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National GuardHealth AffairsDigitization of the Radiology DepartmentIntegrated RIS-PACSPaperless and ﬁlm lessAccurate Diagnosisfor better Patient Care
Centricity ® RIS-PACS:For large Healthcare Enterprises Dr. Abdullah Al Rabeeah, Chief Executive Ofﬁcer, National Guard Health AffairsNational Guard Health Affairs (NGHA) is proud to be a leading orga- In the mid 1990s it was evident that the conventional type of patientnization in the provision of “State of the Art” healthcare services, administration (x-ray, ﬁlm management and reporting) would havewith a clear strategy and vision to continue to develop health no future as this process incurred unnecessary staff activity andsystems and strategies to provide modern advanced medical care avoidable delays in providing a rapid diagnosis. Further, increasedto patients by focusing on the welfare and needs of the community. environmental awareness required a departure from the ﬁlm-screenNGHA’s accomplishments have been realized through the vision system, ﬁlm chemistry and disposal which had been used forand guidance of the Custodian of the Two Holy Mosques, HRH King decades. A further reduction in radiation burden was also an in-Abdullah bin Abdulaziz Al Saud, and the hard work and efforts of creasing challenge.NGHA staff, whose dedication and loyalty are instrumental factors inour success. The solution was identiﬁed with the gradual implementation of an integrated full version of the Radiology Information System (RIS) andIn accordance with Information Technology Strategic Planning, Picture Archiving and Communication System (PACS). The smoothNGHA successfully moved toward a total automated health infor- implementation of this substantial intervention in administration ismation system. Full integration commenced with the latest network due to several months of preparation and training for staff, highlyand IT infrastructure through a complete integration of Enterprise motivated employees and the steady guidance provided by GEResource Planning, and one of the top Clinical Information Systems Healthcare. RIS-PACS and speech recognition speed up the pro-including centralized Computerized Patient Records. In order to cedure of any high-quality radio logical examination, achievingachieve a paperless, ﬁlmless healthcare organization, thus im- a beneﬁcial gain in time ensuring patient satisfaction.proving efﬁciency and effectiveness of patient care, NGHA are intro-ducing Enterprise Electronic Image Processing and Image Storage The project will cover all NGHA facilities in the Central, Western andto all Medical Imaging, Cardiac and Dental facilities. 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 community
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 areaIn the mid-1990s it was already evident that the conventional type will have specialized clinical review workstations with high resolu-of patient administration, X-ray ﬁlm management and reporting tion. The referral physicians will be able to access all images throughwould have no future, for the following reasons: the web.• Referrals to X-ray examinations on paper forms that were Also, doctors will be able to send and receive the images from / to delivered by messengers other National Guard institutes in Saudi Arabia. Moreover, the• Recording of patient data in index card boxes and time-consuming following are in brief the main feature and beneﬁt of such system searches at huge organization like National Guard Health Affairs.• 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 referring ward.All this meant unnecessary staff activity and avoidable delays onthe 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 technologicalprogress.Last but not least, increased environmental awareness called fora 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 increasingchallenge.
Improvement in Quality and PerformanceThe use of an integrated RIS-PACS means a quantum leap forward Appointmentin the work of the radiology department as a whole at Wilhelminen-spital. All patient data is made available in a clearly organized wayand data security is maximized.System convenience allows user doctors and staff members to Appointment inquiriesconcentrate fully on the patient. for inpatients reach Ra- diology by fully electronic means.Shorter waiting times and hence earlier treatment appointments Examinationare pleasing aspects of progress for patients. Due to the integratedRIS-PACS not only are costs reduced, it is a major step towardefﬁcient patient care. Images of the patient are generated at the appropriate radiography unit. The radiation dose is documented automati- • Radiology Information System (RIS) cally by DICOM MPPS. Archiving Conventionally speaking, a RIS is a workﬂow-oriented patient data management system that accompanies and documents patient throughput within a radiology department by providing State-of-the-art storage electronic support. The system also handles reporting and technology for extremely monitoring. fast image access, data security and future-proof paper- capability. and ﬁlm- Reporting • Picture Archiving and All images are always Communication System (PACS) less available at every work- place „on demand“. Speech recognition and 3D proces- The purpose of a PACS is the transfer of digital image data and sing support the reporting safe storage, distribution, and processing. Reporting on digital procedure. The report is dictated into the computer image data is performed at reporting stations with appropriate- direct via a microphone. ly high-quality monitors that are linked to the archive system. Speech recognition When the report has been successfully checked and corrected by the typist it is returned to the radiolo- gist for approval. Approval Reports can be approved very quickly. Image distribution DemonstrationFull integration ofRIS and PACSis the basic requirement Images and reports are One jump in qualityfor ﬁlmless, available to clinicians on the network (WEB brow- can also be seen from the clinical discussion,paperless radiology ser) at any time. employing video beamers and special conference display protocols
One Choice for seamless FunctionalityThe Centricity RIS-PACS is the truly integrated technology for imageand information management in radiology. It brings together all ofGE‘s strengths and experience in information technology, imaging,and process improvement to create a radiology solution focused oninformation and workﬂow needs.Centricity RIS-PACS is more than a combination of discrete RISand PACS functions. GE revolutionizes radiology workﬂow with thenext-generation Centricity RIS/PACS. It integrates RIS and PACS dataseamlessly into a User Based Solution for the Radiologist, Clinicianand Technologist.Uniﬁed RIS-PACS information Reporting at an integratedWith some RIS-PACS systems, it seems as though the user has toplay the role of integrator – accessing data from multiple desktops RIS-PACS workstationand logging on to and using a succession of applications. Radiology Cockpit presents the image data at the integrated repor-Centricity RIS-PACS is different. It brings everything together for ra- ting station in sync with the patient data of the Radiology Informa-diologists and technologists with customized user-centric solutions tion Systems (RIS). The relevant images are very simply selected forthat deliver all required functionality in one view. This simpliﬁed the radiology clinical round, in the demonstration room. An imageapproach enables a huge leap in productivity and eliminates the folder provides all the previous exposures belonging to that regionbarriers to efﬁciency. of the body.There is no need for multiple workstations or multiple logins. And Reporting is controlled with the integrated dictation system. All thein their place Centricity RIS-PACS gives the tools to improve produc- necessary data such as request information and laboratory levelstivity and play a more central and immediate role in patient care. 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 Area Network). 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 monitor.
