Paperless and fi lm lessAccurate Diagnosisfor better Patient Care

National GuardHealth Affairs

Digitization of the Radiology DepartmentIntegrated RIS-PACS

National Guard Health Affairs (NGHA) is proud to be a leading orga-nization in the provision of “State of the Art” healthcare services, with a clear strategy and vision to continue to develop health systems and strategies to provide modern advanced medical care to patients by focusing on the welfare and needs of the community. NGHA’s accomplishments have been realized through the vision and guidance of the Custodian of the Two Holy Mosques, HRH King Abdullah bin Abdulaziz Al Saud, and the hard work and efforts of NGHA staff, whose dedication and loyalty are instrumental factors in our success.

In accordance with Information Technology Strategic Planning, NGHA successfully moved toward a total automated health infor-mation system. Full integration commenced with the latest network and IT infrastructure through a complete integration of Enterprise Resource Planning, and one of the top Clinical Information Systems including centralized Computerized Patient Records. In order to achieve a paperless, fi lmless healthcare organization, thus im-proving effi ciency and effectiveness of patient care, NGHA are intro-ducing Enterprise Electronic Image Processing and Image Storage to all Medical Imaging, Cardiac and Dental facilities.

Dr. Abdullah Al Rabeeah,

Chief Executive Offi cer,

National Guard Health Affairs

In the mid 1990s it was evident that the conventional type of patient administration (x-ray, fi lm management and reporting) would have no future as this process incurred unnecessary staff activity and avoidable delays in providing a rapid diagnosis. Further, increased environmental awareness required a departure from the fi lm-screen system, fi lm chemistry and disposal which had been used for decades. A further reduction in radiation burden was also an in-creasing challenge.

The solution was identifi ed with the gradual implementation of an integrated full version of the Radiology Information System (RIS) and Picture Archiving and Communication System (PACS). The smooth implementation of this substantial intervention in administration is due to several months of preparation and training for staff, highly motivated employees and the steady guidance provided by GE Healthcare. RIS-PACS and speech recognition speed up the pro-cedure of any high-quality radio logical examination, achieving a benefi cial gain in time ensuring patient satisfaction.

The project will cover all NGHA facilities in the Central, Western and Eastern Regions of Saudi Arabia, providing each Radiology Depart-ment with diagnostic workstations. Some areas will also include specialized clinical review workstations with high resolution. All images will be accessible through the web and will be able to be sent and received between all regions.

This achievement represents a major milestone in the continuation of NGHA’s vision to provide advanced healthcare services to the community

Centricity® RIS-PACS: For large Healthcare Enterprises

In the mid-1990s it was already evident that the conventional type of patient administration, X-ray fi lm management and reporting would have no future, for the following reasons:

• Referrals to X-ray examinations on paper forms that were delivered by messengers

• Recording of patient data in index card boxes and time-consuming searches

• Localization and retrieval of legacy X-ray fi lms from various fi lm archives spread across different sections of the building, and some fi lms and /or reports were irretrievable

• Unnecessary repeats in the event of incorrect exposures• Time wasted making the X-ray image, dictating, typing and

reviewing the X-ray report, through to arrival by messenger at the referring ward.

All this meant unnecessary staff activity and avoidable delays on the way toward a rapid diagnosis, which has been the basic require-ment for targeted therapy ever since reliable, sophisticated elec-tronic systems became ready for the market due to technological progress.

Last but not least, increased environmental awareness called for a move away from the fi lm-screen system based on silver com-pounds, which had been in use for decades, along with fi lm che-mistry and disposal.

Also, a further reduction in radiation burden was an increasing challenge.

Simplify Clinical Practice

The solution to all these problems was identifi ed as being the gradual implementation of an integrated full version of RIS-PACS (RIS = Radiology Information System, PACS = Picture Archiving and Communication System). The fact that such a substantial inter-vention in administration could be implemented smoothly at the largest hospital in Saudi Arabia, despite full clinical routine, is not only due to the several months of preparation and training for staff but also to the highly motivated employees in all the departments concerned and dependable advice provided by GE Healthcare. RIS-PACS and speech recognition speed up the procedure of any high-quality radio logical examination, achieving a therapeutically useful gain in time for clinicians and patients, so they make a valu-able contribution on the way to ensuring satisfi ed patients.

The project will cover Riyadh, Dammam, Al Hassa & Jeddah National Guard Health Affair institutes.

