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Digital Health Rewired - Building the Radiology Supernode

Dr Daniel Fascia
March 26, 2019
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Digital Health Rewired - Building the Radiology Supernode

Digital Health Rewired 2019 - Kensington Olympia March 2019

Yorkshire Imaging Collaborative Building the Radiology Supernode

Dr Daniel Fascia

March 26, 2019
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  1. Building the Radiology Supernode Dr Daniel Fascia Clinical Lead of

    The Yorkshire Imaging Collaborative @yorks_imaging yorkshireimaging.org
  2. PHASE B Connect as regional network PHASE A 8 x

    Trusts “Need a new PACS” Co-procurement Deploy PACS Learn + Improve X 8 Transformation “Masterplan” <vendor(s)> Co-procurement Enact Transformations Iteratively improve provider model
  3. Aire Hull Hg NLAG C&H Mid Yorks Leeds Brad Sharing

    Solution Procurement Q3 2019 CLINICAL IMAGING INTEROPERABILITY Interoperating with Xero Viewer “Images and reports visible cross Collaborative”
  4. Q3 2019 CLINICAL IMAGING INTEROPERABILITY Leeds Hg Leeds Teaching Hospitals

    CT Scan Report Qui ut fugiat dolore culpa velit adipisicing amet commodo. Aliquip voluptate sint irure ex minim ea irure nulla laboris nostrud deserunt velit ex reprehenderit. Non ut elit Lorem id sint id occaecat occaecat. Eiusmod excepteur Lorem duis ea labore proident excepteur velit nisi et voluptate. Laborum voluptate elit sint aliqua Lorem magna ea elit aliqua dolore. Harrogate Hospital CT Scan Report Qui ut fugiat dolore culpa velit adipisicing amet commodo. Aliquip voluptate sint irure ex minim ea irure nulla laboris nostrud deserunt velit ex reprehenderit. Non ut elit Lorem id sint id occaecat occaecat. Eiusmod excepteur Lorem duis ea labore proident excepteur velit nisi et voluptate. Laborum voluptate elit sint aliqua Lorem magna ea elit aliqua dolore.
  5. TOTAL INTEROPERABILITY (IMAGING & REPORTS) Aire Hull Hg NLAG C&H

    Mid Yorks Leeds Brad Q3 2020 TOTAL RADIOLOGY WORKFLOW INTEROPERABILITY
  6. Advanced Interoperation TOTAL RADIOLOGY WORKFLOW INTEROPERABILITY GP Community Imaging Centre

    Regional Hospital (Local to patient) Imaging Pathway MDTM Tertiary Hospital (Local to patient) Specialist Care Pathway Complete Imaging Integration without GP input Clinical Pathway
  7. PROCESS & WORKFLOW COMMON PRACTICES SHARED CORE SERVICES BUSINESS INTELLIGENCE

    UNIT LEARNING & DEVELOPMENT MESSENGER SERVICE Regional Dose Monitoring DIRECTORIES (searchable) Staff Machines Rooms Sites Trusts Organisations HUMAN RESOURCES Training Passport Cross site credentials INTERNAL STAFF BANK INSOURCED REPORTING MEDICAL PHYSICS CANCER Priority Group Scanning Protocols Reporting Standards Procedural Documents Patient Advice Paeds MSK Neuro H&N Gastro/Uro Trauma Nuclear Med Chest/Cardiac IR/Vascular SPECIAL INTEREST GROUPS RADIOLOGY SERVICE GROUP Remote Work ACCOUNTING CENTRAL IT FOR SHARING NETWORK PORTAL WEBSITE tScan tReport Standards Regionalised ON CALL PROCUREMENT GROUP 3rd party provider standards Remote Working Standards Priority standards Data Lifecycle Consent for research/AI REDUCING PROBLEMATIC VARIANCE
  8. PROCESS & WORKFLOW COMMON PRACTICES SHARED CORE SERVICES BUSINESS INTELLIGENCE

    UNIT LEARNING & DEVELOPMENT MESSENGER SERVICE Regional Dose Monitoring DIRECTORIES (searchable) Staff Machines Rooms Sites Trusts Organisations HUMAN RESOURCES Training Passport Cross site credentials INTERNAL STAFF BANK INSOURCED REPORTING CANCER Priority Group Scanning Protocols Reporting Standards Procedural Documents Patient Advice Paeds MSK Neuro H&N Gastro/Uro Trauma Nuclear Med Chest/Cardiac IR/Vascular SPECIAL INTEREST GROUPS RADIOLOGY SERVICE GROUP Remote Work ACCOUNTING CENTRAL IT FOR SHARING NETWORK PORTAL WEBSITE Regionalised ON CALL PROCUREMENT GROUP 3rd party provider standards Remote Working Standards Priority standards Data Lifecycle Consent for research/AI REDUCING PROBLEMATIC VARIANCE MEDICAL PHYSICS tScan tReport Standards
  9. • Special Interest Groups (SIG) meeting and building clinical networks

