3. Integrating temporary, donated or non-standard imaging equipment with existing workflows and Patient Administration, Radiology Information System (RIS), PACS, Electronic Patient Record (EPR) etc.
Many hospitals around the world find that additional imaging equipment such as mobile DDR units, relocatable CT scanners and portable ultrasound kits to meet the demand for additional chest and thoracic-related imaging are either offered or provided by commercial organisations or governmental efforts. These new units need to be rapidly integrated into the existing I.T. infrastructure and workflows.
Firstly, ascertain the condition of the equipment – is it new or does it potentially contain other incorrect configurations? Does it require specialist (manufacturer) attendance to make the connectivity changes? Make any arrangements with the manufacturer to attend if necessary.
Secondly, consider ‘hard estate’ factors which mainly form a checklist for the installation, but require much more rapid action for any missing or insufficient items – do you have enough power, or need power supplies provided by your estates departments or even by a local power company? Do you have enough power protection devices (UPS)? Are there physically enough network cables, network switches and capacity on the existing network, servers and storage devices (usually a PACS, but potentially just network shares or standard hard drives). Will any PACS require licence upgrades? Will your storage providers (PACS) need to make a connectivity change also on their systems?
Thirdly, consider ‘soft estate’ factors - wherever possible standards and resources such as DICOM (Digital Imaging & Communications in Medicine), HL7 (Health Level 7), FHIR (Fast Healthcare Interoperability Resources), and IHE (Integrating the Healthcare Enterprise) should be adhered to allow integration and future interoperability between systems.
Obtain the equipment DICOM Conformance Statement and be sure your existing infrastructure will support the equipment (else it can be used as a stand-alone device, but this generally is unsatisfactory due to the increased burdens on imaging personnel having to manually reconcile imaging). Work through a list of your existing systems (e.g. RIS, EPR, PACS, electronic requesting etc.) and work with each team in parallel to make the necessary connections. Having not only efficient workflows, but keeping these as close to the existing workflows as possible will help clinical staff and reduce ‘imaging drag’.