Paperless and ﬁlm less
for better Patient Care
Digitization of the Radiology Department
National Guard Health Affairs (NGHA) is proud to be a leading orga-
nization in the provision of “State of the Art” healthcare services,
with a clear strategy and vision to continue to develop health
systems and strategies to provide modern advanced medical care
to patients by focusing on the welfare and needs of the community.
NGHA’s accomplishments have been realized through the vision
and guidance of the Custodian of the Two Holy Mosques, HRH King
Abdullah bin Abdulaziz Al Saud, and the hard work and efforts of
NGHA staff, whose dedication and loyalty are instrumental factors in
In accordance with Information Technology Strategic Planning,
NGHA successfully moved toward a total automated health infor-
mation system. Full integration commenced with the latest network
and IT infrastructure through a complete integration of Enterprise
Resource Planning, and one of the top Clinical Information Systems
including centralized Computerized Patient Records. In order to
achieve a paperless, ﬁlmless healthcare organization, thus im-
proving efﬁciency and effectiveness of patient care, NGHA are intro-
ducing Enterprise Electronic Image Processing and Image Storage
to all Medical Imaging, Cardiac and Dental facilities.
Dr. Abdullah Al Rabeeah,
Chief Executive Ofﬁcer,
National Guard Health Affairs
In the mid 1990s it was evident that the conventional type of patient
administration (x-ray, ﬁlm management and reporting) would have
no future as this process incurred unnecessary staff activity and
avoidable delays in providing a rapid diagnosis. Further, increased
environmental awareness required a departure from the ﬁlm-screen
system, ﬁlm chemistry and disposal which had been used for
decades. A further reduction in radiation burden was also an in-
The solution was identiﬁed with the gradual implementation of an
integrated full version of the Radiology Information System (RIS) and
Picture Archiving and Communication System (PACS). The smooth
implementation of this substantial intervention in administration is
due to several months of preparation and training for staff, highly
motivated employees and the steady guidance provided by GE
Healthcare. RIS-PACS and speech recognition speed up the pro-
cedure of any high-quality radio logical examination, achieving
a beneﬁcial gain in time ensuring patient satisfaction.
The project will cover all NGHA facilities in the Central, Western and
Eastern Regions of Saudi Arabia, providing each Radiology Depart-
ment with diagnostic workstations. Some areas will also include
specialized clinical review workstations with high resolution. All
images will be accessible through the web and will be able to be
sent and received between all regions.
This achievement represents a major milestone in the continuation
of NGHA’s vision to provide advanced healthcare services to the
For large Healthcare Enterprises
In the mid-1990s it was already evident that the conventional type
of patient administration, X-ray ﬁlm management and reporting
would have no future, for the following reasons:
• Referrals to X-ray examinations on paper forms that were
delivered by messengers
• Recording of patient data in index card boxes and time-consuming
• Localization and retrieval of legacy X-ray ﬁlms from various ﬁlm
archives spread across different sections of the building, and some
ﬁlms and/or reports were irretrievable
• Unnecessary repeats in the event of incorrect exposures
• Time wasted making the X-ray image, dictating, typing and
reviewing the X-ray report, through to arrival by messenger at the
All this meant unnecessary staff activity and avoidable delays on
the way toward a rapid diagnosis, which has been the basic require-
ment for targeted therapy ever since reliable, sophisticated elec-
tronic systems became ready for the market due to technological
Last but not least, increased environmental awareness called for
a move away from the ﬁlm-screen system based on silver com-
pounds, which had been in use for decades, along with ﬁlm che-
mistry and disposal.
Also, a further reduction in radiation burden was an increasing
Simplify Clinical Practice
The solution to all these problems was identiﬁed as being the
gradual implementation of an integrated full version of RIS-PACS
(RIS = Radiology Information System, PACS = Picture Archiving and
Communication System). The fact that such a substantial inter-
vention in administration could be implemented smoothly at the
largest hospital in Saudi Arabia, despite full clinical routine, is not
only due to the several months of preparation and training for staff
but also to the highly motivated employees in all the departments
concerned and dependable advice provided by GE Healthcare.
