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Service transformation through technology: Yorkshire Imaging Collaborative

Service transformation through technology: Yorkshire Imaging Collaborative

The Yorkshire Imaging Collaborative is a combined technology and business transformation project aiming to unify the radiology image and report sharing networks of 8 NHS Trusts across Yorkshire. It will also prepare the County for participation in a National image sharing network.

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Dr Daniel Fascia

March 16, 2018
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  1. Service Transformation Through new technology Dr Daniel Fascia Clinical Lead

    of The Yorkshire Imaging Collaborative RCR Informatics Officer MSK Radiologist @yorks_imaging yorkshireimaging.org @danfascia
  2. 24 HOSPITALS 8 NHS TRUSTS 2.3 MILLION PEOPLE

  3. None
  4. Every patient in Yorkshire should be able to attend an

    appointment and have full availability of their medical images and associated reports at the point of care delivery
  5. The Bigger Picture

  6. The Bigger Picture • Ultimate goal is a UK wide

    radiology network • Regional collaborative networks are recommended and endorsed by the Royal College of Radiologists • Also supported by NHS Improvement ◦ EMRAD Vanguard ◦ Other exemplar networks ◦ STP vision • Radiology workforce must redesign itself for success
  7. The Bigger Picture • Ultimate goal is a UK wide

    radiology network • Regional collaborative networks are recommended and endorsed by the Royal College of Radiologists • Also supported by NHS Improvement ◦ EMRAD Vanguard ◦ Other exemplar networks ◦ STP vision • Radiology workforce must redesign itself for success ◦ A workforce in crisis ◦ 29% retirement in next 5-years ◦ Insufficient trainees ◦ 9 - 25% vacant consultant posts
  8. Vision for National connectivity of Radiology Networks

  9. Preparing Yorkshire • Leeds Teaching Hospitals • Bradford Teaching Hospitals

    • Harrogate • Airedale • Calderdale & Huddersfield • North Lincs & Goole • Hull & East Yorks • Mid Yorkshire MIA • Barnsley • York Teaching Hospitals • Sheffield Teaching Hospitals • Rotherham • Doncaster & Bassetlaw
  10. Preparing Yorkshire • Leeds Teaching Hospitals • Bradford Teaching Hospitals

    • Harrogate • Airedale • Calderdale & Huddersfield • North Lincs & Goole • Hull & East Yorks • Mid Yorkshire MIA • Barnsley • York Teaching Hospitals • Sheffield Teaching Hospitals • Rotherham • Doncaster & Bassetlaw
  11. None
  12. Why current strategies for image sharing fail

  13. Why current strategies fail Push approach on demand (Image Exchange

    Portal)
  14. Why current strategies fail No Image Awareness I had no

    idea she had a CT scan in your hospital last week
  15. Why current strategies fail Dependence on central servers Usually not

    ‘down’ but often poor latency Not supportive of ‘just in time transactions’
  16. Why current strategies fail No Reports

  17. 29-11-2017 CT Brain Lauren Martin (12-1-1980) University College Hospital Anywhere

    25-11-2017 CT Head Lauren Martin (12-1-1980) Lovely District General Hospital 20-11-2017 Chest XR Lauren Martin (12-1-1980) University College Hospital Anywhere 10-01-2013 Rt Knee Lauren Martin (12-1-1980) Lovely District General Hospital 09-05-2010 Rt Knee Lauren Martin (12-1-1980) Supersonic Imaging Centre Timelines with image awareness
  18. 29-11-2017 CT Brain Lauren Martin (12-1-1980) University College Hospital Anywhere

    25-11-2017 CT Head Lauren Martin (12-1-1980) Lovely District General Hospital 20-11-2017 Chest XR Lauren Martin (12-1-1980) University College Hospital Anywhere 10-01-2013 Rt Knee Lauren Martin (12-1-1980) Lovely District General Hospital 09-05-2010 Rt Knee Lauren Martin (12-1-1980) Supersonic Imaging Centre Timelines with pull self service
  19. 29-11-2017 CT Brain Lauren Martin (12-1-1980) University College Hospital Anywhere

    25-11-2017 CT Head Lauren Martin (12-1-1980) Lovely District General Hospital 20-11-2017 Chest XR Lauren Martin (12-1-1980) University College Hospital Anywhere 10-01-2013 Rt Knee Lauren Martin (12-1-1980) Lovely District General Hospital 09-05-2010 Rt Knee Lauren Martin (12-1-1980) Supersonic Imaging Centre Smart timelines with pull logic
  20. 29-11-2017 CT Brain Lauren Martin (12-1-1980) University College Hospital Anywhere

    25-11-2017 CT Head Lauren Martin (12-1-1980) Lovely District General Hospital 20-11-2017 Chest XR Lauren Martin (12-1-1980) University College Hospital Anywhere 10-01-2013 Rt Knee Lauren Martin (12-1-1980) Lovely District General Hospital 09-05-2010 Rt Knee Lauren Martin (12-1-1980) Supersonic Imaging Centre Report awareness and availability
  21. 29-11-2017 CT Brain Lauren Martin (12-1-1980) University College Hospital Anywhere

