Next Generation Ultrasound Reporting workflow at County Durham and Darlington NHS Foundation Trust 2017-06-30T12:34:01+00:00

Project Description

Next Generation Ultrasound Reporting workflow at County Durham and Darlington NHS Foundation Trust.

County Durham and Darlington NHS Foundation Trust chose HealthNetConnections to provide a new and enhanced integrated patient care workflow for women’s health ultrasound by implementing the next generation of GE’s ViewPoint ultrasound reporting system.

All ultrasound findings (images, charts, reports and measurements) are now electronically captured within the GE ViewPoint system; coupled with HNC’s Talk2 integration suite these ultrasound findings are now electronically shared with the existing radiology information systems (HSS CRIS & GE PACS) creating a fully integrated patient care record for women’s health.

“Teams were extremely helpful from HNC – they worked with the Trust Project Team to overcome issues as the implementation was occurring and were actively involved in project team and board meetings. System changes were acted on swiftly and teams were supported to ensure that the system was fit for purpose”

Paul Maylan - Business Manager – Family Health
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Background

Since 2003 (Durham) had been operating a standalone ViewPoint 5.6 reporting system which had been implemented to cover reporting requirements for the local Fetal Medicine & Obstetrics departments. Whilst Durham had electronic reporting they had no ultrasound image capture nor archive facility. Darlington meanwhile had no electronic reporting capabilities; a consequence of which service improvement was hindered and this led to inequitable care when compared with Durham.

With no central electronic storage, captured images were printed on thermal paper and stored within patient notes. Thermal paper cannot be relied upon as a long-term storage medium with images lasting no longer than 5 years. In obstetric care, records should be kept and stored for a minimum of 25 years. A system for the secure storage of images and reports will support the Trust against the potential of future litigation where relevant clinical history may be unable to be reproduced or further examined when required.

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

An electronic process brings more assurances than a manual process including:

  • Less likelihood of data entry error

  • Reports available electronically

  • Access to embedded obstetric charts

  • Availability of data audit history

Reasons for change

The department recognised the need for a more appropriate centralised women’s health reporting workflow solution; this requirement was acutely apparent when an abnormality was suspected, women from the South of the Trust had to travel to Durham for a fetal medicine consultation which then put pressure on the available appointment slots in the Fetal Medicine Department and in some cases appointments could not be provided within the acceptable timeframe.

When timeframes were not able to be met it meant that women would have to then travel to a tertiary referral unit at Newcastle.  These referrals not only carried a travel cost implication for the women but also with the introduction of payment by results there was a referral cost for the Trust as the tertiary unit at Newcastle would then counter charge for the scans carried out in their service.

Chosen Solution

The Trust Radiology department went through a full RIS & PACS refresh process; as part of the new imaging workflow they chose to not only continue using GE ViewPoint as the ultrasound specific reporting system but to also partner again with HealthNetConnections to upgrade and further extend the service provided across the Fetal Medicine & Obstetrics service for University Hospital of North Durham, Darlington Memorial Hospital, Bishop Auckland General Hospital and Shotley Bridge Hospital. Creating a fully integrated Women’s Health Ultrasound Reporting Workflow for the whole Trust, the go-live was completed successfully in September 2016.

 Clinical Reporting and Workflow Benefits

Through the use of an integrated GE ViewPoint system the department can now avail of the following clinical and workflow benefits:

  • The end users are now able to instantly see & share ultrasound scan reports

  • All ultrasound images are instantly viewable and automatically centrally archived

  • The trust now meets national reporting standards for ultrasound

  • The trust now has instant availability of graphs and charts to aid in clinical decision making

These benefits help to vastly improve the information sharing and reporting workflows across the trust with all of the ultrasound reporting information available at the various clinic locations around the trust and to all users in real time.

Data Sharing and Information Access

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.

Our data sharing and information access has vastly improved as the system is now available across all sites. Due to the centralised reporting and collection of this data, we now also have figures available for reporting that can be used to improve services moving forward.

Sheila Reed – Antenatal and Newborn Screening Midwife Co-ordinator

RIS and PACS Integration

The new GE ViewPoint system is integrated via the HNC Talk2 integration engine with the trust’s radiology HSS RIS & GE PACS systems to allow for an end to end electronic ultrasound information workflow.

The automated RIS appointment 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 GE 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.

ViewPoint 6 Screen Shot

Workflow and Clinical Benefits

The implementation project was lead locally by Sheila Reed – Antenatal and Newborn Screening Midwife Co- ordinator in conjunction with the project management team at HNC who worked closely throughout the project to successfully deliver the requirements. On discussing the various requirements and clinical changes made to deliver a successful implementation and updated electronic reporting workflow Sheila comments:

Clinical Benefits Summary

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

  • Increased standardisation of ultrasound reporting with inclusion of mandatory data items.

  • Improved examination times, due to automated transfer of the ultrasound measurement data.
  • Central secure storage of all ultrasound reporting data including images, measurements and reports.

  • Improved data reporting allowing for embedded ultrasound images and charts into the paper reports.

  • Improved availability of ultrasound reporting data with inclusion in the enterprise HSS RIS & GE PACS

  • Lower cost of thermal printer paper with electronic archive and storage of ultrasound images.

  • Improved data quality allowing for better trend analytics and reporting of examination specifics.

Project Management

“The teams were extremely helpful from HNC – they worked with the Trust Project Team to overcome issues as the implementation was occurring and were actively involved in project team and board meetings. System changes were acted on swiftly and teams were supported to ensure that the system was fit for purpose.”

 Training

“Training was of a high quality and HNC were flexible and worked around the availability of clinicians.”

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