Nova Scotia nears end of province-wide PACS rollout

Nova Scotia is on the last leg of a marathon data management project which will see the province fully switch over to digital imaging.

The $25-million project is designed to move medical imaging like X-rays, CTs and MRIs away from film and towards digital, allowing for faster processing, easier storage and the ability to share data between various health-care institutions.

The system, dubbed PACS (picture archive and communications system), began to roll out across the province a year ago. A total of 42 hospitals and facilities are participating. Only six remain and will be added in the next few months, said Dieter Pagani, director of IT for the Nova Scotia Department of Health.

Agfa Inc. is supplying the equipment to make the transition from analogue to digital possible.

“All the images, whether they’re from that system or CT, ultrasound, MRI and so on, are captured by our systems,” said Michael Green, vice-president of health care for Agfa. “We supply the software and hardware that display these images on very high resolution monitors that radiologists can use to do their diagnoses instead of using film.”

The images are then stored using EMC technology and are made available between hospitals on a province-wide network hosted by Aliant. The information is permanently archived simultaneously at two data centres, one acting as a backup for the other.

It takes about five months for each hospital to move from film radiography to digital imaging, said Pagani.

“We allow three months for planning, one month for actual implementation, including putting the equipment in, making sure the network works, making the connections and training people, then one-month for follow-up.”

The province is responsible for implementation and training, said Pagani, but one hospital may pitch in and help another to make future implementations go smoothly.

The department of health is also helping other regions across the country accomplish their own PACS rollouts and recently hosted a delegation from East Toronto. Where Nova Scotia was able to tackle the rollout on a province-wide basis, Ontario is taking a more segmented approach. Hamilton Health Sciences, for example, completed its own PACS project last year.

The advantage of digital is that the images can be produced much more quickly than film, said Green, which helps to cut down on patient wait-times. By sharing a network, it’s also much easier for individual hospitals to collaborate. There’s less chance an image may be lost in transit, which would ordinarily result in a patient having to return to hospital for a do-over.

Newer imaging processes are more involved, added Green, resulting in complexities that would have put a strain on traditional film development processes.

“Some of the new CT scanners, called multi-slice CTs, produce thousands of images for one patient’s study. To print all these out in film . . . is very difficult to do. The PACS system allows the review of these images in a very quick method,” he said.

The province is at a point where’s it comfortable with the technology, said Pagani, and confident it’s working as-advertised. All of the Atlantic provinces are working on their own PACS projects, he said. New Brunswick is building a structure similar to Nova Scotia’s, Newfoundland is about a year behind NS and PEI’s rollout is almost finished.

In the future, the Nova Scotia PACS network may be pressed into service for other medical data. Pagani said cardiac care and ophthalmology are under consideration.

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