Who Shares Wins! Cross-Border Integrated Care IT Solution

Abstract

A cross-border integrated care IT solution for sharing radiology data between Saolta Healthcare Group (ROI) and Altnagelvin (NI) to facilitate a Radiotherapy Treatment Project The Radiotherapy Treatment Project is a cross-border healthcare initiative facilitating patients from Donegal, Republic of Ireland (ROI) to attend nearby Altnagelvin Hospital in Northern Ireland (NI) for Radiotherapy treatment instead of travelling long distances to Galway University Hospitals (ROI) Objective: To implement a safe, secure and easy to use integrated ICT solution to allow bi-directional sharing of clinical images between Saolta Healthcare Group and Altnagelvin Hospital. Access to patient’s radiological data in Altnagelvin will permit effective treatment planning, review and follow up for patients needing readiotherapy. Background: Discussion re data sharing options commenced in June 2016. A project group was established involving collaboration across disciplines and cross-border hospitals to find a solution. From the outset, staff realised the importance of this project for patient care. Radiotherapy treatment provided closer to home would reduce a patient’s travel time from 7 hours to 40 minutes. Scope: An estimated 500 cases from ROI per annum could be treated in Altnagelvin. More cases would be discussed at MDT than would be sent on to treatment so a potential figure of 1000 cases per annum was set out. Only data, on patients who provide consent for their data to be shared, could be made available in the other jurisdiction. Timeline for project start was Autumn 2016, giving less than 6 months to plan and configure the solution. Decisions: Access to the most up-to-date radiology record was paramount for clinicians to evaluate and treat patients appropriately therefore the solution would have to improve on traditional methods of data transfer e.g. CD or Image link, as such methods prove labour intensive, human resource dependant and do not provide real-time access to data. Using Galway’s existing PACS Xero Viewer, within the Agfa HealthCare Integrated Care Suite, allows Altnagelvin consume patient data and display it without having to move or manage it. If image data is required within the local PACS at any stage, it can be downloaded by an authorized user. After consideration and comparison and given the tight timelines, the Agfa HealthCare Integrated Care Suite solution was recommended as the best available solution. It was specifically noted that the system could restrict user access to view only the data of patients who had provided consent for their data to be shared. The project was given a three week window to go-live date. Implementation: Stage 1: Secure sharing of images/reports by manual push from PACS to Portal Download of data from Portal to local PACS also available Stage 2: Full integration between PACS systems with DICOM integration Study availability notifications Report integration Role based access control and authentication Conclusion: This is an integrated care model providing benefit to patients, their families, carers and clinicians. The ability to integrate and interoperate with other systems has always been important to Galway University Hospitals Radiology staff, having implemented the first paperless/filmless radiology departments in Irish public hospitals in 2005. We have witnessed increasing demands for image sharing between public/private hospitals, cross-border and even worldwide. We continue to move with technologic advancements creating integrated care solutions ensuring our patient’s clinical data is available when required at the point of care. This project is a prime example of what can be achieved when hospital personnel collaborate and work together with the technology available to them. This project took less than six months from project initiation to Stage 1 go-live.