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NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
NORrad
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NORrad
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NORrad

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  1. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System A Made-in-the-North Solution! Digital Imaging in North Eastern Ontario "Removing Geography from the Quality of Care Equation""Removing Geography from the Quality of Care Equation"
  2. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System Removing Geography fromRemoving Geography from the Quality of Carethe Quality of Care Equation:Equation: Diagnostic Imaging in North Eastern Ontario
  3. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System NORrad PACSNORrad PACS ((PPictureicture AArchiving andrchiving and CCommunicationsommunications SSystem)ystem) The Impact of the Digital Radiology Project
  4. NORrad Partners •Timmins •Hearst •Kapuskasing •Smooth Rock Falls •Cochrane •Iroquois Falls •Matheson •Kirkland Lake •Moose Factory •Englehart
  5. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System Overview of the NORrad Region • 9 separately governed hospitals • Timmins to James Bay • Over 100,000 people • Over 130,000 Procedures/Year • Over 300,000 square miles • Resource-based economy: mining + forestry • Population older than provincial average • 2 Radiologists
  6. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System Challenges in North Eastern Ontario • Distance • Weather • Access • Health Care and Physician Shortages • Availability of Diagnostic Resources • Sparse Population • Poor Health Status
  7. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System Why a Made-in-the-North Solution? • Patient care improvements locally and regionally • Practical solutions to meet real needs • Enhancing the integration of care among hospitals • Leveraging technology to overcome natural obstacles • Leveraging technology to create medical/fiscal efficiencies • Fiscally viable service • Making better use of limited human resources
  8. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System Health Care Benefits Hospitals • Enhanced support for small hospital physicians • Increased relevance of local and district hospitals • Elimination of lost films, decreased x-ray film storage and operating costs • Transfer of diagnostic images to referral or teaching hospitals to eliminate unnecessary patient travel • Avoids duplication of exams and reduces radiation exposure
  9. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System Health Care Benefits Physicians/DI Techs • Leverages shortage of physician • Reduces medical risk and professional isolation • Provides a virtual consulting relationship between radiologists + referring doctors irrespective of distance • Facilitates retention of existing physicians • Increased hospitals’ attractiveness to new physicians • Provides high tech employment for northerners • Improved working environment • Physician access to images/reports in their offices • Supports northern medical school innovation mandate
  10. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System Health Care Benefits Patients • Better patient care provided locally in distant communities • Improved access to local patient care • Better outcomes • Shorter lengths-of-stay & fewer admissions • Fewer emergency evacuations • Reduced travel to district & regional hospitals
  11. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System Clinical Example of PACS: • Moose Factory patient with bowel obstruction • Patient x-rayed at Moose Factory hospital • Local surgeon calls Timmins radiologist for diagnosis • Diagnosis made • Clinical consultation between radiologist and surgeon • Decision made to treat locally • Successful operative outcome • Enhanced local physician support • Unnecessary $5K emergency evacuation avoided • Better care provided locally
  12. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System 1) NORrad PACS Vision  To improve patient care by providing 24 / 7 / 365 radiologist access to all member hospitals 2) DI/PACS Current State  10 Hospitals in Network 13 – 100% filmless and fully integrated into the Timmins District Hospital Database  5 Hospitals in Network 11 are fully integrated into the Sudbury District Hospital Database  Working with SSM and Network 9 to fully integrate a PACS Solution fully compatible with Network 13 & 11  Working on Integration between all 15 PACS “Live” sites to integrate an MPI Solution. System will be LIVE by end of April 2005. 3) Top 5 challenges and barriers Provincial:  Vision, Leadership, Funding, District:  MPI Solution  Integration between multiple HIS/RIS systems.  Governance structure  Politics
