With courage and a master plan

JiveX is an old acquaintance in the Swiss See-Spital hospital: the Swiss have been using the system for managing and archiving non-DICOM data gathered from cardiology and ultrasound data for many years now. As a result of introduction of the Electronic Patient Dossier (EPD) in Switzerland, the Management expressed their desire to digitize and consolidate all medical data and make it EPD-compatible. A clear case for the JiveX Healthcare Content Management (HCM).  

To be able to define which processes must be tackled and how the requirements can be met using JiveX, Logicare AG—the VISUS Partner in Switzerland—first set up an analysis. The result: it was established that 46 out of around 800 medical devices required digitization. The next steps include integrating the radiological PACS, integration of medical data generated in KIS and implementation of a scan process. Adrian Weilenmann, IT Solution Engineer at Logicare, explains: "We drew up a roadmap using several subprojects covering a period of more than three years in total. We focused first on creating the basis for implementing HCM." Simply put, it means that all necessary modalities were connected for a start. This involved the JiveX Analog Modality Gateway (AMG) and JiveX PDF Print Gateway. The aim is to create worklists and introduce the HCM Viewer.

A completely new concept: metadata as a file structure

HCM strategy implementation, which just has started at See-Spital, is accompanied by drastic changes. An important part of the analysis by Logicare consists of drawing up an appropriate file plan. Ultimately, one of the major advantages of the JiveX HCM is that medical data is displayed in relation to patients or cases, and file plans can be digitally mapped. In the end, Adrian Weilenmann, Head of Finance, Christian Madoery, IT Manager, and Hanspeter Erzinger-Manea, IT Coordinator at the See-Spital, opted for a step that was bold and logical at the same time: the IHE Suisse metadata set should serve the EPD as the file plan in future. "The metadata set was issued by the Federal Office of Public Health in Switzerland and is mandatory for hospitals. It comprises 13 attributes for medical data structuring which shall be contained in every document entering the EPD. With that in mind, taking up the metadata set as a file structure seemed only logical. Thus, we avoid duplicate structures and err on the safe side in legal terms", explains Adrian Weilenmann.

Attributes of the metadata set include for example the author's position and medical subject area, format, confidentiality level or healthcare facility type. The duty of compliance with this set should ensure effortless medical data exchange between the facilities and also its transfer to the respective structure of participating healthcare facilities.

With the JiveX Healthcare Content Management, implementation of this file structure is no longer a problem since, as is well-known, IHE profiles are easily adapted with JiveX and naturally there is also a corresponding profile for the data set with IHE SVS. In addition to the IHE SVS profile, an IHE XDS profile is used which defines the parameters required for data exchange and receipt.

Everything at a glance

"Apart from IHE profile implementation, viewing has a special role since our objective is not only uniform archiving, but also uniform use of the data in daily practice. This means, for example, that we would like to make the data from the external PACS run in JiveX available for evaluation via a viewer too. The HCM Viewer meets all requirements at the same time: it is MPG compliant, capable of presenting medical data irrespective of their format, displaying the file structure, and providing good filter possibilities", explains See-Spital. It could still be some time before users can benefit from the full spectrum of functionalities.  But even now the reactions of the users are extremely positive: "Young doctors, in particular, can hardly wait to obtain all data via JiveX. This is not so much a matter of compliance with EPD standards for them, but rather of a comfort in their daily work. With JiveX, all data is available at any time and any location at a glance. Processes have become so much safer and faster", says Adrian Weilenmann, whose focus is naturally on an optimum EPD support, but also on the numerous advantages which are obvious in daily processes.

See Spital Logo
The See-Spital hospital in Switzerland is firmly established in Horgen and Kilchberg, but is networked across canton boundaries and equipped for emergency care as well as for out-patient and in-patient treatment. Its first-class service is oriented around people with basic and supplementary health insurance. The See-Spital on the Horgen site is a center for basic regional care with the key departments of accident and emergency, an intensive care unit, internal medicine, acute geriatrics, surgery, gynecology, and obstetrics. Logicare AG is responsible for all IT in the See-Spital, with IT coordinator Hanspeter Erzinger-Manea at the Kilchberg site acting as the personal interface between IT and the hospital.