Diagnostic Imaging Repositories: Provincial strategy begins with regional successes

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Many jurisdictions are migrating from film and paper-based diagnostic images such as hospital-based CT scans, ultrasounds, MRIs, mammograms and x-rays, to digital formats. The rationale – digital images are more easily shared among health care providers enabling clinicians to make more informed treatment decisions for their patients.

Ontario’s hospitals have completed this migration and a provincial strategy has been developed by to deliver and reports to all authorized health care providers across the province in support of a longitudinal health record. This will allow health care providers to seamlessly and securely access images and reports acquired from anywhere in the province, 24/7. Perhaps most importantly, real-time clinical collaboration will be enabled to provide the best possible patient care.

Implementing a strategy for a province the size of Ontario, with its large and diverse population, required a regional approach to accommodate the complex and disparate medical systems already in use across the health care system.

The province was broken down into four segments. Each segment, or region, developed its own diagnostic imaging repository (DI-r) implementation strategy and schedule based on individual institutional readiness. The four DI-r projects are: the Southwest Ontario Diagnostic Imaging Network (SWODIN) which currently has 61 of 67 hospital sites connected to its repository; the Hospital Diagnostic Imaging Repository Services (HDIRS) is now complete having connected all 37 hospital sites to its repository; the Northern and Eastern Ontario Diagnostic Imaging Network (NEODIN) which has 57 of 66 hospital sites connected to the repository; and the Greater Toronto Area West Diagnostic Imaging Repository (GTA West DI-r) which is nearing initial implementation.

Referring to the SWODIN DI-r and the progress so far, Dr. Richard Rankin, Interventional Radiologist, London Health Sciences Centre (LHSC) says, “With online access to prior reports and images, I can produce the highest quality radiology report.  You can access your patients’ digital imaging records from wherever you are and wherever these images were produced in one longitudinal patient report.”

Currently, HDIRS is complete and SWODIN and NEODIN are on track to finish their final hospital connections by this spring. The GTA West DI-r, which is the largest project in Ontario, serving 10,000 medical professionals and 1.5 million patients is underway with expected completion the following year.

While the regional implementations continue, eHealth Ontario is developing the DI Common Service, an initiative that supports the sharing and viewing of images and reports across Ontario, not just within the originating region, to hospital and community-based providers. This integration initiative will allow each of the four DI-rs to exchange diagnostic images and reports.

“This investment in technology means that our clinicians are better armed with the information they need to make more informed treatment decisions for their patients,” says  Dr. Bob Bell, President and CEO, University Health Network. “The diagnostic imaging repositories provide the critical infrastructure required to reduce unnecessary patient transfers, as well as duplication of tests. The repositories will also assist in reducing wait times and may reduce a patient’s exposure to radiation.”

eHealth Ontario’s DI program is part of the agency’s overall strategy to improve safety and access to personal health information and ultimately patient care. By putting in place a stable and standards-based technical infrastructure, it guarantees that health care providers have access to vital clinical activity information systems when they need it. It also provides support to multi-disciplinary team settings, making their discussions richer and more informed since specialists have easy and timely access to all imaging studies.

eHealth Ontario coordinates the four DI-r projects covering all hospitals in Ontario and provides funding support to the ONE® Network which gives providers confidential access to the system.

The implementation of DI-rs across the province is a major collaborative effort among a vast array of health care stakeholders. Local Health Integration Networks (LHINs), hospitals, vendors, not-for-profit companies and eHealth Ontario’s project team have been working together toward this shared goal of accelerating the implementation and integration of health information systems.

“This is a perfect example of how collaboration within the health care system is changing the way patients receive care,” said Greg Reed, President and CEO, eHealth Ontario. “The value these repositories are providing clinicians and patients is incredible and, in some cases, life saving.”

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