Canada Health Infoway is investing $10.4 million in a project that will connect eight southwestern Ontario hospitals to a digital imaging network that allows doctors to view X-rays and ultrasounds on a computer screen by year-end.

Tillsonburg

District Memorial Hospital (TDMH) is the first of six community hospitals to link with London’s teaching hospitals, London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London (SJHC). The other five hospitals that make up the eight Thames Valley Hospital Planning Partnership Hospitals (TVHPP) include Alexandra Hospital in Ingersoll, Four Counties Health Services in Newbury, St. Thomas-Elgin General Hospital, Strathroy-Middlesex General Hospital (which Monday started its rollout), and Woodstock General Hospital.

One of the biggest benefits of the implementation is the reduction of patient wait times for their results from days to hours, and in emergencies, minutes. Tillsonburg, for example, doesn’t have a radiologist permanently on site, which, in the film-based system, sometimes meant long turnaround times for patients.

“In the old system the patient would have had to wait until Monday afternoon for the radiologist to come back,” said Diane Beattie, chief information officer for LHSC and SJHC. “In this system, reads are done within an hour. Instead of the patient having to stay in the hospital, the patient was able to go home.”

Other benefits include increased productivity on the human resources side, said Infoway group director of investment programs management, Kurtis Bishop.

“Both the radiologists and the technologists will experience a significant gain in productivity from a digital environment,” said Bishop. “Some of that comes from reduced travel to these community hospitals and when they’re doing on call at night they can access the images from home.”

The Southwest Ontario Digital Imaging Network project, which began in Feburary 2004, is one of two pilot projects of this kind in Canada funded by Infoway. The other is with the Fraser Health Authority in B.C. Infoway’s mandate is to create a nationwide electronic health care record (EHR) by 2009.

Agreement among hospitals is one of the biggest challenges for a project of this kind, said Bishop.

“Each of these hospitals is a separate legal entity,” said Bishop. “We need agreement from the boards of directors, CEOs, directors and so on in order to proceed.”

After that, building out a network to support digital medical images is another large chunk of the project, Bishop added. At that end, TVHPP upgraded the capacity of its network at its community sites from 10 Mbps to 100 Mbps, according to John Lawson, operations manager at London, Ont.-based Largnet, which is one of several vendors involved in the project. Other vendors include Hewlett-Packard Co. and General Electric Health Care.

“The community sites didn’t have as much bandwidth as the London sites because they weren’t pushing as much information back and forth,” said Beattie.

Largnet, which was originally funded through the Ontario Network Infrastructure Program (ONIP) in 1993, works with Internet service providers (ISP) such as Bell and Rogers to provide Internet and intranet connections to companies in and around the London region. The not-for-profit organization has run a wide area network (WAN) connection to the six community hospitals connecting back to the two London hospitals for four years.

“We had to increase capacity of the WAN connection so we built a lot more resiliency into the network,” said Lawson. “We put security practices in place for encrypting traffic.”

In addition to network upgrades to support large file sizes generated by bandwidth-hungry imaging applications like PACS and RIS, Bishop said the hospitals also need a reliable data centre environment and master patient index that allows clinicians to identify all patients across each of the eight hospitals.

The digital imaging project is only one of the pieces in the TVHPP’s plan to create an electronic system. Beattie said the health-care organization is also working on lab, registration and clinical systems that it expects to complete over the next two years.

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