Exams Portabilityin Europe: first steps

Antonio Fernandes CHLC – Lisbon, Portugal

Tiago Baptista CHLC – Lisbon, Portugal

XIX Symposium NeuroradiologicumBologna, 5 October 2010

Outline

•The idea•Benefits•National Projects•The Situation in Portugal•Implementation Issues•Conclusion

The idea

•Radiological Exams available everywhere in Europe whenever they are needed

•An Italian physician in Rome could easily access the CT scan done by a Portuguese physician, in Lisbon. of a portuguese a patient spending his holidays in Italy. This patient hadn’t brought his CD or film.

X

X

X

X

Benefits

Images always available

Faster diagnosis

Better patient care

Benefits•Elimination of repeated exams

▫Cost savings for the patient and/or the Healthcare System

▫Less visits to hospitals▫Less exposure to radiation

•Colaboration between radiologists, even between countries

•Facilitates international telerradiology•Unique opportunities for research

National ProjectsScotland

•5M citizens•3,8M radiological

studies per year•20.000 authorized

doctors•2PB managed

storage

National Projects•2 data centers in different locations•Workstations installed in hospitals, with a

common user interface. Access from home is also possible through VPN

•Data downloaded in a fast and smart way•Primary identification through the

Community Health Index (CHI)

National ProjectsFinland

•5,3M citizens•300.000 authorized

professionals•500PB in the next

decade•Valued at 20M€

National Projects•eArchive

▫Storage of citizen’s health records, including radiology images

•ePrescriptions▫Electronic prescriptions to be accessed

directly at the pharmacies•eAccess

▫Access of citizens over 18 to their own health records, to set permissions and monitor access

The Situation in Portugal•Sharing of exams in sites belonging to the

same enterprise•Lack of exams portability in remaining cases•Citizen Card with chip and digital certificates•Very good internet infrastructures•Political support for projects that use new

technologies to facilitate peoples lives

•It has the conditions for following onScotland and Finland’s footsteps

Integration of different hospitals

SolutionCost

efficiency

Required commitmen

t

Easier implementatio

n and useDeployment of the same PACS over the portability region

- + +Integration different PACS systems – IHE integration profiles

+ - -

Document Repository

Imaging Document

Source

Document Registry

Document Consumer

Imaging Consumer

Provide and

Register

Register

Query Registry

Retrieve Document

Retrieve Images

Basic workflow of IHE XDS-I.b profile

Centralized Storage

Economies of scale on data centers

Better disaster recovery capabilities

Storage of images

Patient Identification•Creation of a European Health

Number

•Creation of National Health Numbers

•Citizen ID/Phone Number/Bank Account

•IHE PIX/PDQ or PID protocol

Ease

of

impl

emen

tati

on a

nd

use

Req

uire

d C

omm

itm

ent

leve

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Privacy•Privacy should be of high concern

▫Countries have different privacy and data protection laws

▫A European archive would have to comply with the stricter of those laws

▫A system like the Finnish should however be enough to comply with these laws

Legislation•Legislation is needed for successful

implementation▫The use of the system must be mandatory

for both public and private radiology facilities

Conclusion•It is technically possible to implement

exams portability in Europe•Great commitment of European

Authorities to tackle the implementation issues is needed

•Legislation should be put into place•A Taskforce should be constituted•Participation of the European Society of

Neuroradiology would be important

Please send your ideas/comments to join this work group:

antoniojlfernandes@gmail.com

Disclosure:Antonio Fernandes, bord member ,S24 Group