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

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
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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

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Radiological Workflows

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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)

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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)

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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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Project Overview: Radiological Workflows in
Public Health Facilities in Zambia (1/2)

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Project Overview: Radiological Workflows in
Public Health Facilities in Zambia (2/2)

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Radiological Workflows Using Enterprise
Medical Imaging Strategies
https://wiki.ihe.net

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Towards a Useful and Interoperable PACS
Platform
https://wiki.ihe.net

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Medical Image Storage, Management and
Access (1/4)

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Medical Image Storage, Management and
Access (2/4)
● Inefficient image organisation
● Example: Optical discs originate
from University Teaching
Hospitals (UTHs)
○ COVID-19 studies

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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

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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

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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

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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

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PACS Implementation: Standards-Based,
Interoperable & Useful PACS Platforms (3/3)

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PACS Implementation: Standards-Based,
Interoperable & Useful PACS Platforms (3/3)

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PACS Implementation: Standards-Based,
Interoperable & Useful PACS Platforms (3/3)

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PACS Implementation: Standards-Based,
Interoperable & Useful PACS Platforms (3/3)

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PACS Implementation: Standards-Based,
Interoperable & Useful PACS Platforms (3/3)

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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

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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