RIS-PACS and speech recognition speed up the procedure of any
high-quality radiological examination, achieving a therapeutically
useful gain in time for clinicians and patients, so they make a valu-
able contribution on the way to ensuring satisﬁed patients.
The project will cover Riyadh, Dammam, Al Hassa & Jeddah
National Guard Health Affair institutes.
Each site will have diagnostic workstations at the Radiology depart-
ment with Long term and short term Archive. In addition, some area
will have specialized clinical review workstations with high resolu-
tion. The referral physicians will be able to access all images through
Also, doctors will be able to send and receive the images from/to
other National Guard institutes in Saudi Arabia. Moreover, the
following are in brief the main feature and beneﬁt of such system
at huge organization like National Guard Health Affairs.
The use of an integrated RIS-PACS means a quantum leap forward
in the work of the radiology department as a whole at Wilhelminen-
spital. All patient data is made available in a clearly organized way
and data security is maximized.
System convenience allows user doctors and staff members to
concentrate fully on the patient.
Shorter waiting times and hence earlier treatment appointments
are pleasing aspects of progress for patients. Due to the integrated
RIS-PACS not only are costs reduced, it is a major step toward
efﬁcient patient care.
• Radiology Information System (RIS)
Conventionally speaking, a RIS is a workﬂow-oriented patient
data management system that accompanies and documents
patient throughput within a radiology department by providing
electronic support. The system also handles reporting and
• Picture Archiving and
Communication System (PACS)
The purpose of a PACS is the transfer of digital image data and
safe storage, distribution, and processing. Reporting on digital
image data is performed at reporting stations with appropriate-
ly high-quality monitors that are linked to the archive system.
Full integration of
RIS and PACS
is the basic requirement
for inpatients reach Ra-
diology by fully electronic
Images of the patient
are generated at the
unit. The radiation dose is
cally by DICOM MPPS.
technology for extremely
fast image access, data
security and future-proof
All images are always
available at every work-
place „on demand“. Speech
recognition and 3D proces-
sing support the reporting
procedure. The report is
dictated into the computer
direct via a microphone.
When the report has been
successfully checked and
corrected by the typist it
is returned to the radiolo-
gist for approval.
Reports can be approved
Image distribution Demonstration
Images and reports are
available to clinicians on
the network (WEB brow-
ser) at any time.
One jump in quality
can also be seen from
the clinical discussion,
employing video beamers
and special conference
Improvement in Quality and Performance
One Choice for seamless Functionality
The Centricity RIS-PACS is the truly integrated technology for image
and information management in radiology. It brings together all of
GE‘s strengths and experience in information technology, imaging,
and process improvement to create a radiology solution focused on
information and workﬂow needs.
Centricity RIS-PACS is more than a combination of discrete RIS
and PACS functions. GE revolutionizes radiology workﬂow with the
next-generation Centricity RIS/PACS. It integrates RIS and PACS data
seamlessly into a User Based Solution for the Radiologist, Clinician
Uniﬁed RIS-PACS information
With some RIS-PACS systems, it seems as though the user has to
play the role of integrator – accessing data from multiple desktops
and logging on to and using a succession of applications.
Centricity RIS-PACS is different. It brings everything together for ra-
diologists and technologists with customized user-centric solutions
that deliver all required functionality in one view. This simpliﬁed
approach enables a huge leap in productivity and eliminates the
barriers to efﬁciency.
There is no need for multiple workstations or multiple logins. And
in their place Centricity RIS-PACS gives the tools to improve produc-
tivity and play a more central and immediate role in patient care.
Reporting at an integrated
Radiology Cockpit presents the image data at the integrated repor-
ting station in sync with the patient data of the Radiology Informa-
tion Systems (RIS). The relevant images are very simply selected for
the radiology clinical round, in the demonstration room. An image
folder provides all the previous exposures belonging to that region
of the body.
Reporting is controlled with the integrated dictation system. All the
necessary data such as request information and laboratory levels
are available at a glance.
