Pilot projects by hospitals in British Columbia and Ontario will use existing technologies in new ways to take diagnostic imaging digital, eliminating the light boards and film we see on television shows like ER.
The projects are fueled in part by a $135 million investment by Canada Health Infoway (CHI), formed in 2000 by the federal and provincial governments to strengthen Canada-wide health infrastructure.
The Fraser Health Authority, which includes 12 hospitals in Southern B.C., as well as eight hospitals in the Thames Valley Region of Southwestern Ontario, will work to develop a shared services model for the sharing of diagnostic images like X-rays online among the member facilities. The other project includes eight hospitals in Southwestern Ontario in the Thames Valley region (London, Middlesex, Elgin and Oxford County hospitals).
The system will allow a doctor who sends a patient to another facility for an MRI to view those results immediately, or a radiologist to view an image on their home computer at night and make an immediate determination without having to drive into work.
Bill Dow, administrative director of medical imaging and nuclear medicine for the Fraser Health Authority, said the organization was already developing a Picture Archive Communications System (PACS) when it began working with CHI. The two groups will collaborate on rolling out the project in the coming months.
A fairly expensive technology, PACS is used primarily in large academic hospitals where a high volume allows a good return on investment. This makes the technology cost prohibitive for most hospitals, but by sharing the technology among a large group of hospitals the necessary economies of scale can be leveraged, health-care experts believe.
“”The vision for our PACS project is any image, anywhere, at any time,”” said Dow. “”In terms of deliverables, that means images we do in a diagnostic imaging department become available much quicker to the clinical decision makers. They’re not waiting for an X-ray to be delivered anymore.””
Delivering images electronically could be more effective and improve patient care by allowing a quicker diagnosis. Dow said Fraser also hopes it will motivate the organization to move towards the vision of an electronic health record, taking all health information and making it available electronically wherever and whenever it’s needed.
“”But that’s down the road,”” Dow said. “”You can’t even begin to go down that road until you tackle some of the challenges around things like what you do with a piece of film.””
For public organizations limited funding is always an issue, and Dow said his team has worked closely with partners like Telus Corp. and their main PACS vendor, General Electric, to look for innovative solutions for their network configuration, maximizing technologies like the Internet rather than adopting expensive proprietary technologies.
Once in place, Dow said the organization hoping for a range of human resources utilization benefits, adding that the clerical staff is really looking forward to getting rid of the big bags of film.
“”This is the way of the future for diagnostic imaging,”” said Dow.
Myrna Francis, Canada Health Infoway’s CEO, said the technology being used here is fairly mature. What’s different is how it’s being used, to facilitate the sharing of resources among a group of facilities to better leverage the benefits the technology brings.
“”We were looking for groups of hospitals we could work with to try the solution, share the technology among several facilities, and then work out the business metrics of how to reduce the cost and increase the speed of implementation,”” Francis said.
Besides the technology, different business practices are being examined through the two projects. In B.C., hospitals and health facilities are grouped into regional health authorities, with a board and overall responsibility for the facilities in a given area. On the other hand, in Ontario most of the facilities are standalone with no unifying body. For the Thames project, Francis says the CHI has had to help build a partnership governance model to provide that unifying body to not only share the costs of the instillation, but also work out the business arrangements to underwrite the ongoing maintenance costs for the project.
The goal is to have some good data available from the pilot projects in six to seven months that will allow for the replication of the projects and facilitate the sharing of diagnostic images electronically by facilities across Canada.
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