Each site will have diagnostic workstations at the Radiology depart-ment with Long term and short term Archive. In addition, some area will have specialized clinical review workstations with high resolu-tion. The referral physicians will be able to access all images through the web.

Also, doctors will be able to send and receive the images from / to other National Guard institutes in Saudi Arabia. Moreover, the following are in brief the main feature and benefi t of such system at huge organization like National Guard Health Affairs.

The use of an integrated RIS-PACS means a quantum leap forward in the work of the radiology department as a whole at Wilhelminen-spital. All patient data is made available in a clearly organized way and data security is maximized.

System convenience allows user doctors and staff members to concentrate fully on the patient.

Shorter waiting times and hence earlier treatment appointments are pleasing aspects of progress for patients. Due to the integrated RIS-PACS not only are costs reduced, it is a major step toward effi cient patient care.

• Radiology Information System (RIS)

Conventionally speaking, a RIS is a workfl ow-oriented patient data management system that accompanies and documents patient throughput within a radiology department by providing electronic support. The system also handles reporting and monitoring.

• Picture Archiving and Communication System (PACS)

The purpose of a PACS is the transfer of digital image data and safe storage, distribution, and processing. Reporting on digital image data is performed at reporting stations with appropriate-ly high-quality monitors that are linked to the archive system.

Full integration ofRIS and PACS is the basic requirementfor fi lmless,paperless radiology

Appointment inquiries for inpatients reach Ra-diology by fully electronic means.

Images of the patient are generated at the appropriate radiography unit. The radiation dose is documented automati-cally by DICOM MPPS.

State-of-the-art storage technology for extremely fast image access, data security and future-proof capability.

All images are always available at every work-place „on demand“. Speech recognition and 3D proces-sing support the reporting procedure. The report is dictated into the computer direct via a microphone.

When the report has been successfully checked and corrected by the typist it is returned to the radiolo-gist for approval.

Reports can be approved very quickly.

Appointment

Examination

Archiving

Reporting

Speech recognition

Approval

Image distribution Demonstration

Images and reports are available to clinicians on the network (WEB brow-ser) at any time.

One jump in quality can also be seen from the clinical discussion, employing video beamers and special conference display protocols

paper- and fi lm-less

Improvement in Quality and Performance

One Choice for seamless Functionality

The Centricity RIS-PACS is the truly integrated tech nology for image and information management in radiology. It brings together all of GE‘s strengths and experience in information technology, imaging, and process improvement to create a radiology solution focused on information and workfl ow needs.

Centricity RIS-PACS is more than a combination of dis crete RIS and PACS functions. GE revolutionizes radiology workfl ow with the next-generation Centricity RIS/PACS. It integrates RIS and PACS data seamlessly into a User Based Solution for the Radiologist, Clinician and Technologist.

Unifi ed RIS-PACS information

With some RIS-PACS systems, it seems as though the user has to play the role of integrator – accessing data from multiple desktops and logging on to and using a succession of applications. Centricity RIS-PACS is different. It brings everything together for ra-diologists and technologists with custo mized user-centric solutions that deliver all required functionality in one view. This simplifi ed approach enables a huge leap in productivity and eliminates the barriers to effi ciency.

There is no need for multiple workstations or multiple logins. And in their place Centricity RIS-PACS gives the tools to improve produc-tivity and play a more central and immediate role in patient care.

Reporting at an integrated RIS-PACS workstation

Radiology Cockpit presents the image data at the integrated repor-ting station in sync with the patient data of the Radiology Informa-tion Systems (RIS). The relevant images are very simply selected for the radiology clinical round, in the demonstration room. An image folder provides all the previous exposures belonging to that region of the body.

Reporting is controlled with the integrated dictation system. All the necessary data such as request information and laboratory levels are available at a glance.

State-of-the-art Centricity ® RIS-PACS archive

The data acquired over several years can be stored In an area cover-ing one square meter. The data sent to a failsafe cluster server is transferred by the latter to a high-security storage system (Storage Area Network).

By simply clicking on the patient on a RIS worklist the relevant data is retrieved from the archive in a fl ash and displayed on the PACS monitor.

On-demand technology

Special lossless data compression methods enable direct fast retrieval of image data over the network. With an on-demand system all the images can be called up at any workstation at any time, without any complicated routing rules or elaborate logistics. This ensures that the reporting doctor always has all the current data at his fi ngertips as well as all the necessary previous reports and images for purposes of comparison.