State-of-the-art Centricity® RIS-PACS archive
The data acquired over several years can be stored In an area cover-
ing one square meter. The data sent to a failsafe cluster server is
transferred by the latter to a high-security storage system (Storage
By simply clicking on the patient on a RIS worklist the relevant data
is retrieved from the archive in a ﬂash and displayed on the PACS
Special lossless data compression methods enable direct fast retrieval
of image data over the network. With an on-demand system all the
images can be called up at any workstation at any time, without any
complicated routing rules or elaborate logistics. This ensures that the
reporting doctor always has all the current data at his ﬁngertips as
well as all the necessary previous reports and images for purposes of
Technology for Patients‘ Well-being
High availability in the server area
Without images there is no report! Operational reliability of the core
components is thus essential. Using a server architecture ensures
that if a server (cluster server) drops out there will be no deteriora-
tion in work. State-of-the-art SAN technology (Storage Area
Network) is also used in the ﬁeld of storage. Continuous, round-the-
clock operation is thus guaranteed.
Due to more and more new developments in radiography units the
radiologist is confronted with a data explosion that is difﬁcult to
cope with. The 3-di-
mensional display of
bones, organs, and
changes are thus
visualized better and
are easier to detect.
In a heterogeneous environment with different information systems,
functioning interfaces between them represents an integral part of
an efﬁcient system as a whole.
Seamless integration with the Hospital Information System (HIS)
can only be achieved with professional interfaces that are based on
Combined image and report distribution
employing WEB technology
The clinician is provided with all the relevant data of the radiological
examination using web technology. Immediate availability of data
ensures that the patient derives maximum beneﬁt from the techno-
logical developments. In the clinical ﬁeld, availability of all informati-
on is often crucial. As the WEB server communicates with the main
server directly without any intermediate storage of its own, previous
reports are always on hand.
We talk seven times faster than we type. The transcrip-
tion of dictated texts takes a lot of time, which could
be spent more usefully. Integrated speech recognition
converts dictations to text in real time. Subsequent
ﬁnalization of the documents takes much less time
than it used to.
Complete integration of speech recognition into the
Centricity RIS-PACS system facilitates the process
cycle and has speeded up the reporting process
If reports are available sooner, targeted treatment
for our patients‘ disorders can commence earlier.
One Company. One Vision. One Partnership.
Transforming Healthcare Delivery
Information technology will transform healthcare as we know it. The
healthcare organization of the future will empower care providers to
do just that – focus on providing care – instead of chasing docu-
ments and ﬁlling out reams of paperwork. Evidence-based medicine
will empower clinicians to provide the highest quality of care for a
speciﬁc condition. Decision-support tools will enable more informed
clinical care decisions for a speciﬁc patient. The digitized healthcare
community will foster collaboration between clinicians, care teams,
patients and provider organizations to ensure the best outcomes.
At GE Healthcare, we are making this vision of tomorrow a reality.
More than just implementing new monitoring networks or updating
monolithic systems, this digital transformation in healthcare means
completely rethinking and re-engineering the clinical process. It
means merging digital record-keeping with daily clinical workﬂow.
It means secure data streaming through both mission-critical and
dedicated life-critical networks that experience minimal downtime.
It means allowing a geographic separation between the point of
clinical care and the location of clinical decision. And that means
workﬂow transformation. Errors are reduced. Patients get well faster.
And your healthcare enterprise advances, because technology has
enabled it to become smarter. Healthcare Re-imagined.
Having the Centricity®
RIS-PACS is the truly integrated technology
for image and information management in radiology. Centricity®
RIS-PACS is more than a combination of discrete RIS and PACS
functions. It integrates RIS and PACS data seamlessly into a user
based solution for Radiologist, Clinician and Technologist.
RIS-PACS is different. It brings everything together
for radiologists and technologists with customized user-centric
solutions that deliver all required functionality in one view. Therefore,
there is no need for multiple workstations or multiple logins. The
integrated digital cockpit is unique to Centricity®
RIS-PACS. It takes
you in one login and one look, and you get the complete picture on
your patient. RIS-PACS Re-imagined.
NGHA IT –
Western Region &
Sales Manager Middle East & Africa,
National Guard Project Team