    25-11-2017 CT Head Lauren Martin (12-1-1980) Lovely District General Hospital 20-11-2017 Chest XR Lauren Martin (12-1-1980) University College Hospital Anywhere 10-01-2013 Rt Knee Lauren Martin (12-1-1980) Lovely District General Hospital 09-05-2010 Rt Knee Lauren Martin (12-1-1980) Supersonic Imaging Centre The ultimate imaging timeline
  22. Choosing the right tech partner Details…

  23. Choosing the right tech partner Details… User interface…

  24. Choosing the right tech partner Details… User interface… Agile…

  25. Choosing the right tech partner Details… User interface… Agile… Resourced...

  26. yorkshireimaging.org @yorks_imaging

  27. Transformation Common Practises Shared Core Services Processes & Workflows Expertise

    sharing Load balancing Technology PACS Mesh network Imaging Awareness Remote Access RADIOLOGY FUTURE Communication & Engagement Strategy
  28. Communicate & Engage @yorks_imaging yorkshireimaging.org forum.yorkshireimaging.org Mailchimp - mailing lists

    Digitally
  29. Communicate & Engage Personally Transformation Workshops Common Practises Process &

    Workforce Provider model Shared Core Services Trust Personal Visits Same presentation Recorded for replay online Plenty of time for Q&A Meet clinical lead, service manager, IT Executive Meetings Keep sponsors in the loop Attract funding opportunities “Stay high on the buffer” Vendors Visit their HQ, make friends with their execs Often kind with resources Often neglected
  30. Working with “Execs” They love a dashboard!

  31. Technical Programme Harrogate Leeds Calderdale & Huddersfield Bradford North Lincs

    & Goole Hull & East Yorks Airedale Mid Yorkshire Transformation Programme Common Practises Process & Workforce Provider model Shared Core Services Communication & Engagement Project Dashboard FEBRUARY 2018 POSITION MIGRATING
  32. HOW TO TRANSFORM A REGIONAL RADIOLOGY SERVICE

  33. Identify your common practices

  34. Identify your common practices Common Scanning Protocols Services already networked

    (cancer, trauma) Minimum data set (not megalomania) Share online for easy access (value for more) Patient Documents Achieve better quality (legal, readable, universal) Deburden service managers Reduce medicolegal costs Safety Practices Contrast & reaction protocols Regionalised priority coding (urgent, routine etc) Regionalised dose management standards Staff training - short & long term PACS training for mass scale (online / in person) Point of reference training material (online) Regionalised dose management standards
  35. Share core services

  36. Share core services Central Patient Index Prepares region for National

    Image Sharing Fast searching - slower retrieval Centralised Data Lifecycles Data Lifecyle Management Policies (RCR, agreed local data policy) Scripts (auto cleansing of duplicates) Single master data origin Workforce Administration Accounts / Permissions Allows cross site work rules (ownership?) Identity management (who, where, when) Physical Work Hub Cross site staffed on-call hub Venue for training / CPD / specialist groups Cross site PACS team
  37. Processes & Workforce

  38. Modern distributable workforce

  39. Workforce Recruitment & Retention Work for Yorkshire not for your

    hospital Stay as a specialist even in remote DGH Attract young workforce (tech & culture) The Radiologist Crisis Networked experts (neuro, IR, trauma) Load balancing of work (reduced stress) Mobility of staff Universal skills across Collaborative (mobile) Potential for insourced locums (cost saving) Greatly reduced training burden (Vision req) Boring stuff... Practice Rights (24 hospitals!) Getting paid (8 Trusts…) Cross site billing (intranetwork money flow) Remote working Big Data / AI assistance (scale required)
  40. Processes Financial Agreed rates for cross site scan/report Process for

    allocation of funds Process to pay remote workforce New Care Pathways So many involved parties... Redesign time precious networked services Worklist Reinvented Open Mind: Regional vs Parochial Ability to call for help (insource in network) Payrolls & tax (HMRC: what you have 8 jobs?) Reduce reliance on individuals (designation) Task based not personal (regional vs parochial)
  41. Reinvent your provider model Specialist imaging closer to home Faster

    access Consistent quality Every image, anywhere
  42. Consider forming an imaging Trust

  43. WHO SHARES WINS: BUT HOW? HOSPITALS PATIENTS Expert sharing Load

    balancing Networked health journeys Out of hours service Procurement costs (early saving) Staff mobility Wide area insourcing Images and reports at point of care Efficiency of pathways Long term cost efficiencies Staff training / CPD Electronic patient record enabler Better diagnostics Wider availability No postcode lottery Shared infrastructure Shared staff
  44. Dr Daniel Fascia @danfascia Thanks for listening.