HealthManagement, Volume 21 - Issue 7, 2021

Regional Radiology Collaboratives - Benefits of Intelligent Networking?

The Yorkshire Imaging Collaborative (YIC) is a combined technology and business ‏transformation project which unified radiology imaging and report-sharing ‏between 8 NHS trusts across Yorkshire, including the recently established NHS ‏Nightingale Hospital Yorkshire and the Humber. Dr Daniel Fascia has extensive ‏experience in radiology practices and technologies and has been in post as the ‏Clinical Lead for Transformation at the Yorkshire Imaging Collaborative since ‏2017.

Key Points

  • The Yorkshire Imaging Collaborative (YIC) transformation programme was designed to create a single unified radiology image and report sharing network across central Yorkshire.
  • Agfa HealthCare’s Enterprise Imaging (EI) is an imaging platform which provides Trusts with a unified PACS,complete with clinical tools, reporting functionality and a powerful workflow engine to maximise productivity.
  • Agfa HealthCare’s XERO Exchange Network (XEN), a web-based platform, is a sophisticated piece of viewing software that offers clinicians the ability to share images with other XERO users as part of a new XERO exchange network (XEN). This is particularly beneficial in support regional networks and ICSs.

Background to the Project 

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, the final contracts were signed with Agfa HealthCare to ‏implement its Enterprise Imaging (EI) solution and XERO Universal ‏Viewer, collectively known as XERO Exchange Network (XEN). In ‏2020, the YIC began to connect the XERO Image 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 ‏at a much quicker rate 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 the transformation - getting Trust ‏teams philosophically on board. 

During the earlier stages, many of the team agreed that the ‏collaborative approach is a great idea, however when it comes ‏to deploying the very concept we’ve discussed, there is resistance ‏from the same group. 

This emphasises that any source of change - positive or ‏negative - is disruptive for human beings. Change needs ‏nurturing carefully, and as a Collaborative, we needed to be ‏sure 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 ‏converge, discuss, and finish the meeting by concluding what ‏we have decided. This way, any decisions and associated ‏actions will not be a surprise, as each franchise holder had a ‏contribution to the conclusion.

Generally, when you explain the concept to the project stakeholders, ‏provide them a background of why a change is needed, ‏and help them to understand how it will improve patient care, ‏improve data accuracy, speed up working and running of meetings, ‏they seem to be on board. This is because they gain an ‏understanding of how it matters, and why it is important to ‏them, the Trust, and our patients. 

‏The Collaborative had the XERO Exchange Network (XEN) ‏deployed within the Enterprise Imaging platform. Can ‏you give an overview of the clinical benefits of a united ‏radiology imaging and report-sharing solution?

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 point of care. XEN allowed ‏us to do that. 

‏The solution provided us with 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 ‏were having to ask patients to be scanned in other hospitals ‏- other than what was routine, and yet we still had to ‏review the results. XEN supported this change in working. 

We experienced an adoption curve, which was combined with ‏the general disturbance of clinical tasks during COVID-19, but ‏the group soon realised the key feature of seeing images from ‏everywhere and understood that it was a big game changer. ‏


How did these clinical realisations equate to benefit to ‏the patient?

The ability to receive remote care. As an example, a patient ‏can receive a scan in one of the peripheral hospitals, and yet ‏his/her clinician at Leeds Teaching Hospital can still review it ‏as simply as if the study was performed in Leeds. 

This flexibility for the patient was paramount, especially ‏during the pandemic when travelling was compromised and ‏larger hospitals were already under significant strain with ‏managing the surges in admissions and wanting to reduce ‏the number of visitors to site. 

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

Enterprise Imaging has been a very successful PACs replacement ‏across our Imaging departments. It’s a very modern ‏piece of software which has a higher emphasis on workflow ‏and built-in image viewing capabilities. The YIC found it to be ‏an incredible productivity upgrade. 

As a Collaborative, 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 to write a ‏more accurate report. As a radiologist, EI helps achieve ‏that gold standard and is what makes a difference, to ‏us and patients, on a daily basis. 

Disclosure of conflict of interest: Point-of-View articles are the sole opinion of the author(s) and they are part of the Corporate Engagement or Educational Community Programme.

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Point-of-View Regional Radiology Collaboratives - Benefits of Intelligent Networking?

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