THE RATU PROJECT IN NORTH FINLAND

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THE RATU PROJECT IN NORTH FINLAND
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Overview Of RATU

• The RATU district covers the following
• Over 50 of the geography of Finland and 25 of
  the population (1m people)
• 700,000 examinations per annum
• One major hospital for each of the five districts
• Sixty nine health centres - not all have digital
  modalities
• Mixture of legacy local HIS / RIS
• Some local PACS
• Kodak
• Agfa

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Project Objectives

• Phase 1
• Community RIS for the 5 District hospitals plus 2
  Health Centres
• Enterprise image archive
• Central PACS Web synchronised with RIS Web
• Installation at the Oulu University Hospital Data
  Centre
• Phase 2 2006 / 2007
• Rollout to remaining Health Centres and private
  institutions
• Either procure own local PACS to use with
  Community RIS/PACS or use Community RIS/PACS only
• Phase 3 2007
• Merge with Finnish National Archive
• National EPR archive of key images and CDA
  extracts from local EPRs
• Currently going through consultation with
  potential suppliers

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Community RIS

• The workflow is completely RIS driven
• Community RIS will be the major system to provide
  and manage bookings, examinations, diagnostic
  reporting, and conferencing
• Integration with existing HIS
• Some integration with existing RIS, e.g. legacy
  RIS to manage the booking
• Community RIS synchronised with local PACS
• Community RIS Web synchronised with Community
  PACS Web
• RIS controls access through Patient Informed
  Consent
• Approx 8,000 users and 1,000 RIS Web users

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Patient Informed Consent (PIC)

• Developed and managed by Mawell under contract to
  Kodak
• Patient signs consent to images being shared with
  other hospitals
• Community RIS checks PIC database prior to
  requesting PACS to display images

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Community RIS Workflow
Existing Systems
New Kodak Systems
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Community Image Archive

• Powered by Kodaks Versatile Intelligent Patient
  archive (VIParchive)
• Initially to archive image data with expansion to
  other patient data
• Local DICOM Access Point (DAP) communicates with
  local PACS or collects images directly from
  modalities
• Northern Finland only 2 people per square
  kilometre
• Health centres with modalities for image
  generation and reporting elsewhere
• Data Centre VIParchive Manager
• Manages Finlands archiving laws via Storage
  Rules/Plans
• Linked to Community RIS for intelligent
  pre-fetching of images
• Forwards images to Community PACS Web for
  reporting / viewing

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Community PACS Web

• Provides community-wide review of images via
  desktop synchronisation with Community RIS Web
  (and PIC)
• Provides Web based diagnostic reporting via
  desktop synchronisation with Community RIS Web
  (and PIC)
• For health centres that do not have full local
  PACS and diagnostic reporting capability
• Full diagnostic toolset available over the Web

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Network in the area

• The current architecture is as shown below.
• The connection between the hospitals and center
  will be min. 100 Mb/s and the satellites will
  have 2-100 Mb/s.

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Lessons

• There needs to be a single contracting
  organisation
• A new legal entity was created
• Provides a single project organisation
• Patient informed consent essential
• This would be better as a national application
• Single patient identifier required and in use by
  all applications
• Where not available - the need to provide Data
  Centre based local archives, e.g. NHS Scotland
• Robust network connections
• Future release of PACS to provide full diagnostic
  reporting over slow lines with first image
  display within than 2 seconds
• Greater benefits if all locations running the
  Community RIS
• Same workflow not possible where we have to use
  legacy RIS for some functions

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Kiitos ! Thank You !