PACS in Scotland Dr Andrew Downie Consultant Radiologist Victoria Infirmary, Glasgow

Scotland is different Devolution 1999 Abolition of NHS Trusts Run by 14 Health Boards CfH does not apply

The PACS Contract Main Contract –Kodak & NHS National Services Scotland – Nov 2005 Archive Storage –ATOS Origin Change Control Note – Dec 2005 Health Board Access Agreements –Kodak & NHS Greater Glasgow – April 2006

“A major project” –“A multi-dollar project…” –“Kodak will roll out PACS to all hospitals in Scotland over the next 25 years…” RAD Magazine announced the contract to the world:

What is included? 39 main acute hospitals 67 satellite centres 3.2 million exams annually 2 central data archives 308 dual 3mp workstations, RIS integrated Web browser access Orthopaedic templating on web

And what isn’t? The Network The RIS Ward & Clinic PCs Theatre & specialist workstations Mammography VR (separate procurement)

Who pays?

Central funding All capital elements –Workstations, hardware, training –Central archive –Software licences –Implementation charges –Software support & upgrades for 10 years –One hardware refresh in 10 years

Local funding –Hardware support charges –Capital charges –Additional catalogue items –Local PACS System Manager(s) –Project Management costs

Storage Policy 1 year on site “Store everything for ever” Until death plus 3 years Use of lossy compression after 3 years Review after 6 years Funded for baseline plus 5% growth pa

Patient ID DICOM ID = RIS ID locally DICOM ID = CHI number nationally CHI = Scottish NHS number, 10 digit “No CHI, you’re not getting in” Dirty store Kodak / RIS / PAS / SCI Store interface

Problems CHI availability SCI Store problems Multiple RIS Image & report viewing Legacy PACS

Differences: England & Scotland Based on English OBS, but No LSP Direct relationship with Kodak Clinical engagement No single RIS Integration with RIS included Spine supplied by Scottish Exec – SCI Store

RIS Procurement Varied RIS in Scotland Many new RIS for Y2K compliance No standard RIS for this project but National RIS procurement now in progress for future RIS needs

EPR Procurement Scottish Executive committed to EPR No actual progress to date

CR Procurement National contract Central funding for pre agreed needs Additional hardware at favourable prices Awarded to Fuji Installations timed to match PACS

The future is bright? April 2006 –PACS –Voice Recognition –and…