  13. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System 1. 10 hospitals network 13 - Filmless and fully integrated into the Timmins District Hospital Database • All DI images from each site are sent via WAN to TDH where they are reported and permanently stored. • Each site has between 6 months and 1 year (or more) of local online storage depending on the workload at the site. • Each site has the ability to access images from any of the other NORrad sites as required. 2. EMPI AGFA (Enterprise Master Patient Identifier) solution • AGFA partnership with Initiate Systems to create an EMPI which will allow the automatic retrieval of relevant prior studies regardless of their origin within NORrad. • complete and seamless integration between all sites 3. Direct link to the North Eastern Ontario Regional Cancer Centre • was established for the benefit of patients referred to Sudbury for cancer care. 4. Web 1000 • VPN remote access to Web1000 permits consultation with specialists outside the NORrad group (e.g Toronto Sick Kids Hospital) 5. Orthopaedic Template software • allows orthopaedic physicians to make pre-operative measurements for hip and knee prostheses digitally. Timmins Network
  14. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System
  15. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System 1. 5 Hospitals in Network 11 are now fully integrated into the Sudbury District Hospital Database • All DI images from each site are sent via WAN to Sudbury Regional Hospital (Laurentian Site) where they are reported and permanently stored. • Each site has between 6 months and 1 year (or more) of local online storage depending on the workload at the site. • Each site has the ability to access images from any of the other NORrad sites as required. 2. Linking of Sudbury and Timmins databases completed. • Now able to transmit/retrieve images between a total of 15 hospitals in Northern Ontario 3. St. Joseph’s and Memorial Sites • Currently moving forward with implementing PACS at these two sites • Emergency, Ortho, ACU, ICU, Cardiac will be film less • Tentative completion date of 1st quarter 2006 Sudbury Network
  16. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System
  17. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System 1. The SAH (Sault Area Hospital) PACS implementation will include Group Health, Richard’s Landing, and Thessalon 2. PACS implementation to commence pending approval of funding requests. a. The technical configuration will be similar to Sudbury and Timmins b. Connectivity will be established using SSH allowing seamless transmission of images with Sudbury and Timmins allowing access to DI Images from all 19 hospitals possible Sault Ste Marie Network
  18. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System
  19. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System 1. Currently undergoing RFP process North Bay Network
  20. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System
  21. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System The NORrad PACS model has been recognized by Canada Health Infoway as a key asset to constructing an EHR 1. EMPI – Enterprise Master Patient Identifier (Initiate Systems) • LIVE Date – End of April 2005 • Will allow access to a patient’s relevant prior DI images regardless of the originating institution 2. North Network has chosen AGFA PACS to facilitate the delivery of clinical care in Ontario. • 100 member hospitals • 1500 health professionals (GP’s, Physiotherapists, Nutritionists, and Speech Pathologists) • 700 specialists across 70 medical specialties • 1000+ clinical consultations/ month • 3000 people participating in 150 educational sessions/month NORrad Phase 2
  22. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System • Projects underway – Sonultra OB Reports – Cardiac Intergration • Holter, Stress, ECG and Pyramis Intergrated Cardiology System NORrad Phase 2
  23. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System
  24. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System – Combination of Storage Appliances – IBM DS8100 and DS4500 – 5 years projected storage on spinning disk. – 14 TB (FC) on the DS8100, expansion to 115 TB – Images requiring quicker access times will reside on the DS8100. – Expansion could be used for other LHIN 13/14 applications that require robust storage capacity – DS 4500 – 135TB useable space using SATA Drives. – Images not requiring faster access times reside on cheaper SATA drives. – IBM Tivoli Storage Manager connecting the above architectures allowing data to be moved between storage media. – IBM 3584 Tape Library for Backup purposes – GEN 3 Drives, 1167 slot capacity – Potential to use site as a true Business Continuance Site. Other factors that have to be considered are network bandwidth, MPI, etc. – Total Cost of this solution - $ 3,001,068.00 Data Centre Design
  25. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System
  26. NORradNORrad Northern RadiologyNorthern Radiology PACSPACS Picture Archive Communication SystemPicture Archive Communication System THANK YOU !!

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