Progress on Tactical and Strategic Data Sharing

1. Progress on Tactical and Strategic Data Sharing Dr Rhidian Bramley RCR PACS & Teleradiology Group Spring Meeting Newquay 30/03/07

2. Drivers and Challenges • 18 week wait • Patient Choice • Choose & Book • National Service Frameworks • Clinical Networks/MDTMs • Independent Sector and PCT providers • National wave 2 contracts • Local ICATS etc.

3. PACS Deployment Model Tactical Data Sharing Strategic Data Sharing

4. Progress on Tactical Data Sharing

5. National Image Sharing Policy • Sets out principles for data sharing across a Healthcare Community (HC) • Must specify participating organisations • Clinical business process to be supported • Sets out framework for setting up data protocol across the HC • Authorises various technical options

6. National Image Sharing Policy • Sets out a framework for setting up data data sharing protocol across a HC • Access control framework • Patient consent model for data to be shared • User access controls to patient identifiable data • Audit trails of data sharing and access • Assess requirement for data encryption • Error correction procedures

7. National Image Sharing Policy • Authorises Various Technical Options • Where available and supported, the following image sharing mechanisms can be facilitated: • secure transfer on removable media • point-to-point sender initiated ‘push’ DICOM image transfer, for example via Teleradiology products • DICOM query/retrieve from another PACS Entity’s local data store • web accessing another PACS entity’s local data store within a healthcare community

8. PACS Reporting Workstation 1Mp 1Mp PACS Server PACS Server PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation 2Mp 2Mp 3Mp 3Mp ModalityWorkstation PACS webWorkstation Imaging Modality RIS Transfer of images on CD • Access control frameworks • Encryption • Error correction

9. PACS Reporting Workstation 1Mp 1Mp PACS Server PACS Server PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation 2Mp 2Mp 3Mp 3Mp PACS webWorkstation ModalityWorkstation Imaging Modality RIS DICOM teleradiology ‘push’ • Access control frameworks • Encryption • Error correction N3 Teleradiology Link 2Mp

10. PACS Reporting Workstation 1Mp 1Mp PACS Server PACS Server PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation 2Mp 2Mp 3Mp 3Mp ModalityWorkstation PACS webWorkstation Imaging Modality RIS DICOM teleradiology ‘pull’ • Access control frameworks • Encryption • Error correction N3 Teleradiology Link 2Mp

11. PACS Server PACS webWorkstation PACS webWorkstation PACS webWorkstation PACS webWorkstation Imaging Modality Web based access teleradiology • Access control frameworks • Encryption • Error correction N3 Teleradiology Link Web access https/SSL

12. National Report Sharing Policy • Doesn’t yet exist • Clear message from clinical community that images and reports MUST be kept together at all times. • Tactical solutions MUST keep images and reports together. You MUST address this in your data sharing protocol.

13. PACS Reporting Workstation 1Mp 1Mp PACS Server PACS Server PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation 2Mp 2Mp 3Mp 3Mp ModalityWorkstation PACS webWorkstation Imaging Modality RIS Transfer of reports on CD DICOM SR

14. PACS Reporting Workstation 1Mp 1Mp PACS Server PACS Server PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation 2Mp 2Mp 3Mp 3Mp ModalityWorkstation PACS webWorkstation Imaging Modality RIS DICOM teleradiology ‘push’ N3 Teleradiology Link DICOM SR 2Mp

15. Tactical Use of Cluster Data Store For data sharing prior to integration with PDS, SSO, LRS • Benefits • Single repository = single search • Not limited to web based access • Risks and Issues • User logon management • Multiple patient Ids. No NHS number prefetch • No report sharing • Error correction procedures • Feasibility studies • Kent & Medway pilot • Broadview risk assessment

16. Progress on Strategic Data Sharing

17. Strategic Clinical Requirements • Workshops • January SC/NWWM Clusters/FJA/CSC • March NEEM Cluster/Accenture • April London cluster/BT • National PACS Clinical Imaging Data Sharing Requirements document • 20 clinical best practice requirements • Describes primary imaging/reporting and imaging review workflows to be supported

18. Strategic Technical Requirements • Keeping Images and Reports together document • IHE Reporting Workflow & Portable Data for Imaging • IHE Profiles for NHS CfH PACS • Scheduled workflow, patient information reconciliation • Reporting Workflow, PDI, Import reconciliation workflow • XDS-I Cross enterprise data sharing for imaging

19. Clinical Imaging Data Sharing Workflow Requirements

20. Objectives Identify common clinical data sharing workflows Form a consolidated set of clinical requirements (best practice guidelines) Use 1 and 2 to perform a gap analysis with existing and proposed LSP services Determine priority and feasibility for implementation of changing system design/features in parallel with the New Functional Requirements process

21. Primary Clinical Imaging WorkflowOverview Referring Clinician IRMER Practitioner IRMER Operator Reporting Clinician Reviewing Clinician All will benefit from access to relevant clinical imaging history, study images and reports

22. Primary Clinical Imaging WorkflowOutsourced Reporting Referring Clinician Reviewing Clinician IRMER Practitioner IRMER Operator Admin Process Reporting Clinician

23. Primary Clinical Imaging WorkflowOutsourced Image Acquisition Referring Clinician Reviewing Clinician IRMER Practitioner Reporting Clinician Admin Process IRMER Practitioner IRMER Operator

24. Primary Clinical Imaging WorkflowOutsourced Acquisition & Reporting Referring Clinician Reviewing Clinician IRMER Practitioner Admin Process IRMER Practitioner IRMER Operator Reporting Clinician

25. Imaging Review WorkflowInformal Imaging Review Referring Clinician Reviewing Clinician

26. Imaging Review WorkflowFormal Imaging Review Referring Clinician Reviewing Clinician Reporting Clinician

27. Imaging Review Workflow MDT Imaging Review Referring Clinician Reviewing Clinician MDTOrganiser Imaging Lead Reporting Clinician Reviewing Clinician

28. Clinical Data Sharing Requirements Study images and reports MUST remain associated at all times. Reports of a displayed study MUST be available via the user interface, by means of a single mouse click or equivalent. Study images SHOULD be made available through an automated direct link from the report so the user does not have to re-key patient or study data.

29. PACS Reporting Workstation 1Mp 1Mp 1Mp 1Mp 1Mp PACS Server PACS Server PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation 2Mp 2Mp 3Mp 3Mp ModalityWorkstation PACS webWorkstation Imaging Modality RIS DICOM teleradiology ‘push’ • Encryption • Access control frameworks • Error correction N3 Teleradiology Link 2Mp

30. PACS Reporting Workstation 1Mp 1Mp 1Mp 1Mp 1Mp PACS Server PACS Server PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation PACS RA600 System Admin Workstation 2Mp 2Mp 3Mp 3Mp ModalityWorkstation PACS webWorkstation Imaging Modality RIS DICOM teleradiology ‘pull’ • Encryption • Access control frameworks • Error correction N3 Teleradiology Link 2Mp