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Enterprise Medical Imaging for Improved Radiological Workflows in Zambian Public Health Facilities

Academic talk, on "Enterprise Medical Imaging for Improved Radiological Workflows: Towards an Interoperable and Standards-Based Medical Imaging Platform in Public Health Facilities in Zambia", given at part of the Zambia Digital Health Conference 2022 [1]. The peer-reviewed publication of the talk is available online [2]. [1] https://www.moh.gov.zm/?page_id=1800 [2] https://www.moh.gov.zm/?wpfb_dl=160

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Enterprise Medical Imaging for
Improved Radiological Workflows in
Zambian Public Health Facilities
1
Adult Hospital, University Teaching Hospitals, ZAMBIA
2
DataLab Research Group, University of Zambia, ZAMBIA
Ernest Obbie Zulu1
Lighton Phiri2
1st
Zambia Digital Health Conference
October 19–21, 2022 | Lusaka, Zambia
2/25
October 19–21 , 2022 1st
Zambia Digital Health Conference
Outline
● Radiological Workflow
● Project Overview
● Zambia eHealth Strategy
● Methodology
● Medical Image Storage, Management and Access
● Prototype PACS Platform
● Conclusion & Future Work
3/25
October 19–21 , 2022 1st
Zambia Digital Health Conference
Radiological Workflows
4/25
October 19–21 , 2022 1st
Zambia Digital Health Conference
Project Overview: Health Sector in Zambia
● ~2815 health facilities
○ Government of the
Republic of Zambia (GRZ),
Military,
Non-Governmental
Organisations (NGO) and
Private
http://datalab.unza.zm/bibcite/reference/37
“Enterprise Medical Imaging in the
Global South: Challenges and
Opportunities”
Ernest Obbie Zulu and Lighton Phiri
(IST-Africa 2022)
5/25
October 19–21 , 2022 1st
Zambia Digital Health Conference
Project Overview: Health Sector in Zambia
● Our work focused on GRZ
health facilities
○ 151 facilities classified as
Level 1, 2 or 3 Hospitals
● Only 9 GRZ Radiologists,
operating in five facilities
http://datalab.unza.zm/bibcite/reference/37
“Enterprise Medical Imaging in the
Global South: Challenges and
Opportunities”
Ernest Obbie Zulu and Lighton Phiri
(IST-Africa 2022)
6/25
October 19–21 , 2022 1st
Zambia Digital Health Conference
Project Overview: Preliminary findings from
EMI project
● Health facility adoption and use of eHealth are more in
private- and military-owned health facilities
● Generally good awareness of potential of eHealth to make
healthcare service delivery more efficient
● Stakeholders in public health facilities desire and are willing
to accept use of eHealth

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Enterprise Medical Imaging for Improved Radiological Workflows in Zambian Public Health Facilities

