tracking
• Report
• Capture and presentation, dictation,
  transcription etc
• Dose records
• Support for IR(ME)R etc
• Statistics
• Examination numbers,
• Equipment utilisation

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Key PACS Functionality

• Integration to HIS and RIS
• Modality worklists, Reporting lists, Prefetching
• Capture image from modality
• Support radiographer QA/verification
• Commit to secure storage
• Make available for reporting display
• Make available for review display
• Make available for future visits
• Support image sharing at cluster and national
  level.

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RIS PACS Integration
HIS
RIS
BROKER
PACS
MODALITY
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Desktop Integration

• Close coupling of RIS and PACS applications
• Ensures that RIS and PACS are in sync
• Generally by establishing communications between
  two applications on the same computer.

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RIS PACS IntegrationDesktop Integration
HIS
RIS
BROKER
PACS
MODALITY
Reporting Station
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Integrated RIS-PACS

• Common patient and exam database
• No confusion about status
• eg dictated/reported
• Desktop integration should be inherent in the
  design.

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RIS PACS Integration
HIS
RIS-PACS
RIS
BROKER
PACS
MODALITY
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Integrated RIS-PACS

• May be appropriate solution if current RIS needs
  replacement.
• Beware of potential gaps in functionality
• Integration to external scheduling
• Film management !!
• IR(ME)R requirements
• Flexibility
• Some apparently fused products are rather
  loosely glued

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Beyond Radiology

• Other Types of Images
• Vascular Angiography
• Cardiac Angiography
• Echocardiography
• Obstetric Ultrasound
• Medical Photography
• Retinal Imaging
• Colposcopy / Cytology..
• May be more of a RIS Issue than PACS

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How IHE fits in

• IHE specifies HIS/RIS/PACS integration.
• And has the potential to do much more!
• No need to identify individual integration
  requirements
• No need to provide an exhaustive list of
  functional requirements
• List the integration profiles that you expect to
  be using and the actors that you want provided
  for them.

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IHE Defines

• Actors
• Abstract entities that are part (or all) of IT
  systems.
• Transactions
• Functional exchanges of information between
  Actors
• Integration Profiles
• Constraints on actors and transactions for
  performing specific functions.

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How to Use IHE

• Be clear about the functionality needed
• State in the requirement (and the contract)
• The Integration Profiles required
• The Actors that will be in existing systems
• Any specific requirements beyond the IHE profiles
• Obtain a specific statement of
• A commitment to deliver all aspects of the
  required functionality.
• The integration profiles that each device
  supplied will be involved in.
• The devices (existing and supplied) that will be
  involved for each profile

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Key issues in Procurement

• Functionality
• Training
• Integration
• Data Migration
• Implementation
• Make them all explicit in the contract.

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Further Key Issues for PACS

• Integration again
• Desktop, modality worklists, broker
• Capacity and Performance
• Reporting functionality
• Screens, tools, workflow
• Review functionality
• Web, user requirements
• Specialist Viewing
• Orthopaedics, Theatres

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Summary

• Understand Activity and Usage
• Get a good team together
• Analyze in IHE terms
• Decide how you want RIS and PACS to relate to one
  another
• Be aware of future changes
• Use IHE in the specifications and the contract