Medical Imaging post the National Programme for IT – quo vadis?

Picture Archiving Communications Systems (PACS) and Radiology Information Systems (RIS) contracts under the National Programme for IT (NPfIT) will come to an end in mid-2013 for the North, Midlands, East and the South of England and in mid-2015 for London.

This will leave a significant gap in the provision of medical imaging systems for UK NHS Trusts. To fill this gap the UK Department of Health’s Informatics Directorate is developing a framework to help Trusts manage the transition [1]. The Department of Health has recognised key to this transition [2] [3] will be the need to:

  • Share images and reports across multiple departments and with Primary Care
  • Improve integration with other clinical systems
  • Provide vendor-neutral archives and
  • Lower system costs.

 Dell recently launched its Virtual Hospital [4], a suite of open, capable and affordable healthcare solutions and services which focus on the innovative use of technology to reduce healthcare costs and improve front-line patient care.

A key component of this suite is the Unified Clinical Archive (UCA) [5], a vendor-neutral, centralised archive of medical images for multiple departments. Dell’s Unified Clinical Archive has been designed to directly address NHS needs:

Share Images & Improve Integration

Dell’s Unified Clinical Archive allows NHS Trusts to store, access and share medical files and images across multiple modalities and PACS systems. Radiology, dermatology, cardiology, endoscopy, opthamology, digital pathology, otolaryngology, neurosurgery and oncology objects can all be managed by the Archive.

The solution provides full support for clinical workflow and automation through, for example: HL-7 Patient Information Reconciliation (PIR), HL-7 forwarding and DICOM routing support. Taken together with Dell’s clinically-focussed deployment model, the solution helps the NHS move from a costly and difficult to manage application-centric data management model to a patient-centric one, focussed on delivering better diagnosis and care.

Vendor Neutral

A vendor-neutral archive is independent of department- or clinically-specific medical imaging applications. Dell’s Unified Clinical Archive is based on a patented, open, standards-based (DICOM, HL7, WADO, IHE ATNA) vendor-neutral and modular architecture. NHS Trusts no longer need to be locked into one PACS vendor, going forward medical imaging data is accessible no matter who a Trust partners with. Consequently, Trusts can mitigate the high cost of future data migrations and potential disruption to clinical workflows.

Lower Cost

Following the challenge issued by the NHS Chief Executive Sir David Nicholson for the NHS to find £15-£20 billion in efficiency savings between 2011 and 2014 [6 ], and the Public Account Committee’s August 2011 report into NPfIT [7] there is a renewed emphasis on identifying cost savings from the innovative use of IT which may be redirected to front-line NHS services [8 ] whilst improving the quality of care [9].

Dell’s Unified Clinical Archive can reduce the cost of medical imaging to NHS Trusts through:

  • A common storage platform which enables Trusts to maintain one central archive of medical images, increasing productivity by streamlining access to medical images across multiple departments.
  • A vendor-neutral, open architecture which eliminates the need for Trusts to undertake future medical imaging data migrations.
  • An object-based and metadata-aware architecture which provides the ability to scale as patient data grows. Standards-based hardware and a modular design enables Trusts to purchase storage on demand, adding, replacing or retiring nodes without the manual setup, management complexity and costs of traditional file and block storage.
  • A single, unified archive which removes isolated, proprietary silos throughout the Trust, simplifying the IT management of systems and medical image data and, consequently, reducing support and storage costs.

Dell & the NHS

Dell has partnered with the NHS to deliver healthcare solutions for over 15 years. Since 2004 Dell’s UK Healthcare teams have also been providing Clinical Transformation consulting, Programme and Project Management and Technical, Application and Testing consultancy to the National Programme for IT and directly to NHS Trusts across England and Scotland.

The roll out of PACS across England has been considered one of NPfIT’s major success stories [6 ][10][11]. Dell’s UK Healthcare teams partnered with BT and London Acute Trusts to successfully deliver NPfIT PACS deployment projects in London, including 29 PACS implementations and upgrades and 45 image sharing and image archiving implementations.

The first Dell Unified Clinical Archiving pilot successfully went live in July 2011 at Sunderland NHS Trust, archiving ophthalmology PACS to a replicated storage environment. Three further pilots are currently in progress.


PACS Beyond 2013, NHS Connecting For Health

DH works on PACS transition framework, ehealth insider, 10 June 2011

Trusts to determine future of PACS deals, ehealth insider, 9 March 2011

Virtual Hospital, Dell Corporation

UK Unified Clinical Archiving Solution, Dell Corporation

[6 ]
The Year: NHS Chief Executive’s annual report 2008/09, Sir David Nicholson

The National Programme for IT in the NHS: An update on the delivery of detailed care records systems, Commons Public Account Committee (PAC), August 2011.

[8 ]
PAC NPfIT report nails down IT problems, NHS Confederation

Quality, Innovation, Productivity and Prevention (QIPP), Department Of Health

Would the take-up of PACS been as high in English acute trusts without the national PACS programme? NHS Connecting For Health

Review of the NHS National Programme for IT, Cabinet Office’s Major Projects Authority (MPA), published September 2011.

About the Author: Andrew Jackson