The implementation follows two years of negotiations between a consortium of 11 NHS trusts across Cheshire and Merseyside to procure new systems before termination of national contracts provided under the disbanded National Programme for IT (NPfIT) in the NHS.
Dr Peter Rowlands, consultant radiologist RLBUHT and clinical lead for the PACS procurement said: "With a large number of trusts within the Merseyside region, patients are frequently required to attend different hospital sites for certain types of treatment or services and sometimes patients have had studies carried out, where there is no specialist available to interpret the results.
"Historically this has meant that the sharing of patient notes and images, between the hospital sites, has been slow and costly. The new PACS will overcome this issue by enabling images to be shared, quickly, efficiently, securely and cost effectively."
Instant sharing of images across the 11 trusts in Cheshire and Merseyside means clinicians will now save approximately one hour per patient needing to be reviewed between sites, resulting in less waiting time for the patient.
Other benefits of the new PACS include the dramatic reduction in time taken to view images scanned at RLBUHT. "Access has been reduced to seconds, rather than minutes or longer as was previously the case," said Dr Rowlands. "We often suffered queues and sometimes downloading was an overnight event, rather than in real-time."
The trust also expects to make additional savings on access costs since it now controls all data held in a newly implemented vendor neutral archive (VNA), rather than having it hosted by a third party under the previous PACS contract.
Dr Rowlands said: "Our strategy is to move all patient notes and correspondence to the VNA over time. We will do the same for the trust's electronic patient record (EPR) as it develops, so that all our storage is in one place. We chose to do this because it fitted with our ongoing strategy for overall data management and exploitation of Big Data within the trust.
"RLBUHT was equally keen to support new ways of working. As it has never been possible for us to work from home, a key PACS selection criterion was to ensure we could work at different sites and from home when necessary, using a secure network to keep patient data safe."
Securing Value for money was also important in RLBUHT's choice of suppliers. Between the PACS and VNA, the trust saved over a third of its revenue compared to the previous contract.
Dr Rowlands added: "We now have a much more flexible and appropriate solution. We had no direct relationship with our previous PACS supplier, which inevitably caused us some issues. We didn't know what had been procured for us, which meant we were always several software releases behind, for instance; whereas now we'll be closer to the supplier and hence the latest version of software."
The new PACS managed service agreement with Carestream UK is for five years, with the option to extend for a further five. Trusts in the Consortium, who previously used a shared radiology information systems (RIS) service, earlier elected to implement Computerised Radiology Information Systems (CRIS) from Healthcare Software Systems (HSS) after completing an earlier phase in the collaborative procurement. This will allow them to receive electronic referrals, vet referrals, book appointments and produce radiology reports.
In line with its move to new PACS, RIS and VNA systems, RLBUHT has installed 30 new triple screened radiology reporting workstations, plus 25 new 27" monitors for use by radiologists in multi-disciplinary team preparation. It has also re-integrated over 90 x-ray and scanning machines into the new PACS, as well as training 1,500 staff to use the new systems - all without disrupting patient care in a 24x7 working environment. RLBUHT installed, tested and went live with the RIS, PACS and VNA systems in under six months.
The 11 trusts in the consortium, who between them operate 15 sites and perform some 1.35m radiology examinations each year, are: Aintree University Hospitals, Alder Hey Children's, Clatterbridge Centre for Oncology, Liverpool Community Health, Liverpool Heart and Chest Hospital, Liverpool Women's, Royal Liverpool and Broadgreen University Hospitals, Southport and Ormskirk Hospital, St Helens and Knowsley Teaching Hospitals, Walton Centre, and Warrington and Halton Hospitals.
About RLBUHT
The Royal Liverpool and Broadgreen University Hospitals NHS Trust is one of the largest and busiest hospital trusts in the North of England, with an annual budget exceeding £400 million. It delivers services across two sites and three hospitals, the Royal Liverpool University Hospital, Broadgreen Hospital and Liverpool University Dental Hospital, and employs more than 5,500 people.
Each year the Trust sees more than half a million people in its outpatient department and deals with around 150,000 emergency patients and day case admissions. It is one of the top teaching trusts in the UK with well-established links to the University of Liverpool, Liverpool John Moores University and international institutions. In 2013 work will begin on a new £450 million state of the art Royal Liverpool University Hospital.