PACS and diagnostic imaging service delivery—A UK perspective

doi:10.1016/j.ejrad.2010.05.012

European Journal of Radiology

Volume 78, Issue 2, May 2011, Pages 243-249

https://doi.org/10.1016/j.ejrad.2010.05.012 Get rights and content

Abstract

This review sets out the current position with regard to the implementation of PACS throughout the United Kingdom and the impact this has had on improving patient care. In December 2007 England had implemented full hospital-wide PACS in all hospitals: a major achievement in the relatively short time period of three years. The different approaches used by each country of the UK to achieve full national PACS are described in addition to the current issues with the sharing of images and reports across different healthcare organisations with regard to technical solutions, clinical safety and governance. The review gives insight into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services and how the national PACS implementation, specifically in England, has made a significant contribution to measures to improve efficiencies. The role of Teleradiology is discussed in the context of supporting local patient services rather than undermining them and the concept of cross-healthcare reporting ‘Grids’ is described. Finally, in the summary it is recognised that the vast wealth of knowledge accumulated during the national implementations has placed the UK in a strong position to facilitate full national data sharing across all healthcare organisations to improve patient care.

Section snippets

Diagnostic imaging service delivery—the drivers for change

It is remarkable that since the introduction of specific targets by the Department of Health (DH) in England for the delivery of diagnostic imaging services there has been a dramatic fall in the number of patients waiting more than six weeks for imaging investigations—from 110,862 in spring 2007 to less than 1000 in spring 2009. More remarkable than this is that many English healthcare organisations are reporting waiting times of no more than two weeks for their patients which, in reality, is

“Plus ça change, plus c’est la meme chose”

In the UK and as described above with reference to the English challenges and organisations involved, much has been achieved in modernising and making fit-for-purpose diagnostic imaging services to provide for the perceived demands from all clinical specialties and PACS implementation has made a major contribution, judging from the success of reducing waiting times for examinations. It is perhaps typical therefore, that despite the successes with PACS and improvement in work flows, nothing

Image and report data sharing

Capacity and demand issues aside the main outstanding issues for the radiologist practicing in the modern environment in the UK are concerned fundamentally with new ways of delivering healthcare which has impacted on the methods of provision of diagnostic imaging services. An example of changing practices arises from the establishment of Multidisciplinary Team Meetings (MDTMs), which are pivotal in many of the established healthcare pathways such as upper gastro-intestinal cancers. At MDMTs a

The perfect data sharing solution?

Against the background of working towards national data sharing in the constituent countries of the UK and the various interim solutions now in place or evolving for healthcare community data sharing there has been a strong chorus of support from the radiological community for the adoption of the ‘Integrating the Healthcare Enterprise’ (IHE) framework profile, Cross-Enterprise Document Sharing for images and other related radiological documents (XDS-i). Both Northern Ireland and Wales have

The role of Teleradiology in supporting the delivery of diagnostic imaging services

The role of Teleradiology in the UK – in that images are transmitted to other organisations within or outside the UK for the purposes of reporting – is currently regarded as a means of balancing reporting capacity shortfalls within the NHS, and is seen as supplementary to other measures described above to increase overall local reporting capacity. The engagement of independent providers of imaging to increase overall imaging capacity (for example MRI) resulted in the reporting of the images to

Maximising the benefits of PACS and Teleradiology—the way forward

Significant achievements have been made in the UK in improving the delivery of diagnostic imaging services such that patients have minimal waiting times for examinations. These achievements have been gained through service redesign and more efficient methods of organizing patient services but a major contribution has resulted from the rapid implementation of PACS across the UK, with the striking success of the national PACS roll-out in England as part of the National Programme for IT and the

Acknowledgements

I would like to thank the following for providing information towards this article: Dr. Erika Denton, FRCP, FRCR, Medical Director PACS Programme, Connecting for Heath, England and National Clinical Lead for Imaging, Department of Health: Dr. Brendan Devlin, FRCR, Consultant Radiologist, Altnagelvin Hospital, Derry, Northern Ireland, UK: Dr Andrew Downey, Consultant Radiologist, FRCR, Victoria Infirmary Glasgow, Scotland and Mr. Andrew Ward, Welsh Health Estates, Wales.

Dr Laurence Sutton is a consultant radiologist of 20 years experience with a main clinical interest in CT and MR in gastro-intestinal oncology. He was instrumental in the introduction of a full hospital-wide PACS in the new Calderdale Royal Hospital, Halifax, England in 2001, one of the few hospitals at that time to do so. He is one of three national clinical PACS advisors for the national PACS programme in England, with a special interest in Teleradiology, data sharing and image data

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