Yorkshire Imaging Collaborative: an organization-wide Enterprise Imaging journey

An organization-wide Enterprise Imaging journey

Dr Daniel Fascia is the Clinical Lead for the Yorkshire Imaging Collaborative (YIC) project, an eight-site group of NHS hospitals whose ambition was to ensure that every patient in Yorkshire could attend an appointment and have full availability of their medical images and associated reports at the point of care.

The YIC went out to tender in 2017, and after a competitive process, final contracts were signed with AGFA HealthCare to implement its Enterprise Imaging (EI) solution and XERO® Universal Viewer, collectively known as the XERO® Exchange Network (XEN). In 2020, the YIC began to connect the XERO® viewer at each site to form the XEN across the Trusts. The network was live within 4 weeks, and enabled the connected hospitals, which collectively cover a patient population of over 3 million, to diagnose patients who are transferred between sites much more quickly than was previously possible.

What was the biggest hurdle in implementing a multi-site project of this size?

The biggest hurdle is less to do with technology, and more to do with the difficulties of transformation: getting Trust teams philosophically on board. During the earlier stages, many of the team agreed that the collaborative approach was a great idea; however, when it came to deploying the very concept we had discussed, there was resistance from the same group. This emphasises that any change, positive or negative, is disruptive for human beings. Change needs careful nurturing, and as a Collaborative, we needed to manage this diligently.

How did you mitigate these challenges?

The Collaborative adopted a specific approach to support a gentle transformation: a franchise model. This entailed lots of meetings, brainstorming, inviting opinions and reviewing how a change could be implemented. The project board would convene, discuss, and finish the meeting by concluding what had been decided. This way, decisions and associated actions are not a surprise, as each franchise holder contributed to the conclusion.

Generally, when you explain the concept to project stakeholders, give them the background of why a change is needed, and help them understand how it will improve patient care, improve data accuracy, and speed up work and meetings, they tend to come on board. This is because they understand how it matters, and why it is important to them, the Trust, and our patients.

What are the clinical benefits of a united radiology imaging and report-sharing solution?

The Collaborative had the XERO® Exchange Network deployed within the Enterprise Imaging platform. The solution provided an index of all medical imaging for the region, along with the relevant reports, so that healthcare professionals could search by the patient’s NHS number, find their record and view current and prior images across other sites, essentially having the full imaging record available.

Reviewing this wider scope of information is an essential part of writing a good radiological report: it reduces administrative questions, enables concise comparisons and allows more certainty. This helps us achieve a gold standard of care.

In addition, as clinicians started to work more remotely due to the pandemic, this exchange of information was a huge benefit. The interruptions of COVID-19 also meant that we had to ask patients to be scanned in hospitals other than the usual ones, and yet we still had to review the results. XEN supported this change in working. We experienced an adoption curve, combined with the general disruption of clinical tasks during COVID-19, but the group soon recognized the key feature of seeing images from everywhere and understood that it was a big game changer.

How did these clinical benefits translate into benefits for patients?

The ability to receive remote care. For example, a patient can receive a scan in one of the peripheral hospitals, and yet their clinician at Leeds Teaching Hospital can review it as simply as if the study had been performed in Leeds. This flexibility was paramount for patients, especially during the pandemic, when travel was compromised and larger hospitals were already under significant strain managing surges in admissions and wanting to reduce the number of visitors on site.

What is your overall experience of Enterprise Imaging within a Collaborative project?

Enterprise Imaging has been a very successful PACS replacement across our imaging departments. It is a very modern piece of software with a greater emphasis on workflow and built-in image viewing capabilities. The YIC found it to be an incredible productivity upgrade.

As a Collaborative, the XERO® Exchange Network allows Yorkshire NHS Trusts to collectively access radiology reports and view all images across our entire region, completing the clinical history and helping us write a more accurate report. As a radiologist, EI helps achieve that gold standard and makes a difference, to us and to patients, on a daily basis.

The Project Board wanted one key outcome for the Collaborative: that every patient’s full set of images, and the associated reports, would be available at the point of care. XEN allowed us to do that.