PACS

Radiology Teaching Archive at Queen Margaret University

Pukka-j recently installed a new radiology teaching archive at Queen Margaret University to help the department deliver teaching images to radiography students.

A windows server has been configured with the Pukka-j teaching archive to provide access to example radiology images to students.  The images are being sent to the archive via a Pukka-j Nexus service running in the hospital network with a DICOM connection to the hospital PACS.  The Nexus service has been configured with the anonymisation plug-in such that any identifiable information is removed from the DICOM header of the images as they pass through.  Because of the streaming nature of the Nexus service, the images are not cached locally and pass though the service, being modified as they are transferred.  In addition to the anonymisation plug-in, the Nexus service has been setup with the redaction plugin so as to remove any demographics in the banner from any ultrasound images and also from the report screen captures of the Dexa images.  DICOM SRs also pass through the service and are attached to the study on the teaching archive.  These SRs are reviewed at the university, to remove any information that is not required before being made available as part of the study.  The images show how the Dexa screen captures have the patient information removed during redaction.

Dexa_Before

Dexa_After

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A successful organisation-wide RIS PACS for GP Care

Pukka-j has recently successfully installed and upgraded PACS imaging and RIS reporting systems to support GP Care’s rapidly expanding Community Ultrasound Service.

GP Care has multiple contracts with NHS commissioners and delivers a range of community-based services that are both efficient and convenient for patients and that offer cost savings to the NHS.   Although GP Care provides a small number of services to patients on a private basis, where NHS care is unavailable, the company’s real focus is on delivering high quality care to NHS patients.   Provision of its ultrasound services to NHS patients is via a network of community settings such as health centres and specialist clinics using a growing team of expert sonographers with consultant radiologist overview.

The new PACS/RIS systems facilitate delivery of ultrasound scanning services from a network of community locations that are close to patient homes.  The linkage of each delivery location to central hub servers means that ultrasound images and reports can not only be generated locally and immediately issued to patients (where appropriate), but can also be immediately transferred to other NHS clinical teams where onward care is required.

Roger Tweedale, GP Care’s Chief Executive comments that, “Even non-urgent ultrasound scans are now being seen within two to five days of referral with immediate reporting available to both patients and referring GPs, as well as to hospital clinicians, where patients require further care.   The implementation of our new and upgraded PACS/RIS systems has significantly increased the speed and efficiency with which we can operate.”       

Pukka-j’s unique RIS-PACS acts as a complete ‘end-to-end’ solution for optimising patient case management workflow for diagnostic imaging services.  It supports a mix of community-based health services for ultrasound, CR/DR, ECHO, MRI, CT and DEXA and is utilised by NHS Clinical Commissioning Groups and private healthcare providers, including treatment centres, minor injury units, community hospitals, general practice services, musculoskeletal services, clinical and treatment assessment services and prison services.  It features advanced IT solutions, services and tools to connect and communicate diagnostic orders, scheduling, images and reports, eliminating duplicate entry with other systems; CaB (Choose and Book) referral systems and PAS (Patient Management Systems), GP management systems and remote reporting provider systems, using Pukka-j’s proven industry standards for HL7, DICOM and web services.   In addition, it is fully compliant with the ISB requirements for Health and Social Care Diagnostic Imaging Dataset.  .

Pukka-j is a UK based, specialist medical technology company offering smart software solutions for enterprise imaging and reporting in healthcare, with particular expertise in all imaging related “ologies”; cardiology, neurology, oncology and radiology.   Established in 2001, Pukka-j prides itself on the ability to tailor its solutions precisely to meet the needs of each healthcare provider.   

Community Healthcare benefits from Pukka-j’s unique Case Management System

In recent months, Pukka-j has been working closely with ultrasound providers to deliver an integrated pathway for prompt diagnosis and a seamless patient journey across the healthcare system.  Ultrasound provision is a service that falls within the ‘Any Qualified Provider’ (AQP)* scheme within community-based services.  It gives patients the choice about the location of a scan and reduces the time between referral and outcome, thus ensuring patients receive the correct diagnostic test in a timely manner and in the most clinically appropriate setting.

