Patient Informatics

9. Prompt and efficient Image Transfers (as patients are moved between centres / temporary centres

Mentioned previously, many centres have found the need to move imaging for one or many patients in the following circumstances:

• Patient deterioration – requires more advanced investigations or treatments than those available locally;
• Patient recovery – no longer requires specialist centre and can be moved to a lesser advanced facility to ‘free up beds’;
• Lack of reporting staff – imaging and tests must be reported remotely due to a lack of suitably trained staff locally;
• Governmental order or health policy – perhaps all confirmed COVID-19 cases are clustered into one or more ‘supercentres’ for efficient treatment or containment.

In all these cases, consider how existing infrastructure can be best utilised. Obviously in a region without reliable internet connectivity, manually conveying CDs (ensure sufficient stock of the correct media is held), thermally printed digital films etc. are the main choices. However even in areas with usually ‘good’ public internet, lockdowns and social isolation guidance is placing pressure on standard network connections due to the increased use of homeworking and even consumption of ‘Netflix’ or Youtube videos! As a result, for those healthcare institutions with good connectivity traffic prioritisation or ‘shaping’ may be needed in conjunction with local I.T. or internet service providers in the country.

Dedicated facilities for rapid image sharing are provided by many PACS vendors.

XDS and XDS-I (Cross Enterprise Document Sharing – for Imaging) is the best practice standard to use if transferring to another hospitals PACS or imaging system. For those without direct connections to destination PACS there are a number of intermediary solutions used to transfer millions of Radiological images daily between hospitals, also allowing for online viewing and manipulation in case the recipients do not have a high quality graphics-processor enabled PC in the remote location. The largest such system currently in use in North America and the United Kingdom is the Image Exchange Portal. Many other vendors and smaller companies in different regions provide similar services and local solutions (peer-to-peer) are likely to be very helpful and rapid to deploy in current circumstances.