University Hospitals Coventry and Warwickshire NHS Trust (UHCW) is one of the UK’s largest teaching Trusts with 1200 beds on two main sites, University Hospital in Coventry, and the Hospital of St Cross in Rugby. These are specialist centres for cardiology, brain, stroke, joint replacement, diabetes, cancer care and kidney transplants with MRI, PET and CT scanners, all of which capture medical images and require a robust system for storage and viewing across multiple departments.
In 2013 the Trust decided to move from a GE LSP PACS to an Insignia PACS environment which resulted in a large number of images needing to be migrated. The Trust had many imaging departments and lacked a long term image archiving strategy which represented a challenge for information governance.
Changing PACS supplier traditionally means entering into a reoccurring cycle of migrating images each time a new PACS vendor is contracted. In order to break this cycle at
UHCW a strategy for separating data and application was essential. A vendor neutral archive (VNA) offered the best solution for this.
The Trust also had an overarching goal to become completely paperless by 2016. Implementing a VNA would be a key milestone in helping to cut paper use and achieve the paperless goal. Charles Yeomanson, ICT Technical Director for UHCW led the project and had clearly defined criteria when looking to appoint the correct vendor. The VNA needed to cater for imaging and medical records from across the Trust, not just radiology studies. It also had to be capable of integrating to the Trust’s EPR and all at an affordable price.
After a tender process, Visbion was chosen to supply UHCW with its VNA through the NHS Supply Chain’s PACS & RIS Framework Agreement. The Framework provides Trusts with the opportunity to source from an approved list of suppliers, facilitating the procurement process for Trusts and reducing costs.
The Visbion VNA includes the functionality for archive and retrieval of both DICOM and non DICOM files. Examples of these include lab results, radiology reports and imaging request forms. To build a true patient record, a Vendor Neutral Archive needs to store and display all of these items.
The trust still runs a number of aging systems that are not capable of supporting a central patient index; however Visbion was able to overcome this by registering multiple patient identifiers against a simple patient record. Interfaces to the legacy applications were then built around the individual system numbers. This was all possible due to the Visbion software containing its own MPI functionality. Visbion’s architecture also has integrated XDS.b repository capability however this does not need to be installed and enabled on initial installation; it can be added as an optional component at a later date as and when an XDS environment becomes available. UHCW elected to install the XDS capability during phase II of the project.
The complete VNA project took less than 8 weeks from installation to go live and Visbion implemented a number of additional interfaces to bring in data not usually stored in PACS, for example the raw nuclear medicine data. Charles Yeomanson commented, “Visbion’s VNA ticked all the boxes and more with extra functionalities such as multi ‘ology diagnostic web viewer and DR options.”
The Visbion VNA eliminates all associated problems with future mass migration when switching PACS vendors by storing all the data in a single repository. All historical data can be retrieved by new applications as and when required from the central archive. This now allows clinicians to have access to one single patient record without having to log in to a variety of system applications to view the complete patient history.
The Trust were very pleased with the installation, with Charles adding, “The implementation went to schedule over just a few weeks and the staff at Visbion have been most helpful in ensuring that the solution fits with the Trusts requirements. We are looking forward to working with the system and realising the benefits of integrated image/document management. The VNA will make a real difference to the way the Trust manages its patient records in the years to come.”
Overall the Visbion VNA implementation was a very quick and smooth process. Clinicians now benefit from an efficient system and can view a single patient record with centralised access control and audit trails reducing information governance risks. In turn the VNA
also eliminates multiple data stores and IT administration overheads.