CHU Brugmann: a hospital-wide Enterprise Imaging and VNA platform

Less noise, more flow: making medical imaging future-ready

A single platform combining Enterprise Imaging and a VNA brings images, disciplines and people together. The result: greater efficiency, transparency and confidence at every step of the care pathway.

In recent years, the radiology and medical imaging department of the Brugmann University Hospital Center (CHU Brugmann) in Brussels faced a serious challenge: the existing imaging infrastructure no longer met the functional and technical requirements of a modern, multidisciplinary care environment.

“We needed a flexible, user-friendly solution that would better support our workflow and facilitate interdisciplinary collaboration,” explains Prof. Mieke Cannie, Head of the Medical Imaging Department and Head of the Radiology Department.

The situation was just as problematic on the IT side: “The underlying infrastructure was obsolete. We wanted a system that not only supported radiology, but that would also enable image management at the hospital level, with a modern architecture, good performance, and strong integration with the electronic health record (EHR) and other systems,” says Bryan Miller, IT Application Manager for Medical Imaging.

Choosing Enterprise Imaging: continuity and confidence

After an in-depth evaluation, the hospital decided to continue working with AGFA HealthCare, implementing the Enterprise Imaging platform together with a vendor-neutral archive (VNA) hospital-wide. The decision was based not only on technology, but also on years of partnership with AGFA HealthCare that created a strong environment of trust.

We have worked with AGFA HealthCare since the late 1990s. We first used their radiology information system (RIS), then their PACS. So we are very familiar with their way of working, the quality of their 24/7 support, and their commitment to actively seeking solutions. Continuing our collaboration was thus an obvious choice.

For the radiologists, Enterprise Imaging also offered the ability to redesign the department around modern, streamlined workflows. “We tested the first version of Enterprise Imaging back in 2015,” explains Prof. Cannie. “The technology has evolved substantially since then. Today, the platform delivers all the functionalities we need: an integrated approach to image management, structured reporting, flexible task distribution, specific workflows for sub-specialties, efficient collaboration and remote access. In other words, a forward-looking solution that meets both our current and future needs.”

A structured and phased implementation

Knowing that a new image management environment would have a major impact on both IT and clinical workflows, the project was approached step by step, in close collaboration between the hospital’s IT department and AGFA HealthCare.

“The migration was technically complex, but our progressive approach and detailed preparation enabled us to roll it out in a structured way,” explains Bryan Miller. “We completely modernized the infrastructure, with powerful servers and storage solutions. The new architecture is more flexible, scalable and secure. We are already seeing significant improvements in speed, stability and availability.”

CHU Brugmann also focused on improving integrations with other systems, such as the EHR, RIS and external distribution platforms. “The open architecture and support for a wide range of interoperability standards enabled us to smoothly integrate third-party applications and AI solutions. Of course, we encountered challenges along the way, but AGFA HealthCare was always very responsive, closely following up on issues, providing consistent feedback, and delivering appropriate solutions,” he continues.

Within the medical imaging department, the introduction of the new environment was equally seamless. “Change is always a challenge, especially when people have worked with the same tools for a long time,” says Prof. Cannie. “But thanks to the efficient support from both AGFA HealthCare and our own IT department, the transition was remarkably smooth. The user-friendly interface is appreciated by both our younger and our more experienced radiologists.”

Clinical advantages: efficiency, collaboration and quality

The move to Enterprise Imaging has brought significant improvements to the day-to-day work of the medical imaging department:

• Fast, integrated access to recent and prior images delivers substantial added value.
• Efficient workflows and worklists enable swift retrieval of studies, with access to image processing tools, 3D reconstructions and AI support for certain types of exams.
• Much faster image retrieval significantly reduces interruptions between exams and eliminates unnecessary wait times.
• Distribution of exams within the team is optimized.
• Sectional reporting and hanging protocols provide structured reports and better support for subspecialties such as cardiology and musculoskeletal imaging.
• Configurable color codes and advanced search functions considerably speed up image analysis.
• Improved speech recognition significantly reduces the effort needed to correct reports and protocols, saving radiologists and administrative staff valuable time for other clinical and organizational tasks.
• The ability to work remotely is a substantial added value, especially during on-call shifts or for multidisciplinary collaboration.
• Multilingual capabilities are a further advantage for this hospital on the outskirts of Brussels: user settings, voice recognition, reporting and interfaces can be configured in multiple languages.
• Enterprise Imaging supports the facility’s role as a teaching hospital, giving students and residents a clear structure and easy access to educational materials.

The improvement in efficiency is clear. The distribution of tasks is more transparent, complex studies are reported more quickly and consistently, residents are supervised more systematically and with greater precision, and collaboration between different sites runs more smoothly.

Telework improves the quality and safety of care

Telework has been structurally integrated into radiology operations, with a twofold benefit. On the one hand, radiologists can, within well-defined quality and safety frameworks, carry out their reporting from home. This lets them work more flexibly, reduce commuting and focus more effectively, contributing to a better quality of life in the face of increasing workloads.

On the other hand, telework also helps improve diagnostic quality. Working in a quiet environment improves focus during on-call shifts, resulting in more accurate image reading and a reduced risk of diagnostic errors.

Remote work is not only an organizational convenience; it is a deliberate choice that supports both physician well-being and the quality and safety of patient care.

A hospital-wide VNA: images bridging disciplines

The hospital-wide VNA is one of the main advantages of the project. It gives CHU Brugmann centralized management of images from different image-producing departments, and offers clinicians a single, unified access point for all medical images, regardless of their source.

