HealthNetConnections creates integrated obstetric care record for The Rotherham NHS Foundation Trust with GE ViewPoint. 2017-04-19T16:22:12+00:00

Project Description

HealthNetConnections creates integrated obstetric care record for The Rotherham NHS Foundation Trust with GE ViewPoint.

The Rotherham NHS Foundation Trust has chosen HealthNetConnections as their technology partner to create an integrated patient care record for obstetric ultrasound using the GE ViewPoint ultrasound reporting system. All obstetric ultrasound findings (images, charts and measurements) are captured electronically within the GE ViewPoint system, coupled with HNC’s Talk2 integration suite the trust can also electronically share the ultrasound reports across a myriad of other clinical information systems both internal and external, creating a truly integrated patient care record for obstetric ultrasound.

“The project management team at HealthNetConnections were incredibly supportive and able to meet our needs and requests in all aspects of the implementation project. I would definitely recommend HNC products and services to others as our experience at Rotherham has been very positive”
Annette Brammer - Deputy Superintendent of Ultrasound.
Rotherham NHS Trust
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Background

Prior to the implementation of GE ViewPoint, Rotherham used the existing Radiology Information System (RIS) solution for obstetric reporting, this system works on a free text and voice recognition software basis to produce a block textual report examination report.

Whilst the RIS system is quick and efficient at producing textual reports, which are preferred in other imaging areas (CT, MRI and plain film) it didn’t allow for a structured template based report and therefore wasn’t ideal for ultrasound reports which included multiple figures based data sets such as the measurements captured during fetal biometry reporting.

The voice recognition system also struggled with accurate dictation of obstetric measurements, this had the potential to lead to transcription errors.  The resulting reports were also unable to demonstrate graphical data a result of which all measurements had to be hand drawn and plotted on to paper graphs.

These drawbacks also meant that there was only one copy of the graphs which was then kept with in the patient’s hand held notes. If these notes were subsequently lost or damaged or the patient failed to bring their notes with them to the appointment that information was then unavailable.

The previous workflow was less efficient and relied heavily on operator accuracy and the availability of the paper based notes for review of previous scan information.  This system was therefore at risk of error in data capture which could ultimately affect patient management and care.

Reasons for change

The ultrasound department recognised the need for a more appropriate reporting solution and approached the current RIS supplier for suggestions as well as investigating the marketplace for potential software solutions.  GE ViewPoint was suggested by the current RIS supplier as an appropriate obstetric add-on to work in conjunction with their current RIS reporting workflows.

Attempts were then made to convince the Trust of the importance in procuring a more appropriate reporting solution, these attempts were further supported by an external Quality Assurance visit from the NHS National Screening Committee who also made the recommendation that the risks associated with the current workflow should be addressed. These factors supported the case to proceed with the implementation of an ultrasound specific reporting solution and the trust then chose HealthNetConnections and GE ViewPoint as the preferred solution, the go-live was then completed successfully in October 2015.

Chosen Solution

The Trust subsequently chose HealthNetConnections as their technology partner to create an integrated patient care record for obstetric ultrasound by using the GE ViewPoint ultrasound reporting system.  The implementation project was lead locally by Annette Brammer who is the Deputy Superintendent of Ultrasound, working in conjunction with the project management team at HealthNetConnections throughout the project to successfully deliver the requirements. The project team initially worked with Annette to assess and categorise the various clinical requirements to enable the system to be implemented in a structured manner and deliver the following clinical benefits.

 Centralised Capture of Ultrasound Data

Once the ultrasound examination is completed via the ultrasound machine the exam images and measurements are sent directly to the central GE ViewPoint server, the GE ViewPoint software instantly matches the received ultrasound study data with the correct patient & joint work list record, this integration enables the ultrasound observations to be automatically available to the reporting user for inclusion with in the ultrasound report.

“HealthNetConnections worked in conjunction with the ultrasound equipment suppliers to configure the ultrasound machines to transfer the correct data to GE ViewPoint and this functionality proved to be another very successful time saving aspect to the project.”

EPR & ICE Enterprise Integration

The ViewPoint system is also then further integrated via the Talk2 integration engine with the Trust PAS system to allow for additional demographic updates which are not normally available via a standard RIS interface, namely referring doctor details and other patient demographic and record updates, The ultrasound report is also then sent back to the trust Cerner EPR for incorporation into the Sunquest ICE reporting system.

ViewPoint 6 Screen Shot

 Clinical Reporting and Workflow

“Prior to the go live the team from HealthNetConnections worked with us to tailor the software and integration workflow to meet our clinical reporting requirements. Report templates were defined to reflect the current radiology examination codes and quick reports were then installed to enhance the efficiency of the system. Drop down question answers were custom built into the report pages to provide answers appropriate to our unit and local tertiary referral centres.”

