An Overview of PACS-RIS Procurement

An Overview of PACS-RIS An Overview of PACS-RIS ProcurementProcurement

Dave PlummerDave PlummerDepartment of Medical Physics and BioengineeringDepartment of Medical Physics and Bioengineering

UCL Hospitals NHS Foundation TrustUCL Hospitals NHS Foundation Trust

IHE 20 October 2004IHE 20 October 2004 Dave Plummer, UCL HospitalsDave Plummer, UCL Hospitals


Procuring IT SystemsProcuring IT Systems

1.1. Identify the needIdentify the need

2.2. Survey the marketSurvey the market

3.3. Prepare a business casePrepare a business case

4.4. Obtain fundingObtain funding

5.5. Write a specificationWrite a specification

6.6. Request tendersRequest tenders

7.7. Select supplierSelect supplier

8.8. Finalize contractFinalize contract

9.9. PurchasePurchase

10.10. ImplementImplement

11.11. ReviewReview

POISE POISE

Procurement of Information Systems EffectivelyProcurement of Information Systems Effectively


Project ManagementProject Management

Use a recognized methodologyUse a recognized methodology eg PRINCE2eg PRINCE2

Involve the full spectrum of usersInvolve the full spectrum of users Right from the startRight from the start

Meet RegularlyMeet Regularly Don’t allow issues to go awayDon’t allow issues to go away

Have a defined time frameHave a defined time frame Have a defined end pointHave a defined end point


The Affect of NPfITThe Affect of NPfIT(in England)(in England)

RIS is not a ‘core’ applicationRIS is not a ‘core’ application LSPs will provide RIS options but trusts are free to LSPs will provide RIS options but trusts are free to

make their own arrangements.make their own arrangements.

PACS is now a ‘core’ componentPACS is now a ‘core’ component NPfIT does not permit open PACS procurement. NPfIT does not permit open PACS procurement.

The range of ‘viable’ products may now be more The range of ‘viable’ products may now be more narrow. narrow.

Need to support integration to local clusters and Need to support integration to local clusters and the spine.the spine.


RIS and PACSRIS and PACS

RIS is a database of radiology RIS is a database of radiology examination detailsexamination details

PACS is a database of radiology PACS is a database of radiology examination detailsexamination details


RIS and PACSRIS and PACS RIS is a database of radiology examination RIS is a database of radiology examination

details including:details including: scheduling, film management, report capture….scheduling, film management, report capture….

PACS is a database of radiology examination PACS is a database of radiology examination details including:details including: ImagesImages Integration to modalitiesIntegration to modalities

In both cases the core data records are patients In both cases the core data records are patients and exams.and exams.


Key RIS FunctionalityKey RIS Functionality Integration to external systemsIntegration to external systems

HIS (CRS)HIS (CRS) Scheduling: Scheduling:

Rooms & resourcesRooms & resources Examination detailsExamination details

Request information, Exam details & ConfirmationRequest information, Exam details & Confirmation Film managementFilm management

TrackingTracking ReportReport

Capture and presentation, dictation, transcription etcCapture and presentation, dictation, transcription etc Dose recordsDose records

Support for IR(ME)R etcSupport for IR(ME)R etc Statistics: Statistics:

Examination numbers,Examination numbers, Equipment utilisationEquipment utilisation


Key PACS FunctionalityKey PACS Functionality Integration to HIS and RISIntegration to HIS and RIS

Modality worklists, Reporting lists, PrefetchingModality worklists, Reporting lists, Prefetching Capture image from modalityCapture image from modality Support radiographer QA/verificationSupport radiographer QA/verification Commit to secure storageCommit to secure storage Make available for reporting displayMake available for reporting display Make available for review displayMake available for review display Make available for future visitsMake available for future visits Support image sharing at cluster and national Support image sharing at cluster and national

level.level.


RIS PACS IntegrationRIS PACS Integration

HIS

RIS BROKER

MODALITY

PACS


Desktop IntegrationDesktop Integration

Close coupling of RIS and PACS Close coupling of RIS and PACS applicationsapplications

Ensures that RIS and PACS are in syncEnsures that RIS and PACS are in sync Generally by establishing communications Generally by establishing communications

between two applications on the same between two applications on the same computer.computer.