Achieving these high standards can present a challenge for providers and identifying this need, Pukka-j has developed a unique Case Management System (CMS) that helps providers deliver their services more efficiently.   The Case Management System uses the latest innovative RIS PACS technology to manage patient records, scheduling, and text message appointment reminders, allowing reporters to complete and share results with the health community, all of which assists the provider in the provision of a first class experience for the patient.    In the case of RIS, Pukka-j can assist providers in realising the full potential of medical informatics in ways that work for them.   Easy to interface into a new or existing department, it helps optimise workflow and securely manage patient information throughout the facility. 

One of the challenges Pukka-j faced was to tailor the workflow to fit with the provider’s rota of ultrasound clinic locations, many of which lacked the communications needed to run web-based services.   The Pukka-j ‘Return to Base’ model enables a Health Care Assistant (HCA) to utilise an encrypted laptop to synchronise data to and from the provider’s central RIS PACS, over a dedicated broadband running a Virtual Private Network (VPN).   From a HCA’s home, appointments and exam orders are downloaded to the laptop, which then accompanies the portable ultrasound scanner to the different clinic locations.  At the clinic, the laptop connects to the portable ultrasound scanner populating it with a worklist, allowing the acquisition of images on the scanner without the need for manual entry of patient, and order details. Once acquired, images are transferred from the scanner to the laptop and the sonographer completes the report.  At the end of each clinic session, the HCA takes the laptop home to upload images and report to the central RIS PACS system, which, in turn, downloads a worklist to the laptop, allowing orders to be accessible for the following clinic session. 

Louise Crossley, Business Development, Pukka-j comments …”Pukka-j’s product has evolved over 12 years of continual development and we pride ourselves on high levels of customer satisfaction.  From deployment support through to patient case management, our team is focused entirely on making sure providers get the support they need.  Our customisable workflows enable us to build a system that reflects individual requirements and which is also adaptable to current needs and future growth, regardless of how many diagnostic services and sites providers wish to run.”

An additional CMS module includes Key Performance Indicator (KPI) reports, enabling providers to make decisions on immediate response to the demand and capacity of their services.  KPI reports fulfil providers’ contractual obligations to allow them to present their outcomes to healthcare commissioners.  The Pukka-j solution fully complies with the Information Standards Board (ISB).

Pukka-j Donates PACS Equipment to Hospital Project In Pakistan

Pukka-j has recently donated a PACS loaded server and software for installation in a MDAUK hospital in North Kashmir, Pakistan (Midland Doctors Association UK).

Pukka-j made the donation through Tanweer Arif of Care UK.   Care UK has been a customer of Pukka-j for many years, with Tanweer being responsible for RIS/PACS and system interfacing products across the whole UK organisation.  Commenting, Tanweer says, “Pukka-j is the preferred RIS/PACS supplier for Care UK and delivers a first class product and support for our company.   I thought that the MDAUK hospital should be equipped with the same product we offer for diagnostic services at Care UK and I therefore approached Pukka-j for the donation.”  Tanweer and his family, through arranging the donation, have provided a strong IT base for the MDAUK hospital, with Tanweer giving up his spare time to set up the system in Pakistan.    Without a robust IT and communication to handle medical data, the hospital infrastructure would lack organisation and process.   The server and equipment will be installed shortly on-site at the near-complete hospital, ready for the forthcoming inauguration later in the spring.

 The Pukka-j PACS will be used initially for radiology, CR, DR and US, and it is anticipated that it will be expanded to other systems later on.   

 MDAUK was initially created to serve a simple purpose: the construction and running of a charitable national medical institution in the earthquake-hit region of Pakistan in order to provide free healthcare at the point of delivery and serve as a major training centre for local health care professionals as well as acting as a focal point for any future relief operations should other natural disasters occur again.

