NHS PACS System
And
Comparison
Old System
New System
Introduction
PACS means Picture Archive Communication System. This is computerizes, network based diagnostic image & X-ray storage and also patient reports, distribution and retrieval system.
Managing workflow, organizing studies of patient diagnosis & presenting it clearly in hospital in done by using this system. Apparently for that, PACS system consists typically of an archive device, diagnostic viewing stations for radiologists and clinical review by physicians, servers to distribute the images via a public network and the required database and workflow management software. Digital X-ray modalities such as Computerized or Digital Radiography (CR/DR) are sometimes considered PACS components as well.
Before & After
Before PACS introduce to the world the scheduling time of the examinations used to be sorted out by their own. So then correctly ordered and patients get diagnosis. Then nurses prepare the patient for the examination while radiographer prepares to produce image production of patient’s diagnosis. Then the radiographer do the film processing from the machine which is contained the X-Rays films and fetches the diagnoses images.
After finishing the process of examination of the patient’s diagnoses film, it put to light board by radiographer to view the diagnoses.
After PACS introduce the radiographer take the images of the patient’s diagnoses and stored in the PACS. When the radiographer ready to view the X- Ray of a patient that patients X-Ray will appeared on the screen as image, when radiographer click the image of x-ray.
Before | After |
Scheduling time of the examinations used to be sorted out by their own Radiographers have to take time to prepare for the examination Take longer time to do the examination. | No waiting list for the examination. No lost or misplace of images, because it’s place in the system. Better collaboration. Fast delivery of the & flexible to view |
Advantages and disadvantages of PACS
Advantages | Disadvantages |
Decrease in storage and filing costs Consistently high quality of images Examinations in order according to dates No chemical use for processing Rapid access to patient examinations An improved work area Deletion of images before closing case Elimination of film artefacts No lost films | Learning curve for software Transferring images from portable capture unit Cost of technology maintenance Archive retrieval can be slow when demand is high |
Golden rules of successful PACS
· Avoid Making Mistakes
· Network Infrastructure
· Protocols Usage
· Privacy and Security
· Choice of Monitors
· Choice of Archiving Servers
What are the benefits of sharing PACS information?
To make best care and deciding of the patients PACS images analyse by team of doctors and medical expertise. This is a benefits which will patients get from PACS. These medical expertise and team of doctors known as “Multi Disciplinary Teams”, they will meet and discuss the diagnosis of a patients instance.
In some instances PACS information may need to be accessed by health professionals at different locations, for example if a patient is being transferred to a specialist hospital, and doctors need to see relevant prior images and reports.
According to the Lundberg report; the problematic in new system supported to cover the goal of a successful integrated and transformation of process. It’s bit complicated to find-out and cutting off the bad sectors comparing old and new working method.
Therefore many integration problems between the old systems work method and the new working method was evident some of the instances are,
· The old system requires the A&E medical personnel to log off the system before attending a patient however this will not be accepted since in the current work pattern importance is given to the medical case where they do not have the time to log off systems as patients need immediate care.
· According to the shortest list is on the old patient administration system, patients aren’t allowing find physicians.
· The current system facilitates critical patient prioritising through the triage list while the new system facilitates this list by the use of the screen called “whiteboard” which does not provide any prioritising option.
Ways Radiographers influences with PACS
· As PACS cut off the needs of repeating examinations via inaccurately taken images, this makes radiographers experience lower radiations.
· Only once radiographers have to enter data to the system. This makes radiographers free from administration tasks and make freeing to keep attention on the certain patients.
· As the lack of filming required PACS contribute to make chemical free environment in the wok place.
Way PACS affected to Hospital Consultants
· Easy to accesses to patients diagnosis images
· Reduce the amount of post-pone and wasted procedures, regarding not available of the patients diagnosis images.
· Increase the consultations in between radiologist and the clinicians and this makes better collaboration too.
Number of way PACS change patients care
· Lower Radiation dosage due to less retesting the patient
· Quickly receive test results.
· Treatments and discharging makes quicker than earlier and less wasting time with better care plane.
What is EPR?
An EPR is Electronic Patients Record system, which keeps record about a patient health in a computer. This will up to-date (past to present). EPR system is easier than keeping records in a file.
Changes of the Test results Distribution
Test results of the examination of a patient came to ward by mail, before introducing the EPR to the hospitals. There were two inboxes. One is normal inbox, which is for nurses in the hospital. Other one is abnormal for doctors (physicians). Then they discuss examination reports.
As EPR introduce to world. It makes work easier in the Hospitals. Patients test or examination results directly goes to patient’s folder in the EPR system. As soon as the certain physician read it he/she will delete it.
New Task introduced with EPR
Though the test results of a patients updating time to time in the EPR, some physicians wait until nurse came and discuss about the patient records, some physicians delete after they read reports of a patients without taking or looking further action for it. This makes work wired in the hospital.
The test results of a patient automatically flow to EPR system and this has challenge-seated routines, especially the nurse’s and physicians traditional pattern. Before EPR comes the results comes 3 o’ clock which is routines, but currently due to EPR system physicians or nurse can pop up patients records and result of test any time of the day as soon test finishes. So there is no harsh to waiting till results come to table.
Before EPR system nurses are used to discuss with the physicians after physician called them, and also sometimes nurses are unsure of that they could meet and discuss about test results or report with physicians in 3 o’clock or when physician call to them. But now its bit complicated, because its not finished. One goal of it should be improve effectively through exchange of information’s with the hospital staff, so this goal is a challenge.
Though the test results done twice from the electronic infrastructure, some test results not covering for daily ward work lot. This thing happening, because hospital staff paying more attention to serious results, and paying less attention in to less serious results, so less serious result not noticified by any until it comes to serious.
Reference:
Standards for patient confidential and PACS – Royal College of Radiologist
Impacts of PACS on Radiological Work – Nina Lundburg
Subtle Redistribution of Work, Attention and Risks: Electronic Patient Records and Organizational Consequences - Signe Vikkelsø
Assessment of PACS - Claudia Wild, Walter Peissl, Hilda Tellioglu
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