PACS in practice

Daloni Carlisle

A general practice in Portsmouth has established secure links into its local hospital in what is thought to be the first GP PACS project in the UK.

The Portsdown Group Practice already carries out ultrasound scans on site and a year ago invested in the DICOM (Digital Image and Communication in Medicine) software that allows its scanner to communicate via PACS.

Earlier this month, the practice established the secure telephone links to the Portsmouth Hospital NHS Trust, which implemented the GE Centricity PACS system in 2003. The system was installed outside the National Programme for IT.

The practice can now send its digital ultrasound images to the hospital system where they can be viewed by clinicians.

David Tones, business development manager at Portsdown Group Practice, told E-Health Insider: “We have the technology working. Now we have got to get on with the business of interfacing with the hospital consultants so that we can use the system effectively.”

The practice already uses ultrasound regularly with the scanner operated by GP Dr Richard Mannings who has an MSc in ultrasonography. He runs regular clinics and trains GPs and ultrasonographers with the University of Portsmouth.

Dr Mannings, who also works at the hospital, said: “It has been a real benefit for us having DICOM because it means I can send my own images down to the hospital and view them there.”

He outlined three potential scenarios for using PACS in general practice: diagnostic; getting a rapid second opinion; and clinical audit.

In the first scenario a patient has an ultrasound at the practice and the GP diagnoses gall stones. The GP then writes a referral letter asking the consultant radiologist to confirm the diagnosis from the electronic image and put the patient directly onto a waiting list for gall stone removal.

“We hope that by starting with something simple like gallstones we can show that this can really benefit patients. We can then go from there,” he said.

PACS could also be used to obtain a second opinion by sending the image directly to the hospital consultant in charge of ultrasound. This again would be quicker for the patient and potentially save money.

Finally, the system could be used to support the practice’s clinical audit and governance by asking hospital clinicians to review a percentage of the practice’s scans, transmitting them via PACS.

Bill Flatman, director of ICT at Portsmouth Hospitals trust, said: “The technical side has been tested and it works. It is essentially no different from communicating with any of the other remote sites within the trust that are already connected to our network. The issue now is more about the organisational side such as funding and support by the PCT.”

Dr Mannings admitted that it can be an “uphill struggle” to get the radiologists at the hospital to accept images taken outside their unit, but added: ‘We will get there eventually.”

Iain Fairley, consultant radiologist at Portsmouth Hospitals trust, said he had held no formal or informal discussions with the practice yet and he had received no project proposal. However, he added: “I would support the idea.”

Photo credit: David Wilmot.