Hello folks, I’m a trainee in Rehab Medicine now doing my current run at a private brain injury rehab unit in Auckland.
When patients come over to my unit from Waikato, BOP or elsewhere, I ask for their trauma scans/X-rays to be uploaded to Auckland regional PACS and I can access it through Testsafe. They get sent over promptly, but the radiology reports don’t. The PACS administrators at the outside Auckland DHBs need to print and fax them to my center. When I contacted the ADHB PACS support team, I was told that the reports are stored in different formats on different DHBs and hence cannot be transmitted along with the images. Nobody is willing to commit time and effort to scanning these results onto the Testsafe portal too.
Can someone please shed some light on why these systems still can’t talk to each other in this day of advanced interoperability?
This is an excellent question.
PACS almost predates the internet, it is a venerable old system.
That said there is no technical reason why all the data cannot be brought together under a single umbrella.
In an ideal world you would never access any single source system (Test results, imaging etc) instead you would access the patient info portal which accesses the data.
So it’s not a problem of getting these systems to talk to each other. It is a problem of building/acquiring a portal to which all systems can talk to. Such things do exist. However it’s still a big ask, and would require national collaboration. Something that only became possible in the last week.
Thank you guys for the reply. Am I reading it right that there is no way forward as of now and that we should wait for the DHB integration in 2022-23 and then wait for the EHR integrations?
I believe that this forum with an abundance of clinical leaders and CCIOs have great leverage. For a start, will any of you be able to provide some leads on the right doors to knock, so that we can get things rolling?
Many of us are just a bit cynical due to the multiple roadblocks we have experienced on the way to achieving interoperability! But that is a poor reason not to try. And waiting for the DHB merger to open the door to solving our integration problems is rather like waiting for hell to freeze over in order to go ice skating.
You are right, Somu. If you are willing to lead the charge to tackle national interoperability with radiology reports I will help you to the best of my ability.
We can also tap into the #open-forum as the UK has the same problem and I believe has tackled it successfully in many regions (each of which are NZ-sized).
Now, my other thought is perhaps it is now time to re-open a push for connecting up all of the Orion Clinical Portals. I’ve had some interesting discussions with some senior Orion people about this; it is technically feasible. If coupled with access for those ‘outside’ the DHB system, we could have the whole country joined up for $1-2 Million for a lot more than radiology reports.
It is madness that we have so many instances of Concerto in this country, all silo’d. It is even madder that they are not connected. Many of our patients are receiving substandard care as a result and many of our clinician colleagues are frustrated with the workflows and workarounds needed to get what we need (as @somu.victor has articulated so clearly).
What RIS do they use at Waikato? It should be able to send as HL7 to Eclair CDR (TestSafe).
NZ needs the nHIP National diagnostics platform - core diagnostic data set = labs, imaging, cardiology reports.
This is to do with access to any sort of medical records from DHBs outside the Northern region, not specifically radiology reports.
Images are DICOM and can be transmitted anywhere, but reports are medical records and need to have a receiving system and integration if they are sent electronically.
ADHB email reports as PDFs but it is a manual process and they are also making reports available via PACSLink so external users will be able to access the reports.
This looks like a classic Robotic Process Automation (RPA) use case to me! An unattended robot could quite easily retrieve the radiology reports from the DHB, scan them into the correct format and upload them into TestSafe. Very happy to discuss.
Q. Does anyone have any process data?* i.e. approx volumes, cycle time, FTE $ spend, etc by DHB? If not, I can scout for this information quite easily.