Technology for Patients‘ Well-being

High availability in the server area

Without images there is no report! Operational reliability of the core components is thus essential. Using a server architecture ensures that if a server (cluster server) drops out there will be no deteriora-tion in work. State-of-the-art SAN technology (Storage Area Network) is also used in the fi eld of storage. Continuous, round-the-clock operation is thus guaranteed.

3D reconstruction

Due to more and more new developments in radiography units the radiologist is confronted with a data explosion that is diffi cult to cope with. The 3-di-mensional display of bones, organs, and vessels supplements 2-dimensional display while pathological changes are thus visualized better and are easier to detect.

Optimized interfaces

In a heterogeneous environment with different information systems, functioning interfaces between them represents an integral part of an effi cient system as a whole.Seamless integration with the Hospital Information System (HIS) can only be achieved with professional interfaces that are based on industrial standards.

Combined image and report distribution employing WEB technology

The clinician is provided with all the relevant data of the radiological examination using web technology. Immediate availability of data ensures that the patient derives maximum benefi t from the techno-logical developments. In the clinical fi eld, availability of all informati-on is often crucial. As the WEB server communicates with the main server directly without any intermediate storage of its own, previous reports are always on hand.

Speech recognition

We talk seven times faster than we type. The transcrip-tion of dictated texts takes a lot of time, which could be spent more usefully. Integrated speech recognition converts dictations to text in real time. Subsequent fi nalization of the documents takes much less time than it used to.Complete integration of speech recognition into the Centricity RIS-PACS system facilitates the process cycle and has speeded up the reporting process considerably.If reports are available sooner, targeted treatment for our patients‘ disorders can commence earlier.

One Company. One Vision. One Partnership.

Transforming Healthcare Delivery

Information technology will transform healthcare as we know it. The healthcare organization of the future will empower care providers to do just that – focus on providing care – instead of chasing docu-ments and fi lling out reams of paperwork. Evidence-based medicine will empower clinicians to provide the highest quality of care for a specifi c condition. Decision-support tools will enable more informed clinical care decisions for a specifi c patient. The digitized healthcare community will foster collaboration between clinicians, care teams, patients and provider organizations to ensure the best outcomes.

At GE Healthcare, we are making this vision of tomorrow a reality. More than just implementing new monitoring networks or updating monolithic systems, this digital transformation in healthcare means completely rethinking and re-engineering the clinical process. It means merging digital record-keeping with daily clinical workfl ow. It means secure data streaming through both mission-critical and dedicated life-critical networks that experience minimal downtime. It means allowing a geographic separation between the point of clinical care and the location of clinical decision. And that means workfl ow transformation. Errors are reduced. Patients get well faster. And your healthcare enterprise advances, because technology has enabled it to become smarter. Healthcare Re-imagined.

Having the Centricity ® RIS-PACS is the truly integrated technology for image and information management in radiology. Centricity ® RIS-PACS is more than a combination of discrete RIS and PACS functions. It integrates RIS and PACS data seamlessly into a user based solution for Radiologist, Clinician and Technologist.

Centricity ® RIS-PACS is different. It brings everything together for radiolo gists and technologists with customized user-centric solutions that deliver all required functionality in one view. Therefore, there is no need for multiple workstations or multiple logins. The integrated digital cockpit is unique to Centricity ® RIS-PACS. It takes you in one login and one look, and you get the complete picture on your patient. RIS-PACS Re-imagined.

Project Executive,

Dr. Bakheet Al Dosari

Chairman Project – Steering Committee,Dr. Majid Al Tuwarijri

NGHA IT – Steering Committee,

Abdullah Al Ammari

Leader Integration,

Mohamed Musalam

Leader PACS Installation,

Mark Boyd

Leader IT Support,

Abdul Aziz Al Rumaih

Leader GE Modalities,

Ziyad Qahtani

GE Project Manager,

Mohd Mustafa

Project Secretary

NGHA Project Manager,

Mark Boyd

Radiology Chairman

(Central Region, Western Region & Eastern Region)

Leader Modality Installation,Abdul Rahman Al Khudair

Wael Khalil,

Sales Manager Middle East & Africa,

GE Healthcare

National Guard Project Team

National Guard Health AffairsInformation Systems & Informatics DivisionP.O. Box 22490, Riyadh 11426Kingdom of Saudi Arabiawww.ngha.med.sa

GE imagination at work© 2006 General Electric Company, doing business as GE Healthcare

www.gehealthcare.com