RIS PACS IntegrationRIS PACS IntegrationDesktop IntegrationDesktop Integration

HIS

RIS BROKER

MODALITY

Reporting Station

PACS


Integrated RIS-PACSIntegrated RIS-PACS

Common patient and exam databaseCommon patient and exam database No confusion about status No confusion about status

eg dictated/reportedeg dictated/reported Desktop integration should be inherent in Desktop integration should be inherent in

the design.the design.


RIS PACS IntegrationRIS PACS Integration

HIS

RIS BROKER

MODALITY

PACS

RIS-PACS


Integrated RIS-PACSIntegrated RIS-PACS

May be appropriate solution if current RIS May be appropriate solution if current RIS needs replacement.needs replacement.

Beware of potential gaps in functionality:Beware of potential gaps in functionality: Integration to external schedulingIntegration to external scheduling Film management !!Film management !! IR(ME)R requirementsIR(ME)R requirements FlexibilityFlexibility

Some apparently ‘fused’ products are Some apparently ‘fused’ products are rather loosely gluedrather loosely glued


Beyond RadiologyBeyond Radiology Other Types of Images:Other Types of Images:

Vascular AngiographyVascular Angiography Cardiac AngiographyCardiac Angiography EchocardiographyEchocardiography Obstetric UltrasoundObstetric Ultrasound Medical PhotographyMedical Photography Retinal ImagingRetinal Imaging Colposcopy / Cytology…..Colposcopy / Cytology…..

May be more of a RIS Issue than PACS May be more of a RIS Issue than PACS


How IHE fits inHow IHE fits in

IHE specifies HIS/RIS/PACS integration.IHE specifies HIS/RIS/PACS integration. And has the potential to do much more!And has the potential to do much more!

No need to identify individual integration No need to identify individual integration requirementsrequirements

No need to provide an exhaustive list of No need to provide an exhaustive list of functional requirementsfunctional requirements

List the integration profiles that you expect List the integration profiles that you expect to be using and the actors that you want to be using and the actors that you want provided for them.provided for them.


IHE DefinesIHE Defines

ActorsActors Abstract entities that are part (or all) of IT Abstract entities that are part (or all) of IT

systems.systems. TransactionsTransactions

Functional exchanges of information between Functional exchanges of information between ActorsActors

Integration ProfilesIntegration Profiles Constraints on actors and transactions for Constraints on actors and transactions for

performing specific functions.performing specific functions.


How to Use IHEHow to Use IHE Be clear about the functionality neededBe clear about the functionality needed State in the requirement (and the contract)State in the requirement (and the contract)

The Integration Profiles requiredThe Integration Profiles required The Actors that will be in existing systemsThe Actors that will be in existing systems Any specific requirements beyond the IHE profilesAny specific requirements beyond the IHE profiles

Obtain a specific statement of:Obtain a specific statement of: A commitment to deliver all aspects of the required A commitment to deliver all aspects of the required

functionality. functionality. The integration profiles that each device supplied will The integration profiles that each device supplied will

be involved in. be involved in. The devices (existing and supplied) that will be The devices (existing and supplied) that will be

involved for each profile involved for each profile


Key issues in ProcurementKey issues in Procurement

FunctionalityFunctionality TrainingTraining IntegrationIntegration Data MigrationData Migration ImplementationImplementation Make them all explicit in the contract.Make them all explicit in the contract.


Further Key Issues for PACSFurther Key Issues for PACS

Integration againIntegration again Desktop, modality worklists, brokerDesktop, modality worklists, broker

Capacity and PerformanceCapacity and Performance Reporting functionalityReporting functionality

Screens, tools, workflowScreens, tools, workflow

Review functionalityReview functionality Web, user requirementsWeb, user requirements

Specialist ViewingSpecialist Viewing Orthopaedics, Theatres …Orthopaedics, Theatres …


SummarySummary

Understand Activity and UsageUnderstand Activity and Usage Get a good team togetherGet a good team together Analyze in IHE terms Analyze in IHE terms Decide how you want RIS and PACS to Decide how you want RIS and PACS to

relate to one anotherrelate to one another Be aware of future changesBe aware of future changes Use IHE in the specifications and the Use IHE in the specifications and the

contractcontract

An Overview of PACS-RIS Procurement

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