NHS diagnostics of the future: integrated imaging across regions

As the NHS transforms to deliver digitally mature and sustainable models of care across entire regions, every diagnostic speciality across the country has a role to play.

Sectra is working with NHS pioneers to ensure the ‘ologies’ are not left behind; and to embrace one of the biggest opportunities ever encountered to genuinely integrate diagnostics with the rest of medicine, with new and emerging fields like artificial intelligence, and across organisational boundaries.

We have an opportunity to elevate the intelligence from diagnostic silos to the enterprise level, enable more efficient collaboration between care teams across the patient pathway and facilitate shared use of resources – including finite specialist skills that are in high demand.

What does integrated diagnostics mean for me?

We are witnessing an unprecedented growth in digital imaging generated across departments. We must be sure that information is not locked away in silos. Integrating diagnostics means we can create a more complete picture of the patient across their entire journey.

Integrated diagnostics is: 

  • Enabling closer working between radiology, pathology, other diagnostics and the rest of medicine.
  • Not a takeover bid – there is no need to lose departmental system functionality.
  • Taking information out of silos to support cross enterprise working.
  • A valuable opportunity to support regional working ambitions and sustainability footprints.
  • A means to make the most of scarce expertise beyond organisational boundaries.

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This is about empowering staff with new but relevant imaging and information, allowing them to make better informed decisions based on complete information.

We are providing pathologists, radiologists, and other healthcare professionals with:

  • The means to look at patients in new ways – to make informed decisions and create informed reports.
  • The means to access information at the point of care, or to access clinical context in the reporting stage.
  • Easier ways to collaborate with colleagues within a department, across a hospital, or across a region.
  • Advanced benefits, without compromising on departmental functionality and image interrogation tools.

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Imaging has long been the domain of radiology. But it now offers much more, providing organisational champions like the chief information officer, and chief clinical information officer, with new resource.

CIOs and CCIOs can be empowered through:

  • Access to richer sources of information for relevant professionals across the hospital to aid in better clinical decision making.
  • The opportunity to transform imaging from a data silo to a point of clinical relevance.
  • The opportunity to align diagnostics with advancements like machine learning, and to enrich other investments such as the EPR.
  • Leadership opportunities within the diagnostic environment, so that new systems are procured in line with wider enterprise and regional ambitions.

Streamlining the patient journey must become more than a buzz word. By joining up information across diagnostics we can allow hospitals to:

  • Put an end to unnecessary repeat examinations.
  • Create a patient centred workflow – enabling co-ordination of lists so that multiple scans or samples can be taken during a single visit to hospital, rather than multiple trips.
  • Arrive at better outcomes – through more informed decisions on the right treatment, based on a more complete understanding of the patient.

A much bigger role for diagnostics in the NHS 

Regionalised health and care will become commonplace with the implementation of sustainability and transformation partnerships (STPs), whilst concurrently, global digital exemplars (GDEs) will enhance NHS digital maturity. In parallel, we have an unprecedented chance to break down silos for diagnostic disciplines, whilst retaining specialist departmental services.

The role of the hospital picture archiving and communication system (PACS), electronic patient record (EPR) and vendor neutral archive (VNA) is changing to support enterprise wide digitisation ambitions and regionalised ways of working:

  • A modern PACS must serve more than radiology. Every hospital diagnostic discipline, from radiology to pathology, dermatology, breast, and more, must be enabled to work more closely with each other and with the rest of medicine by fully harnessing information and imaging captured.
  • This does not require the erosion of diagnostic discipline identities.
  • Integrating diagnostics is an opportunity to share information to better inform reports.
  • Multi-directional information flows between ologies, the rest of medicine and linking back to the EPR can improve diagnoses and alert frontline clinical staff to important information.
  • The role of the VNA is moving from a necessary storage archive for radiology, to an intelligence goldmine harnessing the data captured by all ologies for decisions at the point of care, richer reporting and machine learning.
  • We can now start to create regional diagnostic hubs, that allow digital imaging to flow where it is needed to make the best use of scarce resources, and to follow the individual, so that timely and better decisions can be made for and with patients. Economies of scale can be exploited to maximum gain – enabling better use of specialist resources and skills.

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Breaking information out of silos has implications beyond informing immediate clinical decisions. There are significant implications for artificial intelligence and machine learning.

In radiology alone, millions of X-rays, CT scans, MRIs and a plethora of other diagnostic imaging have been stored digitally for many years, for the most part sitting in departmental archives undisturbed.

Teaching computers to analyse this imaging, could unleash one of the NHS’ biggest un-tapped resources.

  • Rich datasets from all diagnostic departments may very soon be accessible from single points of storage like the VNA. This will become a central component of the NHS enterprise, where data can be re-processed and re-analysed continuously to add clinical decision support for precision and personalised medicine based on population comparisons.
  • Machines can be more than a powerful decision support system, they could be programmed to proactively suggest patients suspected of having conditions.
  • Artificial intelligence technologies can search through imaging in advance of reports being carried out and flag to healthcare professionals patients who appear to be at risk.

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We have an opportunity to think big. Enterprise and regionally integrated diagnostics are fast becoming essential. But the NHS could even think about national economies of scale when it comes to diagnostic technology infrastructure.

Cloud technology, and private cloud in particular, has the potential to speed up the time in which all parts of the health service benefit from the latest innovation and software updates, to enable the collaboration demanded by evolving models of care, and to use the ‘N’ in the NHS to greatest effect, whilst still allowing specialist functionality demanded by the frontline.

  • There are opportunities for national economies of scale without reverting to the National Programme for IT.
  • Northern Ireland has already exploited cloud to deliver one of the biggest PACS deployments in the world, covering the entirety of Northern Ireland, so that healthcare professionals across different disciplines can access a patient’s radiology record from almost any location.
  • Large scale cloud deployment has already been seen in England where more than 400 NHS sites are using the Sectra Image Exchange Portal.
  • NHS organisations can no longer afford to work from IT systems that are years out of date. We can do more than leapfrog digital maturity; and we can enhance cyber resilience.
  • Security, often cited as a point of concern in cloud adoption, has the potential to be significantly enhanced, particularly at a time when skilled IT resources are in high competition.

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