Radiology Reporting Networks: understanding the technical options
The College is seeking comments on the draft document Radiology Reporting Networks: understanding the technical options. This guidance, which is an update to the original version published in 2016 entitled ‘Who Shares wins: efficient, collaborative radiology solutions’ , has been developed by the RCR’s Radiology Informatics Committee (RIC). The guidance has been updated to reflect the current state of affairs; including reference to NHS Improvement’s ‘Transforming imaging services in England — a national strategy for imaging networks’ strategy published in November 2019. The document specifies what imaging departments could link to a Radiology (image and report sharing) Network. It has been written by NHS radiologists with the help of industry experts and will hopefully be of use to clinical PACS Leads, PACS and IT teams when they begin to procure standards-based, vendor neutral, seamlessly interoperable Radiology Network Platforms.
We have looked at this in the context of using out bee regional PACS based reporting solution as the ‘Network Radiology Platform’ NRP.
Some additional considerations and challenges we have discussed in that context include:
File locking/flag status indicating if someone else has opened the study for reporting and risk of overwriting a report. We also included requirement for this ‘status’ to be communicated bidirectionally between the local reporting platform (RIS) and NRP (PACS) - in effect communication between the report manager actors.
PACS based reporting can provide enhanced reports including hyperlinks to key images, tabulation of results, body marker images etc. It is important to ensure in these circumstances that there is safe and effective translation between an enhanced DICOM SR report and a text based HL7 report, which is transmitted to other systems.
Consideration of DICOM SR as a means to ensure communicate reports with other imaging networks/NRP.
Red dot type mechanisms for effective communication between radiographers and NRP clinicians (preferably standards based key image notes, presentation states etc?)
Technical network level encryption requirements VPNs and bandwidth requirements.
For outsourced reporting with independent/private sector companies to date we have found it simpler to provide access to the local RIS/NRP rather than integrate with an external NRP - due to the complexity of integrating the request details, patient history timeline, reports, scanned documents etc.
Our main challenge with with transferring imaging with existing private NRP providers for outsourced reporting is the lack of adoption of DICOM standard based KIN and presentation states for recording and comparing marker lesions.