1. Picture Archiving and Communications System (PACS) London NHS CFH PACS Programme Tony Newman-Sanders.

2. Picture Archiving and Communications System (PACS) April Fools Day Deployment completed Many ongoing challenges Time for reflection Lessons learned –PACS in other clusters –Rest of CFH programme in London

3. Picture Archiving and Communications System (PACS) Overview OBS Tender and Contract Design Build Test Planning –Change Management –Benefits baselining –Safety Deployment –Clinical Engagement –Do once and Share –Documentation –Early adopters –The Final Countdown Lessons Learnt –Benefits realisation Next Steps –Datasharing –Security Releases –Spine, other ‘ologies’ etc

4. Picture Archiving and Communications System (PACS) In fact OBS Tender and Contract Design Build Test Planning –Change Management –Benefits baselining –Safety Deployment –Clinical Engagement –Do once and Share –Early adopters –The Final Countdown Lessons Learnt –Benefits realisation Next Steps –Datasharing –Security Releases –Spine, other ‘ologies’ etc

5. Picture Archiving and Communications System (PACS) Clinical Engagement CRG plus URG =ERG Participation inversely proportional to distance from EBT. London small yet large. Variety of institutions. Mix of Home and Away. Workshops. Engagement events.

6. Picture Archiving and Communications System (PACS) Clinical Engagement Single point of contact Struggled with communication structure –outbound and inbound –National/Cluster –CFH/LSP/NCA –Within Trusts ? NLOP ?NHS London Clinical Engagement universally valued –Honest broker.

7. Picture Archiving and Communications System (PACS) Do once and Share Model deployment plan. Hit squads Website Clinical engagement events Tracking database RFC/CCN Gold build upgrade path

8. Picture Archiving and Communications System (PACS) Early adopters vs Final countdown EAs settled and largely happy. –Many lessons learned quickly overtaken by developments –Often disproportionately well endowed FCs stressed, resentful of deadlines –Considerable bargaining power –Latest versions of PACS/RIS

9. Picture Archiving and Communications System (PACS) Benefits Workflow and Change Management DD/VR Templating etc. Interfaces with Ordercomms/EPR Webbrowser utility –Design –Large data sets Image sharing eg Out of Hours. Overall satisfaction with COTS deployment.

10. Picture Archiving and Communications System (PACS) Benefits Significant number of unresolved issues –‘Work off’ Management. Safety –IRMER –Merge and multiple MRNs –MPR, CDs Acute sense of importance of success of next Steps

11. Picture Archiving and Communications System (PACS) Next Steps Data sharing; MIA –Technical requirements Grid technology XDS and XDSi –Clinical requirements Intercluster workshops –Contractual and IG issues Dirty grid NUPI

12. Picture Archiving and Communications System (PACS) Conclusion Clinical Leadership valued –Risk becoming a resource. PACS is an intrinsically worthwhile product –Exposes weak points in other parts of the digital world. Robust mechanism for sharing lessons learnt and best practice –Microsoft ? FAQs. Database management. The real challenge is just beginning.