RIS & PACS Integration

The new GE ViewPoint system is integrated via the HNC Talk2 integration engine with the existing trust Agfa RIS & PACS systems to allow for an improved electronic ultrasound information workflow.

The automated RIS worklist automatically includes all demographic and examination data required for rapid selection of the correct patient for examination with in the ultrasound clinic, this automated process improves reporting times by removing the need for any manual entry of patient information at point of capture and allows the sonographers primary focus to stay on the patient during examination.

Once the report is finalised there is an automatic data export which contains both the ultrasound images and clinical findings along with the graphical charts to the trust PACS system. A copy of the same ultrasound report but in textual form is also then sent to back the RIS via HL7 results messaging for inclusion within the originating RIS patient record.

The GE ViewPoint server also uses the Agfa PACS system as a long-term image archive, lowering the total cost of ownership due to not having to support a long-term file store on the ViewPoint server.

Workflow and Clinical Benefits

With the successful go-live of the GE ViewPoint system and the custom designed workflow delivered by HealthNetConnections the clinical benefits of this fully integrated workflow are now being felt across the trust, these clinical benefits can be broken down into the following improvements:

Clinical Benefits Summary

The key benefits that the Rotherham NHS Foundation Trust is now experiencing by using a fully integrated GE ViewPoint ultrasound reporting workflow can be summarised as follows;

  • Increased standardisation of obstetric reporting with inclusion of mandatory data items.
  • Improved exam times, with automated transfer of the ultrasound measurement data.
  • Central storage of ultrasound report data including images, measurements and reports.
  • Improved reporting allowing embedded ultrasound images and charts into the paper reports
  • Improved availability of ultrasound reports with inclusion within Agfa RIS & PACS
  • Ultrasound reports available within Integrated Clinical Environment ICE system
  • Ultrasound reports available within Cerner Electronic Patient Record.
  • Lower cost of thermal paper with electronic archive and storage of ultrasound images.
  • Improved quality allowing for better trend analytics and reporting of examination outcomes.

 Intuitive System

“The staff have reported how easy and intuitive the system is to use and there has been really positive feedback from the primary users. The referring clinicians are also pleased with the report layout and have been impressed with the availability of the results. Although there hasn’t been much statistical analysis of the data up to this point, there are plans to use GE ViewPoint to audit and monitor results and performance and to assist in reporting data for National KPI’s.”

Standardised Reporting

“Having ViewPoint has made a significant difference to the workflow in the unit. Reports are now more standardised and with the addition of mandatory fields crucial clinical information cannot be inadvertently omitted from a report. The system has enough flexibility built in to allow unusual or complex cases to be reported appropriately.  The addition of mandatory field such as “impression” and “follow-up” ensures that reports form a conclusion and the next step in patient management is highlighted to the clinician.”

 Faster Reporting

“The biggest change to our unit was the electronic graphical representation of the results which previously were only available as a single hand-written copy. All individual fetal biometry, liquor volume and Doppler results are now automatically plotted, with previous, consecutive results also displayed which assists with patient management immensely. Reports can be produced quicker with Viewpoint, particularly those that are straight forward when a quick report is applied.”

 Minimal Disruption

“There are a significant number of staff involved in the obstetric ultrasound service at Rotherham including the sonographers and obstetricians. Despite the number of staff to become familiar with the system, the training and implementation was very successful. There was minimal impact/disruption to the service in the first couple of weeks of implementation and now the workflow is firmly embedded.”

Future Expansion Plans

The Trust is also now looking forward to the future with plans to work with HNC further to roll out the GE ViewPoint system for reporting of gynaecological ultrasound scans, which make up a small proportion of the workload in the shared antenatal and gynaecology out-patient department allowing for a fully integrated ultrasound care record across the full OB/GYN service.

“This complete Obstetric and Gynaecology electronic record would be beneficial to the ultrasound staff working in the unit, as they could then seamlessly access GE ViewPoint for any examination performed be that obstetric or gynaecological eliminating the need to switch between other reporting systems and ViewPoint.”

Overall Experience

“The project management team at HealthNetConnections were incredibly supportive and able to meet our needs and requests in all aspects of the implementation project.  There didn’t seem to be anything they couldn’t do/adjust to meet our reporting needs and even as challenges arose weeks after implementation they were able to quickly help us resolve these teething troubles.  Later down the line when needing to access the service desk, the same high level of service has been experienced. Staff on the service desk always answer the phone straight away and in the majority of cases can resolve any issues whilst we are on the phone or at worse on the same day.  I would definitely recommend HNC products and services to others as our experience at Rotherham has been very positive.”

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