The Dutch exit

  • The Dutch exit

The Dutch have left. They already stopped participating more than two years ago. And all parties involved are unanimously happy to have taken the step. Reason: Without DVDs containing imaging data, life and work in healthcare is simply easier. Especially when radiological images and findings can be sent nationwide to health facilities in Holland simply by pressing a button. This has been possible since the introduction of the national DVDExit/Twiin program, which promotes digital exchange of radiological images nationally and to which 86 hospitals and close to 30 medical care centers now belong. 

The fact that our neighbor country has actually succeeded within a reasonable period in constructing a central structure for exchange of radiological data, in which all relevant facilities participate, cannot even be praised highly enough. And it's sufficient reason to take another close look at the basis for this success. 

Said and done: It can be that simple

Flashback: In early 2020, when the Corona pandemic was just beginning to spread, the decision was already made nationwide to get out of the DVD shipping business. As early as 2017, The Dutch Radiology Society had formulated the objective of a central platform for exchanging images and findings. With the first restrictions of contact and the awareness that they would last much longer, the schedule for the DVDExit project was accelerated once again. As things turned out, it was not possible to achieve the ambitious goal of connecting all 75 general hospitals by summer of 2020. Nevertheless, by reaching the goal in late 2020, the Dutch still put on a remarkable sprint. 

The fact that it was possible to switch from DVD shipping to exchange via a central infrastructure was based on several factors. The first was the good preparation of the project and the willingness of all participants to also implement it. The second was also the underlying technology and the speed with which it was successfully set up nationwide in the 75 institutions. Two components played a role in the process: The establishment of the central network and the transmission of data over that network. 

Alphatron and VISUS: A perfect team

Alphatron Medical, the Dutch partner of VISUS, was responsible for setting up the network. The technology behind it that enables the sending of data is based on a DICOM-Mail solution from VISUS. Simple installation and handling of the DICOM-Mail structure was an absolute prerequisite for high acceptance among the participating institutions. Painstaking client management was also needed for this purpose. This is naturally so because, in Holland also, it is permissible to transmit medical data to specific third parties only with the consent of the patients. VISUS technology meets these prerequisites and represents a true easing of everyday radiological practice, something that users no longer want to do without. Since the introduction of the DVDExit/Twiin Portaal, it has become much easier for them to communicate data selectively. Thus a broken arm needs only the corresponding radiograph, while in the case of tumor patients, further images – for example from previous years – are useful. Selecting and sending the needed images and findings are now not only much more convenient but are also more secure. In particular, the electronically transmitted date are encrypted, which is not the case during delivery on DVD. 

An important realization from the first years of DVD-less data exchange: Many more radiological images are dispatched on the trip – whether for getting a second opinion or in the course of transportation of patients. This means that the quality of (further) treatment increases or that the number of follow-up inquiries or duplicate examinations simultaneously decreases. A further reason for the smaller number of duplicate examinations is also the new speed of information transmission and the fact that images usually arrive before the patient does. In the case of DVD shipping, new images were often recorded in emergencies, so as not to lose any time for therapy. This waste of resources is now a thing of the past.

Meanwhile, besides the 75 general hospitals, some specialized hospitals have also joined the DVDExit/Twiin program, and so now close to 90 institutions are capable of sending image data by pushbutton. Around 30 medical care centers are also involved. In conclusion, more than 1.4 million studies in total were dispatched by e-mail in 2022. By July 2023, another 930,000 had already been added, showing that the potential is still far from being exhausted