Technology for Patients‘ Well-beingOn-demand technologySpecial lossless data compression methods enable direct fast retrievalof image data over the network. With an on-demand system all theimages can be called up at any workstation at any time, without anycomplicated routing rules or elaborate logistics. This ensures that thereporting doctor always has all the current data at his ﬁngertips aswell as all the necessary previous reports and images for purposes ofcomparison.High availability in the server area 3D reconstructionWithout images there is no report! Operational reliability of the core Due to more and more new developments in radiography units thecomponents is thus essential. Using a server architecture ensures radiologist is confronted with a data explosion that is difﬁcult tothat if a server (cluster server) drops out there will be no deteriora- cope with. The 3-di-tion in work. State-of-the-art SAN technology (Storage Area mensional display ofNetwork) is also used in the ﬁeld of storage. Continuous, round-the- bones, organs, andclock operation is thus guaranteed. vessels supplements 2-dimensional display while pathological changes are thusOptimized interfaces visualized better and are easier to detect.In a heterogeneous environment with different information systems,functioning interfaces between them represents an integral part ofan efﬁcient system as a whole.Seamless integration with the Hospital Information System (HIS)can only be achieved with professional interfaces that are based onindustrial standards. Speech recognition 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 considerably. If reports are available sooner, targeted treatment for our patients‘ disorders can commence earlier.Combined image and report distributionemploying WEB technologyThe clinician is provided with all the relevant data of the radiologicalexamination using web technology. Immediate availability of dataensures 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 mainserver directly without any intermediate storage of its own, previousreports are always on hand.
One Company. One Vision. One Partnership. 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. Wael Khalil, And your healthcare enterprise advances, because technology has Sales Manager Middle East & Africa, enabled it to become smarter. Healthcare Re-imagined. GE Healthcare Having the Centricity ® RIS-PACS is the truly integrated technology for image and information management in radiology. Centricity ®Transforming Healthcare Delivery RIS-PACS is more than a combination of discrete RIS and PACS functions. It integrates RIS and PACS data seamlessly into a userInformation technology will transform healthcare as we know it. The based solution for Radiologist, Clinician and Technologist.healthcare organization of the future will empower care providers todo just that – focus on providing care – instead of chasing docu- Centricity ® RIS-PACS is different. It brings everything togetherments and ﬁlling out reams of paperwork. Evidence-based medicine for radiologists and technologists with customized user-centricwill empower clinicians to provide the highest quality of care for a solutions that deliver all required functionality in one view. Therefore,speciﬁc condition. Decision-support tools will enable more informed there is no need for multiple workstations or multiple logins. Theclinical care decisions for a speciﬁc patient. The digitized healthcare integrated digital cockpit is unique to Centricity ® RIS-PACS. It takescommunity will foster collaboration between clinicians, care teams, you in one login and one look, and you get the complete picture onpatients and provider organizations to ensure the best outcomes. your patient. RIS-PACS Re-imagined. NGHA IT – National Guard Project Team Steering Committee, Abdullah Al Ammari Chairman Project – Steering Committee, Dr. Majid Al Tuwarijri Project Executive, Radiology Chairman (Central Region, Dr. Bakheet Western Region & Al Dosari Eastern Region) Project Secretary NGHA GE Project Project Manager, Manager, Mark Boyd Mohd Mustafa Leader Leader Leader Leader Leader Integration, PACS IT Support, GE Modality Installation, Modalities, Installation, Abdul Mohamed Mark Boyd Abdul Aziz Ziyad Rahman Musalam Al Rumaih Qahtani Al Khudair