Digital

NW London cross-organisation NHS Radiology platform allows efficient and rapid sharing of images and radiology reports between trusts, sites and clinicians. The NWL Radiology Network has worked closely with NHSI and other experts to ensure that the solution integrates with long-term London digital and imaging strategies. The NWL Radiology Network is a first of its kind, using existing Commercial-off-the-Shelf (COTS) technology to create a platform to connect local applications, enabling a collaborative Network. 

The NW London Network System allows for efficient and rapid sharing of images and Radiology reports between trusts, sites and clinicians. This has main benefits:

• Better sharing of images and reporting to support MDT and other professional advice.
• Access to a unified imaging record of current and historical images for all patients across the Network to support clinical decision making in enhanced reporting and MDT workflows
• Real time communication across the Network to facilitate clinical decisions and reduce delays
• No wait for IEP images for patients transferred within the NWL Radiology Network. Eliminates deferrals in MDTs due to missing imaging (shorter patient pathways).
• All image reports available – no need for duplication of reporting before treatment.
•  Images taken at one Trust can be reported by specialist radiologists in different Trust/s.
• Quick access to sub-specialty opinions and reporting groups
• Local PACS will display all cross-site imaging for patients
• Better clinical diagnosis when viewing long term conditions (for example cancer surveillance)
• Teaching Database create an online learning resource for radiology training schemes

Growing demand, higher expectations and more patient interactions. This is the reality of healthcare today.

Swiftqueue deliver an enterprise scheduling platform to better manage the requirements of everyone involved -clinicians, administrators, health managers and patients. Swiftqueue is an online platform that supports booking and communications to all parties involved in the booking process and keeps patients informed with reminder emails and SMS notifications.  It is a platform allowing to share available appointments for patients to manage their next visit online and improve communication flow. This will enables better patient engagement and communication pre and post appointment and examination, as it supports a range of specialities delivering patient self-service appointments online, real time statistics, reduced DNA rates which put together work towards improving the patient experience overall.

We are working with the project team to align the product to the radiology workflow. This will allow us to move radiology advice and guidance from email to the integrated Rego system. Rego is not integrated with ICE so recommendations for imaging will still need to be made using the existing workflow.

• CDS is a decision support tool that sits within the ICE ordering system
• National pilot for 3-year funded by NHSE/I. The National pilot will enable implementation of Medcurrent CDS across NWL for primary (ICE phase 1) and secondary care providers (Cerner phase 2).
• This is a quick and easy to use system for Informed Decision Making
  • Support clinicians with evidence-based radiology referral guidance at the point of care
  • Integrated with NWL clinical pathways
  • GIRFT
  • Co-designed with clinician groups to update clinical guidelines
  • Iterated based on real life feedback post go-live
• Anticipated outcome/improvement       
  • Improvement of referring practice and reduction in unwarranted referrals
  • Improved patient outcomes, reduced administration time
  • Reduced unnecessary clinical utilisation

The ordercomms in use across NW London is Clinisys ICE. Coverage of GP practices across NW London highlighted some gaps in electronic access particularly where practices lie close to boundaries between boroughs. Additional licences have been purchased to provide licences for all GP practices where 5 or more referrals are made per year to a provider Trust.

Electronic ordering through ICE is the most secure process for requesting integrated with the primary care EPR and radiology systems. Other routes of referral using paper requests or email attachments to the radiology booking services have now been turned off.

We have worked with primary care to

• Improve the time taken to on board new requesters
• Support the changeover to full electronic requesting
• Harmonisation of ICE screens across all 4 Trusts
• Create a unified process for non-medical referrers to access requesting rights for all Trusts

• All 4 acutes able to see shared history​
• Secured £4m in 2019 for NWL image sharing and reporting platform  (NWLISP) across 6 Trusts.​
• Secured £2.1m in 2021 for extension of NWLISP to community providers​
• Home reporting workstations funding secured & rolled out​
• AI strategy funding secured across Imaging and Pathology in NWL​

• Image Sharing
  • Access to shared patient record across NWL now live for all radiology departments. 
  • Early adopter group testing functionality in CTC reporting​
  • Linking up MDT across the network to improve treatment time. Development completed.
  • NHSE funding of £1.92m over 3 years approved in principle to join with additional services, Paul Strickland Scanner Centre, Healthshare and community services.
• Imaging analytics – Foundational platform built at LNWHT.  Mature platform in place at ICHT.  CW work beginning in December. NHSE funding of £700k over 3 years approved in principle.
• Swift queue configuration completed, now in user testing phase ready for 2023 go live.
• CDS – readiness to engage with Hillingdon GPs for 2023 implementation
• ICE order comms 100% coverage of targeted practices preparation complete for completion.
• AI strategy, roadmap, options appraisal and benefits framework completed

• NW London London Image Sharing Platform – Access to prior images across the network for reporting.
• Swiftqueue patient booking portal roll out completed for plain film X-ray out-patient booking at Imperial. After go live review demonstrated the significant reduce of DNA for plain film out-patient booking.
• Clinisys ICE Order Comms System evaluation of single instance

• NW London Image Sharing Platform – Access to images across the network via XDS for all clinician
• Swiftqueue patient booking portal roll-out to be followed by other modalities and other trust sites.
• Clinical Decision Support (CDS) platform go live across all trusts
• Real-time Imaging BI and Dynamic Analytics- further development