    (Started January 2019) ◦ Paediatric - investigation of suspected abuse ◦ Urology - Stones / renal mass pathways • Radiology Service Group creating service standards and cross-site working rules + dealing with challenging topics ◦ Workforce ◦ Outsourcing ◦ Training and skill drive for radiographers • Cancer Priority Group close links - Cancer Alliance ◦ Capacity & Demand analysis for cancer ◦ Surveillance of SIG progress • Regional On Call Service feasibility deep dive planning (September 2019 by SpR Leadership Fellow) COMMON PRACTICES CANCER Priority Group Scanning Protocols Reporting Standards Procedural Documents Patient Advice Paeds MSK Neuro H&N Gastro/Uro Trauma Nuclear Med Chest/Cardiac IR/Vascular SPECIAL INTEREST GROUPS RADIOLOGY SERVICE GROUP Regionalised ON CALL 3rd party provider standards Remote Working Standards Priority standards Data Lifecycle Consent for research/AI REDUCING PROBLEMATIC VARIANCE MEDICAL PHYSICS tScan tReport Standards
  10. PROCESS & WORKFLOW COMMON PRACTICES SHARED CORE SERVICES BUSINESS INTELLIGENCE

    UNIT LEARNING & DEVELOPMENT Regional Dose Monitoring DIRECTORIES (searchable) Staff Machines Rooms Sites Trusts Organisations HUMAN RESOURCES Training Passport Cross site credentials INTERNAL STAFF BANK CANCER Priority Group Scanning Protocols Reporting Standards Procedural Documents Patient Advice Paeds MSK Neuro H&N Gastro/Uro Trauma Nuclear Med Chest/Cardiac IR/Vascular SPECIAL INTEREST GROUPS RADIOLOGY SERVICE GROUP Remote Work ACCOUNTING CENTRAL IT FOR SHARING NETWORK PORTAL WEBSITE Regionalised ON CALL 3rd party provider standards Remote Working Standards Priority standards Data Lifecycle Consent for research/AI REDUCING PROBLEMATIC VARIANCE MEDICAL PHYSICS INSOURCED REPORTING MESSENGER SERVICE PROCUREMENT GROUP tScan tReport Standards We beat the CQC to it Strong indications of service level standards for reporting. Time to scan Time to issue report Continuous heuristic monitoring with alerts to service managers Reduction in Outsourcing RCR model insourcing Home workstations Sessions at home? Challenges due to doctor’s pension rules
  11. PROCESS & WORKFLOW COMMON PRACTICES SHARED CORE SERVICES BUSINESS INTELLIGENCE

    UNIT LEARNING & DEVELOPMENT Regional Dose Monitoring DIRECTORIES (searchable) Staff Machines Rooms Sites Trusts Organisations HUMAN RESOURCES Training Passport Cross site credentials INTERNAL STAFF BANK CANCER Priority Group Scanning Protocols Reporting Standards Procedural Documents Patient Advice Paeds MSK Neuro H&N Gastro/Uro Trauma Nuclear Med Chest/Cardiac IR/Vascular SPECIAL INTEREST GROUPS RADIOLOGY SERVICE GROUP Remote Work ACCOUNTING CENTRAL IT FOR SHARING NETWORK PORTAL WEBSITE Regionalised ON CALL 3rd party provider standards Remote Working Standards Priority standards Data Lifecycle Consent for research/AI REDUCING PROBLEMATIC VARIANCE tScan tReport Standards MEDICAL PHYSICS INSOURCED REPORTING PROCUREMENT GROUP Glue that binds the project Insourcing not outsourcing Awareness of workforce (directories of abilities) Friction Free Human Resources Mandatory training ONCE - Training Passport Staff mobilisation Cross site credentials
  12. 2.6 Million Attendance Records 22 Years Londitudinal Data Machine Learning

    trends FORWARD INSIGHT April 2025 CT SCANS 448 3 x Scanners Req CT DAY STAFF BAND 7 x 4 BAND 6 x 2 BAND 3 x 4
  13. COMMON PRACTICES CANCER Priority Group Scanning Protocols Reporting Standards Procedural

    Documents Patient Advice Paeds MSK Neuro H&N Gastro/Uro Trauma Nuclear Med Chest/Cardiac IR/Vascular SPECIAL INTEREST GROUPS RADIOLOGY SERVICE GROUP Regionalised ON CALL 3rd party provider standards Remote Working Standards Priority standards Data Lifecycle Consent for research/AI REDUCING PROBLEMATIC VARIANCE Thanks to the work of our Special Interest Groups, data and practice standardisation are already underway