1. 20.4.05 David S. Grant FRCP, FRCR Consultant Radiologist Whittington Hospital NHS Trust PACS The London Picture

2. 20.4.05 Topics Brief review. The Package. Cost. Issues. N3 and intersite connections. Views from the coalface.

3. 20.4.05 NPfIT live 2003 PACS £160m Dec 2003 Autumn 2004 Quick, easy deliverable with “benefit realisation” Contracts let Nigel Crisp edict; only buy PACS from designated LSP

4. 20.4.05 Key players LSPCCA led by BT PACSPhilips RISiSOFT ( for next 2 phases at least)

5. 20.4.05 The 6 elements PURCHASING 1.Centrally funded 2.Trust Funded 3.Additional options MAINTENANCE 4.Central storage ☺ 5.Service £ 6.Maintenance / update £

6. 20.4.05 The Package 1yr on-site local store. Workstations for radiology ÷ central and local funding. Clinical w/s + software license. Web server + software. CR Discussion about digitising legacy.

7. 20.4.05 Costs Every Trust will have costings. Revenue is higher than anticipated with 24/7 cover and hardware renewal. Capital cost is also higher, but SHAs looking at freeing up capital to Trusts. 8 Emergency RIS packages

8. 20.4.05 Hidden costs Interfacing Legacy storage Legacy equipment

9. 20.4.05 Issues For NCRS IDX functionality will come later. IDX implementation of Path orders is inadequate at present; delivered later. Clinical advantage is end-loaded within the scheme and we need some clinical wins now.

10. 20.4.05 N3 Dispute whether really designed to deliver PACS. Single Trust site to central store is probably OK. Multisite / intersite connection less clear as local PACS is unclear ?? May need more money.

11. 20.4.05 Urgent clarification NCRS is in 3 phases with generally 2 releases per phase. What is the universal accession number policy for entry into the central store? ? iSOFT / legacy non iSOFT RIS. Essential as DICOM uses accession numbers.

12. 20.4.05 Interoperable -v- Interfaceable Interoperable; RIS database closely coupled to NCRS database. Interfaceable; Able to send orders and results, but scheduling independent. Care package plans need interoperability and this is at least 2 phases away. Initial P1R2 does not have order coms.

13. 20.4.05 Views from the coalface NPfIT / (CfH) still not getting good clinical advice. Indicator hospitals e.g. Hillingdon, RFH, Mayday. Cost implications have focused Trusts to look at Imaging and this offers a huge opportunity to influence service delivery.

14. 20.4.05 More views from the coalface Interface costs are high and need to be transparent. Interoperability is critically important to deliver clinical benefit and justify cost. Philips, BT & NPfIT are starting to address the issues.