UK Digital Imaging Forum

GP access to PACS

Do GPs have access to PACS in UK? or just get sent radiology results?
The setup here is slightly different in that all primary care is Private, so not funded by the government. They currently have access to the web version of our RIS (iCRIS) and we are now considering giving access to PACS as their networks will now cope. There has been opposition form some here, but what happens in the UK?
Thanks.

Hi Paul, here in IOM our GP’s have access to PACS and have had since at least 2012 - for the most part they have found it beneficial. I’m sure there are some that have never logged into it but those that do would be unhappy if we took their access away now.

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Hi Paul,
In my previous NHS role, we gave GP’s the ability to look at images via a web client, the sign in rates on this were extremely low, suggesting even though they had requested the ability to look at images, they were not doing so and were still exclusively using reports.
Thanks,
Mike

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Hi Paul,

It’s not common on the mainland, nor is it widely requested. There’s obviously the issues around viewing conditions, QA, access security etc. etc. even before you get into who pays for the extra licensing, connections and so on, all of which would make it more complex to deliver in the event GPs (or community nurses) did start requesting it.

Al.

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Oz not UK, but a common model here across all the private providers is the report is delivered back to the GP/specialist referrer’s PMS as a HL7 report with an embedded secure hyperlink the GP clicks on from within the PMS to open that’s patients images through a zero footprint HTML5 viewer. Saves giving GPs access to the whole PACS/all patients, and it’s all audited.
Demand varies, but it’s an expected service for any private radiology operator these days. Public health catching up, bigger scale and security issues (and of course funding) slow things down

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That’s really interesting, we tend to fall back on the standpoint that GPs haven’t usually had training to review the images (or carry insurance to do so), plus they generally don’t want them. In Aus, how did it evolve to setting access up in that way? Was there any backlog of reporting (etc.) requiring an approach like that, or just it was written into private providers contracts they had to make the imaging available?

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Image access is purely informational for the referrer not diagnostic, and often limited to key images by default not the whole study/history although that can be viewed if needed. Not applicable or wanted in many cases, but for those GPs/specialists and/or conditions where it’s clinically relevant or of interest it’s considered a standard offering by radiology groups.
Over here the service is free to the referrer (to drive referrals), the radiology provider pays per report delivered and for any additional PACS licence/infrastructure. Login via a web/mobile portal is standard, but best referrer user experience is being able to view the report and optionally open images without leaving their PMS to log in and navigate through another system.
Next step is to replace all paper referral forms with an e-order via secure HL7 or other method from the PMS to the RIS.

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Here in West Dorset we rolled out PACS access to the majority of GPs around 2005 as part of the National PACS project. We have a large community service and at the time a number of GPs wanted to review imaging. It was well received and we would not want to remove that access although we are more likely to move towards hyperlink launch to a zero footprint viewer via one of the EPRs that cover the region/s.

In Cheshire & Mersey we are involved in project called Share 2 Care which is in the near future is going to include PACS access to the wider Cheshire Care primary care settings

Which will include GPs for those interested in linking to the images

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We enabled GP access through the NW PACS portal project from 2009. It was up to trusts whether to advertise this and accept GP requests through the portal to access. Some did and gave positive feedback. Others decided not to. We didn’t have any negative issues reported.

The main benefits found were GPs being able to access appointment and results, where not available through the GP and hospital correspondence. Also being able to show imaging findings to patients. We had one example of a GP who contacted the hospital over a ‘normal’ X-ray where the GP suspected there was an abnormality. The imaging was reviewed and it was a cancer that had been missed.