Short lines of communication and chain-thinking are essential
Effective cooperation within the team is and remains essential. “You need a close-knit team with both technical and functional people, a team that is very good at sparring. What’s more, including the key users from each department in the change process from the very beginning is crucial – you must ask for their input and keep them informed. Ultimately, they are the ones who will disseminate the new working method to the rest of the department, making the go-live that much easier,” explains Lauri Buijs, Technical Application Manager within the project team.
“Because we consolidated PACS1 and PACS2 together in Agfa HealthCare’s Enterprise Imaging, we now have a team that can take wide-ranging actions,” adds Dirk. “A form of chain-thinking also arose across the departments and functions as well as outside the walls of the hospital with the software and device suppliers. Given the tempo with which we aimed to connect the departments, this was extremely important. And after the roll-out, it is much easier for this collective team to respond to new requests from the departments and to develop innovations.”
Working with the closed order loop
“One of the departments where we have set up the closed order loop is Dermatology,” Edwin van Harn, one of the team’s Functional Application Managers, tells us. “There, they took photos with a camera and these photos were saved somewhere on a network disc. Now, an order is created in the EPR. With the Capture tool from Agfa’s universal viewer, XERO, we can add the photos that were taken to the order in a simple and secure manner. That way you can link the report and the images to the actual request, and all the patient data ends up in a secure place.”
“We were also able to achieve added value quickly in the Clinical Neurophysiology Department,” explains Lauri. “One examination that I would like to single out is the duplex ultrasound. In the past, the images from that examination were printed out, glued to a piece of paper and scanned again, if needed. The act of printing and scanning them resulted in such a significant loss of depth and grey scale values that the images lost all their diagnostic value. The images were secured by burning a DVD directly from the ultrasound device that had produced the images. And this DVD ended up in a locked cabinet which was only accessible to the people in the department.
But now, because all images are managed centrally in Agfa HealthCare, all these unnecessary operations are no longer required. The measurement values, which in the past had to be manually typed out, are now automatically entered into the EPR. This saves quite a bit of time and helps prevent errors. The images and results can be retrieved together from a logical location. And, what’s more, it’s quick – so the patient’s course of treatment is not delayed.”
Especially those departments that had to wait somewhat longer and that have all kinds of work processes that are labor-intensive – they have welcomed the project team with open arms. “I am positively surprised about the enthusiasm with which this is being taken on board in the departments and about how everyone is putting their backs into achieving this. Knowledge, competency, commitment and passion from the people. I see that over and over again in all the departments,” says Dirk.
Better experience for the clinician and for the patient
In the past, everything was segregated. The images could often only be viewed by the specialist who had performed the examination and not by those who had not submitted a formal request. Or the images were located somewhere that the user thought was very logical at the time, but they could not be easily found later on.
“For the specialist, it is handy to have all the images from one patient, together with the results, stored away neatly in one system,” explains Barbara. Now they can inspect the images using the XERO Viewer that is integrated into the EPR. Not only are the images easier to locate, the whole process is just much faster.”
“According to me, it is also important from a multidisciplinary point of view. A doctor from a different department can see the examinations a patient has already undergone,” observes Lauri. “Imagine you have a lung disorder. In addition to the CT scan of your lungs, you have also had a neurological exam which may also be correlated to your symptoms.”
The opportunity to avoid double examinations is also of enormous benefit to the patient. In the past, if a cardiologist ordered the same exam as the neurologist, that would go unnoticed, but not anymore.
More secure and more manageable
“By centralizing all the medical images in one well-oiled system, everything becomes easier to manage and control. And when a system has fewer links, you can raise the overall security to a higher level while reducing the chance of errors,” continues Arnaud.
And, within the new platform, a log is automatically created of who views which images when. All measures for safeguarding the security of the platform. And because the images are now all in one place, they have a better overview of, and choice of, the retention periods for the images than they did when they were stored in many decentralized locations.
“With this system we have also created the opportunity to examine possible next steps, such as improving the exchange of images with other hospitals and care professionals in the region (via XDS), making the images accessible to patients and applying AI for decision support. Consider, for example, algorithms for COVID-19 screening, which are of great interest currently and which, of course, the hospital is already using,” adds Dirk.
“And the benefits are not only qualitative. If you look at the cost of the system, this was definitely an attractive business case. The fact that we can phase out the old systems, limit the administrative burden and agree to better conditions with the supplier means seriously positive returns for our hospital,” concludes Arnaud.