This will happen at the end of July 2020, a good six months after the start of the project: The radiological image data of Dutch citizens will then no longer be transported throughout the country via DVD or another storage medium but instead can be sent via a central, digital infrastructure. DVDexit is the name of the project which will link the 75 Dutch hospitals with each other in the future. It is a first step on the path to link all 75 Dutch hospitals with each other this year and thus promote the digital exchange of data. The final objective is Twiin, a nationally accessible “timeline” in which all radiological data of every patient can be viewed by every authorized physician in the Netherlands.
The Netherlands creates a national radiology network
But back to DVDexit. The desire to easily and securely exchange radiological image data can be traced back to the initiative of the Radiological Society of the Netherlands: “Back in 2017, we in the association drafted a document in which we call for the elimination of DVDs and CDs and at the same time outline how we envisage a central, national platform for the exchange of radiological image data and reports. A central challenge was the fact that the exchange of data must function independently of the respective system which a physician works with. Whether or not the leading system is a PACS or a HIS and no matter who the manufacturer of the system is, it should be possible to make radiological information available nationwide,” explains Mark Kruit, radiologist and neuroradiologist at the University Medical Center in Leiden and member of the Twiin Advisory Board.
The preferred solution of everyone involved was ultimately Twiin: a national, central registry of all radiological images and reports which the attending physicians can easily view via their workplace.
"This is a so-called pull solution: all data is automatically – of course with the patient’s consent – entered, the attending physician sees the information chronologically in the form of a timeline and can view the desired images and reports simply by clicking,”
Radiologist and Neuroradiologist at the University Medical Center in Leiden and member of the Twiin Advisory Boards
To bridge the time period until the final implementation of this pull solution, a push solution was initiated with DVDexit as an interim step to be rapidly implemented. This means that (previous) radiological images must be actively (digitally) sent to an attending physician at another hospital so that the images and reports can be viewed there.
Simple, central and secure: JiveX networks the Netherlands
Technologically speaking, DVDexit has similarities to the infrastructure of the Westdeutschen Teleradiologieverbunds (West German Teleradiology Association) and to the DICOM email network which Alphatron already established two years ago with JiveX in 18 Dutch hospitals. And just as for both of these projects, VISUS is also providing the technology for DVDexit for the exchange of image data which is secure and easy for users. Alphatron Medical, who has been a partner of VISUS for many years, is responsible for the implementation and service of JiveX in the Netherlands. Patrick Zondag, Business Unit Manager at Alphatron, explains: “There are two scenarios for the exchange of image data: either directly sending and receiving radiological image data via a DICOM email gateway, or – if such an infrastructure is not available in an institution – via the JiveX Connect Portal, which provides a web-based upload/download portal. The use of JiveX Connect has the advantage that, perspectively, patients can also be included in the image data communication.”
The persons in charge planned on a good six months for the implementation of this central infrastructure in all 75 hospitals – and it does not appear that the timetable will be a problem. How can such a large project be successfully implemented in such a short time? “The secret lies in a general consensus of all parties on the importance of a central solution and the fact that, with the national Dutch insurance association, we have a sponsor for the project,” explains Hans Mekenkamp, DVDexit project director. And of course also in the good preparation and the proper choice of a technology partner. Martin Klingelberg, responsible at VISUS in Bochum for sales in the DACH (Germany, Austria and Switzerland) region and the Netherlands, is impressed by the speed of the implementation: “DVDexit convincingly shows that major national IT projects can also be carried out quickly and purposefully when everyone involved pulls together and the parties in charge remain focused on the solution. We are pleased that we will be a part of this smart initiative now and in the future.”
Good choice: JiveX was impressive during the selection process
The rapid implementation of the project was an important precondition for the choice of a partner. Additional requirements included easy handling which was verified in a user test group, as well as proof of Dutch and international projects which suggested that a national project of this size could be managed. Of the approximately eight companies who participated in the tender procedure, three notable health IT manufacturers ultimately remained and of them, Alphatron with JiveX from VISUS offered the most impressive overall package in terms of quality and usability.
In order for the implementation to take place smoothly, the Netherlands was divided into ten regions, with each regional manager being responsible for about seven hospitals. This ensures that delays in one institution will not have any effects on the national project.
“We are optimistic that by July 31, 2020, all hospitals will be able to digitally send and receive radiological image data. The Twiin infrastructure should, incidentally, be implemented by the end of 2020 – the question of whether and, if so, where radiological images are available will then finally be a thing of the past"
Project Manager DVDexit
COVID-19 as an accelerator
Originally, the entire DVDexit and Twiin project was scheduled to take place over two years, from November 2019 until the end of 2021. Then came corona and COVID-19. And suddenly the national availability of radiological images and reports as well as the networking of hospitals with each other became even more urgent. This was reason enough for those in charge to cut the implementation timetable in half then and there, which was not a problem for Alphatron and VISUS – by the end of July 2020, all 75 hospitals will be connected.