Radiographers had great expectations when Erika Denton was appointed three years ago to be the National Clinical Lead for Diagnostic Imaging in England and Wales.
Known for her support of radiographer role development, how has clinical imaging changed since Dr Denton - she has continued to be a 'hands-on' radiologist - took up her post?
In a wide ranging interview with the SoR, she looked at four key areas of the Diagnostic Imaging Board's work: Picture Archiving and Communications Systems (PACS), the National Stroke Strategy, progress on meeting the 18-week target, and skill mix.
This month, we look at PACS and what it has meant to radiographers and patients since it was introduced across England.
The "unbelievable speed" at which PACS has been rolled-out to trusts is, according to Erika, in large part thanks to the co-operation and support of radiographers. Now, more than half a million images have been captured on PACS, at an estimated saving per trust of £290,000.
Improving benefits
Developing features such as a voice recognition tool that allows a clinician to dictate their report directly into PACS, with the notes automatically attaching to the image and becoming available instantly to any other professional, means that the time taken to report images is dramatically improved.
However, Erika, who is also the PACS programme medical director, said "It is time that we got the real benefits. We need to get data sharing sorted out so that there are no problems accessing images for clinical work for a patient, wherever that individual goes in the UK. There are technical challenges to be met before universal access of every patient's diagnostic imaging records is possible."
She continued: "There is frustration that we cannot do everything now, but having different suppliers and different systems was inevitable because no one provider could have delivered PACS for all of England. We couldn't have taken the risk of relying on one company and they simply wouldn’t have had the kit and staff to meet the scope and speed of the PACS programme.
"The Scottish solution where they have got one provider, was fine for their smaller infrastructure, but we couldn’t have done that in England. So we have the negative side of having multiple providers with regard to data sharing, but the positives that competition is driving innovation and research, and costs have been kept as low as possible."
As well as getting the regional PACS systems to talk to one another, the emphasis is now on expanding the patient care record. Now that PACS is well-established within radiology, the plan is to extend the technology to the host of other clinical services which use medical images. Breast screening is one of the first targets, as well as how PACS could be used to support the National Stroke Strategy.
Integrate disciplines
Other areas on the horizon for PACS are cardiology, endoscopy, foetal medicine, and radiotherapy, all of which have their own unique challenges. This degree of integration will allow multi-disciplinary teams to have a complete 'picture' of a patient over the course of their medical history.
Erika points out that the PACS record in the future will not just be limited to procedures undertaken in the NHS: "Patients move between the state and private sectors and we need to ensure that their images are available to all clinical practitioners, wherever they are."