  • 1. Enterprise Medical Imaging for Improved Radiological Workflows in Zambian Public Health Facilities 1 Adult Hospital, University Teaching Hospitals, ZAMBIA 2 DataLab Research Group, University of Zambia, ZAMBIA Ernest Obbie Zulu1 Lighton Phiri2 1st Zambia Digital Health Conference October 19–21, 2022 | Lusaka, Zambia
  • 2. 2/25 October 19–21 , 2022 1st Zambia Digital Health Conference Outline ● Radiological Workflow ● Project Overview ● Zambia eHealth Strategy ● Methodology ● Medical Image Storage, Management and Access ● Prototype PACS Platform ● Conclusion & Future Work
  • 3. 3/25 October 19–21 , 2022 1st Zambia Digital Health Conference Radiological Workflows
  • 4. 4/25 October 19–21 , 2022 1st Zambia Digital Health Conference Project Overview: Health Sector in Zambia ● ~2815 health facilities ○ Government of the Republic of Zambia (GRZ), Military, Non-Governmental Organisations (NGO) and Private http://datalab.unza.zm/bibcite/reference/37 “Enterprise Medical Imaging in the Global South: Challenges and Opportunities” Ernest Obbie Zulu and Lighton Phiri (IST-Africa 2022)
  • 5. 5/25 October 19–21 , 2022 1st Zambia Digital Health Conference Project Overview: Health Sector in Zambia ● Our work focused on GRZ health facilities ○ 151 facilities classified as Level 1, 2 or 3 Hospitals ● Only 9 GRZ Radiologists, operating in five facilities http://datalab.unza.zm/bibcite/reference/37 “Enterprise Medical Imaging in the Global South: Challenges and Opportunities” Ernest Obbie Zulu and Lighton Phiri (IST-Africa 2022)
  • 6. 6/25 October 19–21 , 2022 1st Zambia Digital Health Conference Project Overview: Preliminary findings from EMI project ● Health facility adoption and use of eHealth are more in private- and military-owned health facilities ● Generally good awareness of potential of eHealth to make healthcare service delivery more efficient ● Stakeholders in public health facilities desire and are willing to accept use of eHealth
  • 7. 7/25 October 19–21 , 2022 1st Zambia Digital Health Conference Project Overview: Radiological Workflows in Public Health Facilities in Zambia (1/2)
  • 8. 8/25 October 19–21 , 2022 1st Zambia Digital Health Conference Project Overview: Radiological Workflows in Public Health Facilities in Zambia (2/2)
  • 9. 9/25 October 19–21 , 2022 1st Zambia Digital Health Conference Radiological Workflows Using Enterprise Medical Imaging Strategies https://wiki.ihe.net
  • 10. 10/25 October 19–21 , 2022 1st Zambia Digital Health Conference Towards a Useful and Interoperable PACS Platform https://wiki.ihe.net
  • 11. 11/25 October 19–21 , 2022 1st Zambia Digital Health Conference Medical Image Storage, Management and Access (1/4)
  • 12. 12/25 October 19–21 , 2022 1st Zambia Digital Health Conference Medical Image Storage, Management and Access (2/4) ● Inefficient image organisation ● Example: Optical discs originate from University Teaching Hospitals (UTHs) ○ COVID-19 studies
  • 13. 13/25 October 19–21 , 2022 1st Zambia Digital Health Conference Medical Image Storage, Management and Access (3/4) ● Inefficient image organisation ● Some medical images are stored on external hard drives ○ Medical images are stored and organised on generic filesystem in hierarchical folder structures
  • 14. 14/25 October 19–21 , 2022 1st Zambia Digital Health Conference Medical Image Storage, Management and Access (4/4) ● Some medical images are stored on external hard drives ○ Medical images are stored and organised on generic filesystem in hierarchical folder structures
  • 15. 15/25 October 19–21 , 2022 1st Zambia Digital Health Conference PACS Implementation: Standards-Based, Interoperable & Useful PACS Platforms (1/3) ● PACS platform implemented using the Dicoogle open source PACS archive software ○ Web-based, with the user interface consisting of a management module and a public end user interface ○ Configured to use the Lucene and File Storage prerequisite plugins, for facilitating indexing and querying of DICOM file metadata and storage of DICOM files
  • 16. 16/25 October 19–21 , 2022 1st Zambia Digital Health Conference PACS Implementation: Standards-Based, Interoperable & Useful PACS Platforms (2/3) ● Standards-based platforms using international standards ● Interoperable with other systems used in health facilities ● Useful to key stakeholders involved in radiological workshops: Physicians, Radiographers and Radiologists
  • 17. 17/25 October 19–21 , 2022 1st Zambia Digital Health Conference PACS Implementation: Standards-Based, Interoperable & Useful PACS Platforms (3/3)
  • 18. 18/25 October 19–21 , 2022 1st Zambia Digital Health Conference PACS Implementation: Standards-Based, Interoperable & Useful PACS Platforms (3/3)
  • 19. 19/25 October 19–21 , 2022 1st Zambia Digital Health Conference PACS Implementation: Standards-Based, Interoperable & Useful PACS Platforms (3/3)
  • 20. 20/25 October 19–21 , 2022 1st Zambia Digital Health Conference PACS Implementation: Standards-Based, Interoperable & Useful PACS Platforms (3/3)
  • 21. 21/25 October 19–21 , 2022 1st Zambia Digital Health Conference PACS Implementation: Standards-Based, Interoperable & Useful PACS Platforms (3/3)
  • 22. 22/25 October 19–21 , 2022 1st Zambia Digital Health Conference Conclusion and Future Work ● PACS platform anticipated to facilitate effective storage, management and access of medical images ● PACS platform design can potentially be standards-based to facilitate interoperability with current HMS ● Current and future work ○ Requirements elicitation to design a useful PACS platform ○ Usefulness and usability evaluation of PACS platform ○ Design and implementation of RIS platform ○ Feasibility of using artificial intelligence for semi-automated interpretation of common pathologies ○ Interactions with key stakeholders: Ministry and Infratel
  • 23. 23/25 October 19–21 , 2022 1st Zambia Digital Health Conference Q & A Session ● Comments, concerns and complaints?
  • 24. [1] Zulu, E.O., and Phiri, L. (2022). Enterprise Medical Imaging in the Global South: Challenges and Opportunities. In Proceedings of 2022 IST-Africa Conference (IST-Africa 2022). [2] Zulu, E.O. and Phiri, L. (2021). Enterprise Medical Imaging for Streamlined Radiological Diagnosis in Zambian Public Health Facilities. The University of Zambia. [3] C. J. Roth, L. M. Lannum, and K. R. Persons, ‘A Foundation for Enterprise Imaging: HIMSS-SIIM Collaborative White Paper’, J. Digit. Imaging, vol. 29, no. 5, pp. 530–538, Oct. 2016, doi: 10.1007/s10278-016-9882-0. [Online]. Available: https://doi.org/10.1007/s10278-016-9882-0 Bibliography
  • 25. Enterprise Medical Imaging for Improved Radiological Workflows in Zambian Public Health Facilities 1 Adult Hospital, University Teaching Hospitals, ZAMBIA 2 DataLab Research Group, University of Zambia, ZAMBIA Ernest Obbie Zulu1 Lighton Phiri2 1st Zambia Digital Health Conference October 19–21, 2022 | Lusaka, Zambia