Eight departments are currently integrated in the VNA: radiology, nuclear medicine, cardiology, gastroenterology, neurology, ICU, stomatology and rheumatology. Certain subspecialties within the operating room and gynecology are partially integrated into Enterprise Imaging. Gynecology/obstetrics, urology and ophthalmology are scheduled for integration.

Immediate access to images for referring physicians and patients

Clinicians across the hospital view images in the XERO® Viewer, fully integrated into the EHR, in both clinical and diagnostic contexts. XERO® Xtend adds a comprehensive set of tools tailored to the needs of different clinical disciplines.

Images and reports are accessible to external referring physicians and patients via the health portal connected to the Abrumet regional network. The hospital also has a portal for viewing images with a personal access code.

“Referring physicians can access images and reports almost immediately,” explains Prof. Cannie. “For patients, this means shorter wait times and better communication around their exam.”

IT advantages: simplicity, control and stability

For the IT department, the Enterprise Imaging platform with VNA has considerably simplified system management. “We now work with a single, central platform,” explains Bryan Miller. “This has reduced complexity while improving reporting and monitoring capabilities. Dashboards and logging tools provide an overview of performance and usage, allowing us to intervene more quickly when necessary.”

He also appreciates:

• The user-friendly interface for managing processes
• Extensive configuration options to tailor the system precisely to specific needs
• Strict access controls and regular updates that reinforce security and data protection
• Cost savings from lifecycle rules that make data management more efficient and optimize storage capacity

The system reacts quickly and efficiently, which is critical given the complexity and scale of our environment. Downtime has become rare, and uptime is now 99.9%, which has a direct impact on the continuity of care.

Business Intelligence makes data talk

The clinical and technical benefits are complemented by Business Intelligence (BI) tools, which play a growing role in the department. AGFA HealthCare’s BI tools give the hospital an objective, real-time overview of activity, performance and workflow efficiency.

“With the BI tools, we finally have a clear and reliable view of the real activity of the department,” says Prof. Cannie. “We can track workloads, turnaround times, productivity and capacity utilization with much more precision. This is essential in a context where volumes are increasing but resources aren’t.”

The dashboard functions include:

• Analysis of the number of exams per modality and per subspecialty
• Objective monitoring of wait times and report turnaround times
• Measuring the impact of organizational choices, such as remote working or task distribution
• Early detection of activity and growth trends

For both IT and management, BI is an important decision-making tool. “The data from Enterprise Imaging ensures transparency,” explains Bryan Miller. “It helps us to identify bottlenecks, optimize performance and support investment decisions, for example in infrastructure, storage or future AI implementations.”

By bringing together clinical data, workflow information and technical parameters, BI supports both operational efficiency and strategic decision-making, enabling continuous, fact-based improvement across departments.

Next steps

In the coming years, the hospital plans to roll out additional integrations, multidisciplinary collaboration enhancements and new AI tools.

“We are already working with AI; for example, we have integrated it into Enterprise Imaging for detecting bone lesions and for diagnosing and treating strokes. This allows the radiologist to see the results side by side with the original images in Enterprise Imaging, without needing additional applications. Other third-party tools are also integrated using APIs, so the radiologist can open a single application to access all the information centralized in Enterprise Imaging,” explains Bryan Miller.

“AI enhances diagnostic quality and helps us work more efficiently, in emergency situations but also for radiology residents,” adds Prof. Cannie. “We are currently evaluating new screening applications for breast and lung cancer, and for image segmentation.”

Enterprise Imaging gives us a solid foundation for the future. The platform is fully capable of handling the constant growth in our volume of medical imaging exams. And now we can continue to develop innovative applications that directly contribute to delivering the best care to our patients.

The AGFA HealthCare solution at CHU Brugmann

• Enterprise Imaging for Radiology and Medical Imaging
• VNA
• XERO® Universal Viewer and XERO® Xtend for image processing integrated in the EHR
• Radiology Information System (RIS)
• AGFA HealthCare Scheduling for hospital-wide appointment management
• Enterprise Imaging Business Intelligence advanced edition

Benefits of the solution

For radiologists

• Increased efficiency and transparency
• Streamlined workflows with flexible task distribution
• Structured reports
• Enhanced diagnostic quality
• Better collaboration and support for multidisciplinary care
• Remote access

For IT

• A central, unified platform that simplifies management
• Extensive configuration and integration options
• Improved performance and security
• 99.9% uptime
• Greater visibility and better monitoring
• Cost optimization

For referring clinicians within the hospital

• A single, central source for viewing all medical images, regardless of their origin, integrated in the EHR

For external referring physicians and patients

• Almost immediate access to images and reports via the health portal connected to the Abrumet regional network for Brussels
• Shorter wait times for patients and better communication about their exam

Did you know?

• CHU Brugmann is a university hospital affiliated with the Université Libre de Bruxelles (ULB) and the Vrije Universiteit Brussel (VUB).
• In addition to the Horta site in Laeken, CHU Brugmann includes the Paul Brien site in Schaerbeek and the Queen Astrid Rehabilitation Unit at the Military Hospital in Neder-Over-Heembeek.
• Together with four other Brussels hospitals, CHU Brugmann is part of the Iris network, one of the largest hospital networks in Belgium.
• The hospital complex was first built between 1911 and 1923 in an 18-hectare park to a design by architect Victor Horta, in an eclectic, Art Deco-influenced style. The century-old hospital continues to adapt and innovate to meet medical and societal change.