The effective use of digital medical data requires workflow re-engineering and use of modern data transfer technology.
Using the latest HIS/PACS technology, the radiology department at the East Tallinn Central Hospital (ETCH) has completely re-engineered radiology workflow management during the last four years.
The hospital started to use PACS with limited diagnostic workstations and web user licenses. By the end of 2007 the hospital became ‘filmless’, with an annual volume of 170,000 radiology examinations. The case mix includes all imaging modalities and radiologists also provide reporting services for external facilities.
Our web-based PACS with streaming technology allow archiving of all kinds of images, including non-DICOM and non-radiology images. The PACS is integrated with the web-based HIS, so the radiologist or referring physician can open images using the HIS and simultaneously view other patient data. The same possibility is available for general practitioners (GPs) outside ETCH. This kind of holistic patient approach achieved by HIS-PACS integration minimises the risk of having inadequate patient history or referral letters before imaging or during reporting.
Inspired by successful digital image sharing with other health care providers, ETHC has opened the entire electronic patient record for authorised GPs and even more – a patient can access his/her medical data in HIS. The security of delicate patient data is guaranteed by using a personal ID-card.
Classic hospital or department workflow is linear, meaning that almost all patient data resides with the individual patient or physician and can’t be accessed from different locations.
Digital processing of patient data opens new dimensions for patient care management. Now, if needed, patient data can be used any time and any place.
From this point of view, the implementation of PACS is allowing radiologists to achieve workflow optimisation. The radiologist can report not only the images made in the department or radiologist’s location, but also the images that have been taken in other locations. Reporting can be done on the basis of the anatomic region, modality, urgency, department, etc. The successful and secure radiology data sharing can be taken as a good example for implementing similar solutions for other medical information distribution.
From the outset of HIS/PACS planning, it is essential that HIS/RIS and PACS should be integrated.
CV: Dr Peeter Ross studied medicine in Tartu University, Estonia, and in Helsinki University, Finland (1985-91). In 1996, following his residency in radiology at Tartu University, he undertook further studies in radiology at Oulu University, Finland, and in Armed Forces Institute of Pathology, Washington DC, USA. He took on further studies in healthcare management at INSEAD, France.
Dr Ross has participated in the EU funded eHealth projects InterregPacs, Baltic eHealth and R-Bay.
In 2004, he was appointed to his current position as Director of Research and Development in East-Tallinn Central Hospital, Estonia. He is also acting president of Estonian Society of Radiology and a member of the supervisory board of Estonian Health Insurance Fund and Estonian eHealth Foundation.