The NORrad PACS Project


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Introduction

Radiology is a core element of delivering effective medical care to a large number of patients in a modern health care system.  Patients are referred to radiologists by family physicians and other medical specialists to diagnose a suspected condition using a variety of diagnostic imaging modalities such as x-ray, ultrasound, nuclear medicine, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI).  Radiology is the most dynamic area of medicine because of the rapid changes caused by new technologies.  These advances have permitted diagnostic imaging modalities to create digital images that can be transmitted across a Wide Area Network (WAN) and the World Wide Web without any degradation to the image quality.  This is essential to radiology since this medical specialty is dependent on the highest resolution possible.  Any image distortion could result in a misdiagnosis.

 

Until recently, x-ray was predominantly an analogue-acquired image that had to be digitized on a special scanner if it needed to be transmitted remotely.  There have been many ongoing concerns about the loss of important diagnostic information in both the scanning and digitizing steps of this analogue x-ray image.  Each x-ray image contains a substantial amount of data.  For example, a chest x-ray contains 20 MB of information.  A loss of information on a digitized analogue x-ray can have a direct and negative impact on the diagnosis and the resulting treatment plan.

 

Breakthrough innovations have contributed to the development of a digital x-ray device in the past five years that have revolutionized x-ray imaging.  This is the most important new development since x-rays were discovered 107 years ago.  Approximately 70 -100% of the average rural hospital’s workload is “plain film” x-ray imaging which requires large expenditures on radiology film, chemistry and staff.  Now digital x-rays can be transmitted digitally from one location to another without any loss of information, without digitizing and without film.  Additionally, there are several productivity benefits, reduced operating costs, and vastly improved patient care advantages associated with the adoption of digital x-ray technology.

NORrad’s Integrated Health Care Vision

NORrad’s vision is to employ proven health care and communications technology as an enabling factor to support physicians and other health care professionals to provide high quality care locally to the patients in north eastern Ontario in a manner that is consistent with the delivery of care elsewhere in the province.  NORrad, or NORthern radiology, reflects the intent to:

*       Develop long term solutions integrating many proven facets of telecommunications and digital diagnostic imaging technology

 

*       Work collaboratively with other regional Networks to develop systems and capabilities not currently available such as the creation of a Electronic Patient Record and a Master Patient Index

 

*       Provide specialist care to patients and service to primary care physicians living in north eastern Ontario communities in a quick and efficient manner while minimizing the need for patients to travel for basic diagnostic examinations

 

*       Remove natural and fiscal obstacles to provide care in a manner consistent with the standard of medicine in more urban areas of Ontario

 

*       Optimize scarce medical, health care professional and technical human resources

 

*       Provide leading edge diagnostic care to people living and working in a resource economy spread across several small communities and separated by vast distances

 

*       Ensure that key regional health care resources such as the cancer centre or the cardiac care program are more readily accessible to citizens living in any community in north eastern Ontario

 

*       To facilitate the ability of the new Northern Ontario Medical School to reach out in a meaningful way into each of the surrounding networks and to facilitate the education of medical students and other health care professionals to use modern technologies necessary for the delivery of health care services in northern and remote communities

 

*       Collaborate with other key partners such as North Network to ensure the integration of other health care technologies to facilitate ease of access

 

*       Involvement with Smart Systems for Health to use broadband communication links for the deployment of NORrad in the Networks and to create the necessary critical mass for the addition of other health care programs using this communications link

The Genesis of NORrad - Why PACS? Why Radiology?

Integrating health care and telecommunications technology provides a tangible means to more efficiently respond to the:

  • Chronic shortage of physicians, particularly radiologists

  • Shortage of imaging technologists and other health care professionals

  • Community remoteness

  • Immense size of the region combined with a small population

  • Weather

  • Availability of emergency services locally

  • Sufficient critical mass to access new technologies

  • Access and quality care equivalent to that received by patients in the urban areas of the province

Critical Success Factors

  • Vision and Support of all CEO's, physicians and staff at each NORrad site.

  • Funding - Northern Ontario Heritage Fund, MOH, CHIPP, Health Canada, FedNor, NeoNet.

  • Radiology and management leadership skills combined with a strong working relationship with IT department.

  • On-site AGFA service representative and 24/7 technical support line.and consulting expertise.

  • Complete PACS solution (AGFA) geared to optimize the performance of all clinical users in all departments.