 The catastrophic earthquake measuring 7.6 on the Richter scale struck Northern Pakistan on 8th October 2005.   A trauma team from Nottingham and Derby flew into the region one week after the tragedy and worked in a field hospital consisting mainly of tents.   Over one thousand patients were treated in the five and a half days the team was there, with 134 major surgical procedures being carried out under general anaesthetic.   At any one time, 70 inpatients were being treated.

 The trauma team returned and made a long-term commitment to help the people affected by the earthquake.   This escalated to into the development of a health infrastructure.   The team initially consisted of doctors from the Midlands, but as the scale of the needs became apparent, a range of professional disciplines spanning both the private and public sectors became involved.   

For further information on the MDAUK project go to www.mdauk.co.uk/projects

Pukka-j’s PACS Localisation Solutions Prove Popular with North West NHS Trusts

250 million PACS images were recently migrated by Pukka-j on behalf of four NHS Trusts located in the North West of England.  The Pukka-j PACS migration solution was deployed at Royal Liverpool and Broadgreen University Hospitals NHS Trust; St Helens and Knowsley NHS Trust; Aintree University Hospitals NHS Foundation Trust and the Liverpool Heart and Chest Hospital NHS Foundation Trust. 

Although the commissions from the North West Trusts were separate projects, the end goal proved to be the same.  The Trusts employed Pukka-j to localise PACS images from a local and central data store, provided by CSC, their existing PACS local service provider.

The trend in PACS localisation is a result of PACS local service provider contracts expiring in June 2013.  For those Trusts wishing to implement a replacement PACS with a new provider,  it is a sensible approach for all of the PACS data to be migrated from the existing system and held in one place to enable the Trust to be the data owner and controller, prior to a new PACS being implemented.

Kevin Wilson, Technical Director of Pukka-j comments:  “Every migration is unique however with the LSP solutions in place we were faced with the added complexity of data being flushed from the Trusts local PACS and residing in a remote Central Data Store. Our solutions coped well with the challenge, completing the projects within a timely fashion, whilst ensuring the migration process had no impact on the live PACS environment. Until an existing PACS is no longer in use by a Trust, Pukka-j performs a regular synchronisation process to guarantee recent images acquired and imported images with historic dates in PACS are continually localised to the Pukka-j environment.”    

The main advantage of Pukka-j PACS localisation solutions is the flexibility of the products, which allow migration to be scheduled out-of-hours, with options for storing data temporarily, or in a long term archive enabling data to be cleansed and migrated to a new PACS  or VNA supplier as and when required.

Pukka-j continues to support the North West Trusts with their roadmap for PACS replacement and as a result Pukka-j has received additional commissions for providing the Trusts with a mix of product, including VNA, technical consultation, bespoke software and integration services.

Pukka-j’s RIS PACS for Barlborough NHS Treatment Centre

Pukka-j’s RIS PACS for Barlborough NHS Treatment Centre. Barlborough NHS Treatment Centre is an Independent Sector Treatment Centre providing high quality orthopaedic care, serving Derbyshire, Nottinghamshire, Lincolnshire and South Yorkshire. It is run by Care UK an independent company purely for NHS patients, and was originally part of the Government’s initiative to offer patients more choice and to reduce waiting lists.

Pukka-j migrates PACS for Liverpool Heart & Chest Hospital NHS Foundation Trust

Pukka-j migrates 38 million PACS images for Liverpool Heart and Chest Hospital NHS Foundation Trust. Liverpool Heart and Chest Hospital is one of the largest specialist heart and chest hospitals in the UK, providing specialist services in cardiothoracic surgery, cardiology, respiratory medicine including adult cystic fibrosis and diagnostic imaging. In 2010 the Trust was rated as the top performing hospital for “overall patient care” in the Care Quality Commission’s National Inpatient Survey.

The Science and Knowledge of PACS

Pukka-j will introduce a range of Pacsology products and services at UKRC in Manchester this year with the aim of meeting the challenge of providing information services to an increasingly technology -driven healthcare service.