The staff of Rostock University Medical Center (UMR) have had to wait a long time, more than seven years, for their new PACS to be accurate. In the fall of 2021, the JiveX Enterprise PACS of VISUS was finally introduced, replacing the previous system first of all in Radiology. By year's end, the complete clinic will be connected. Has the wait been worth it? A visit to Radiology and the IT Department yielded answers.
"That it took so long at all until JiveX was able to go live was not really due to the implementation project of the PACS solution," were the reassuring words right away of Thomas Dehne, IT Head of Rostock University Medical Center. To the contrary, the delay was due to a mixture of request denials, new requests, expert opinions and releases of funds: "Once the concept and financing were approved, things went very quickly and the bidding and award process was ended in favor of VISUS within only six months or so. The project started in early 2021 and reached kickoff in September."
A PACS for all and a high degree of interoperability
The list of requirements concerning the new PACS was extensive. What was essential for Thomas Dehne was above all the issues of data standards and IHE capability as well as the implementability of a platform strategy. "We consciously opted for two archive components on one platform: A traditional document archive of another provider, which deals with the typical administrative tasks such as invoice review and central patient records, and the PACS of VISUS as the image archive. The two systems have to be completely integrated with one another, so that smooth, bidirectional data exchange is possible. We also apply this principle with other systems. To achieve this goal and to be able to access data independently of the software, the use of standards for the PACS was a central concern." With the introduction of JiveX, Rostock University Medical Center has practiced a classical best-of-breed approach, consisting of a set of special systems, which operate and share a common data platform via standard interfaces.
Beyond this, the new PACS is used clinic-wide. In other words, all imaging systems are integrated regardless of the discipline. They include not only the functional departments such as Cardiology or Endoscopy but also research units such as Experimental Surgery. The JiveX Enterprise PACS was one of the first software solutions that supported such clinic-wide use. The concept and the functionality have become correspondingly mature with a view to connection and integration of all imaging systems.
Building stable networks
"As a university clinical center, we have networked intensively in the surrounding region with other medical facilities such as hospitals or physicians' practices – and we also hope to support and optimize this networking with the PACS," added the IT Head as further important tasks of JiveX. In this context, Mecklenburg-Vorpommern Teleradiology Network, known as TeleRad M-V for short, to which Rostock University Medical Center belongs, is comparable in its function to the West German Teleradiology Association, the technical basis of which is JiveX. To this extent, the PACS from Bochum was also technologically best prepared for this task:
"The connection of TeleRad M-V and other partner clinics to our JiveX teleradiology server was simple and we were quickly able to ensure that the surrounding hospitals can send us their DICOM studies. Even the upload portal of VISUS, which permits experts and treated persons to prepare images quickly and without complication for the UMR, is still being intensively used."
Head of IT at Rostock University Medical Center
The connection of medical care centers is not proceeding quite so smoothly: "Here we are encountering entirely different software architectures and, for example, we first have to check whether the medical information system used to date are still suitable. Our goal or introducing JiveX in the radiological MVZ practices of the UMR, is quite clear, however, because the medical personnel there also work for the most part here in the clinic and in the best case should do so in an accustomed and uniform environment."
The radiologist Dr. Thomas Beyer also finds the good networking to be very positive, especially the involvement of referring physicians: "Meanwhile, many practices are using JiveX Upload to make the images available to us, for example for tumor conferences. This is truly practical, since in this way we can free ourselves from sending images via physical data media and also have information such as letters of findings provided to us via the upload portal. This minimizes transmission channels and saves everyone involved valuable time."
But not only are external facilities networked via the JiveX Enterprise PACS, so also is the Radiology Department itself, which is represented at several sites throughout the municipal district. And, finally, the radiologists also have the opportunity to access the images from home while on standby duty.
Facilitation in conference preparation
For Dr. Thomas Beyer and his medical colleagues, it is not only the good networking but also the excellent functionality that in particular plays the decisive role: "The PACS has decisive significance in our everyday activities. Any change in mode of operation is initially also a change of our daily routine and a transition. This is why changes are not unconditionally popular in themselves. However, when an additional benefit is realized and the operating comfort increases, then the acceptance for a new PACS also increases rapidly. This is also what happened with JiveX."
JiveX offers a special extra benefit among others with the Capture Function, which is the capability of saving a finding status including the hanging of image sequences or added annotations. This facilitates not only the supervision of physicians in further education by senior staff but in particular also the preparation for tumor conferences, for example. These can now be prepared in great detail at any workstation whatsoever. Given the large number of conferences that the radiologists of the university medical center attend, capturing represents a real workload reduction. "In principle, it would also be a great help if demo lists could also be filled out automatically in this connection. However, this procedure has not proved to be feasible during the introductory phase, because simply no adequately foreseeable regularity exists. At present we are filling out the demo lists manually, but then, during the discussion, only the relevant cases are available," explained the radiologist.
"Ultimately we need a total package, which supports our everyday activities, is simple to operate and is highly available. JiveX meets these criteria optimally, and so we are very satisfied with the system."
Dr. Thomas Beyer
Radiologist of the University Medical Center Rostock
And also Thomas Dehne, the IT Head, is very satisfied with the entire course of the project and likewise with the implementation of the software itself. In short: For the Rostock people, the wait for the PACS has been worth it from all aspects.