2005 C.I.P.A. Winners

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Thames Valley Hospital Planning Partnership

Transforming Diagnostic Imaging Delivery

Digital diagnostic imaging is transforming the efficiency of hospitals. This new technology eliminates the expensive use of films. As soon as an X-ray or other image is taken, it can be viewed on a computer screen and transmitted instantly on a network to any authorized person who needs to see it.

In 2002, hospitals in Southwestern Ontario began exploring the feasibility of sharing diagnostic imaging services. A group of eight hospitals, which had formed a partnership in the late 1990s called the Thames Valley Hospital Planning Partnership, secured federal and provincial funding to conduct a pilot project as the first phase of the Southwest Ontario Digital Imaging Network Project.

Challenge

There aren't enough radiologists in Southwestern Ontario. The average age of radiologists in the region is 58. To serve patients needing X-rays, CT scans and other medical imaging services in rural communities, radiologists travel from hospital to hospital. If a patient has an X-ray taken by film on a Friday, the radiologist probably does not see the result until a return visit Monday. If the problem appears serious, the patient is often transferred to a teaching hospital in London, the region's largest city, where tests and images are done all over again.

Small hospitals cannot afford their own radiology departments, even if there were enough specialists available to staff them. Hospitals saw a clear need to implement shared services, but it had never been done before and there was no money to implement such a system -- until the federal government established an agency called Canada Health Infoway in 2002 to accelerate development of electronic patient information.

That was the inspiration for action. Under the leadership of Diane Beattie, who is chief information officer for London's two teaching hospitals, St. Joseph's Health Care and London Health Sciences Centre, a group of administrators and health-care professionals applied for federal and provincial funding for a shared-services project that won the enthusiasm of 22 hospitals serving 38 sites in a region stretching from Owen Sound to Windsor.

Eventually, the group secured $15 million from Canada Health Infoway and $35 million from the Ontario Ministry of Health and Long-Term Care for eight hospitals to carry out a pilot project to implement a shared system for digital diagnostic imaging, the first of its kind in Canada.

Objectives

The Southwest Ontario Digital Imaging Network Project is intended to eliminate duplicate and inefficient services and improve patient care through shared services. Hospitals have agreed to adopt and use common standards and a common system for digital diagnostic imaging.

The first phase, the pilot project of the Thames Valley Hospital Planning Partnership, was intended to prove the concept and measure the benefits of a shared imaging network.

Solution

PACS (Picture Archiving and Communications Systems) is a system from GE Healthcare that captures, stores, retrieves and manipulates images such as X-rays and CT scans using digital computer technology. It is the same technology that is used in a digital camera -- it's filmless. It gives authorized people in multiple hospitals the ability to update and access digital images simultaneously and instantly, at any time from any location within the network.

Implementation of PACS in the first eight hospitals began in June 2004 and will be completed by the end of 2005. It has been a challenging project for Diane Beattie's six-member project team to manage; for example, in the two London hospitals alone, 9,000 health-care professionals had to be trained on the new system within six months.

The solution also includes a data repository using Cerner Millennium Radnet and a shared-services radiology information system from Cerner Corporation. Within that system, a Master Person Index provides the ability to complete a procedure, dictate a diagnosis, transcribe a report and view all patient images through a single patient record regardless of where the procedure was performed. This gives diagnostic imaging departments the ability to schedule, order, track, report, transcribe, bill and manage all procedures. All the hardware to run the systems is supplied by Hewlett-Packard Canada.

The pilot project, though not yet fully implemented, has already produced measurable results. London Health Sciences, for example, has achieved $1.2 million in film savings alone.

The Thames Valley Hospital Planning Partnership member hospitals are improving access to imaging services and specialists and mitigating the diagnostic imaging professional shortage. Patient management is improved through tracking of order status, drastic reduction in storage space requirements, and increased specialist and radiologist productivity by eliminating film searches and procedure duplication.

The first benefit that Diane Beattie cites, though, is better treatment for patients.

"It used to be that, if a patient here in London had an X-ray in the morning, the person would walk down the hall to the clinic with the film in hand," she says. "By the time it was developed, the doctor would be busy, and the patient could expect to be there for three or four hours.

"Today, by the time the patient walks down the hall, the specialist already has the image on the screen, so the patient doesn't have to wait to discuss the diagnosis. He or she is out of the hospital within an hour.

"The system has significantly changed the flow of the patient experience and the efficiency of the flow. Patients love it."

Innovative Use of Technology

The pilot project of the Thames Valley Hospital Planning Partnership is a leading international project in the transformation of healthcare services using information and communications technologies. It is being watched and evaluated by institutions around the world.

When all 22 Southwestern Ontario hospitals have joined the project, probably by the end of 2008, it will be one of the largest shared-imaging services anywhere, and 1.48 million residents will benefit from the improved productivity of the healthcare system.

A 2005 CIPA Winner!

For its exceptional and innovative application of information technology to solve real-world business problems and bring greater benefit to all its stakeholders, Thames Valley Hospital Planning Partnership has been awarded a Silver Award of Excellence from the 2005 Canadian Information Productivity Awards in the Customer Care Not For Profit category.

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