Yvonne Goff BSC, MSc, Presenter: Nothing to Disclose

Neil O'Hare, Abstract Co-Author: Nothing to Disclose

Keith Morrissey, Abstract Co-Author: Nothing to Disclose

Julie Bellew, Abstract Co-Author: Nothing to Disclose

Breda Matthews, Abstract Co-Author: Nothing to Disclose

Kate McKenna, Abstract Co-Author: Nothing to Disclose

Lisa Morrin, Abstract Co-Author: Nothing to Disclose

Damien Duffy, Abstract Co-Author: Nothing to Disclose

Sharon Flatley, Abstract Co-Author: Nothing to Disclose

Peter Smith, Abstract Co-Author: Nothing to Disclose

Pre NIMIS implementation there were 52 hospitals existed in the Health Service of which only 15 had PACS. Except for some teleradiology systems for image transmission to the neurosurgical and spinal national centres, none of the existing PACS could communicate with each other. Today NIMIS is achieving 6,000, 000 Images and reports, with 35, 000 studies added weekly, using a central archive, a major achievement in the relatively short time period. The first site went live over 3 years ago, with 31 sites currently live on the system and one a month being added. While NIMIS is inherently a Radiology system, the original design and implementation has extended the boundaries of the solution into other imaging type services such as Cardiology, Vascular, Arthroscopy, Obstetrics, and Respiratory functions.The critical components of this enormous task to achieve fully national integrated RIS/PACS using a single archive will be discussed. In addition, the current issues with sharing of images and clinical reports across different hospitals without a national identifier, and the ability of NIMIS to adapt to the current healthcare reconfiguration will also be presented. NIMIS was introduced into fully operational departments in which work flow had to continue with minimal impact. Impediments to user acceptance will be discussed along with difficulties experienced transitioning to a paperless environment. The review will present the very many benefits accruing from the move to a single national system around patient care, service delivery, metrics and end-user support. The cost and process efficiencies of a single system support mechanism that have resulted will be presented along with the inherent risks and resultant mitigation strategies.  

In 2007 the Health Service Executive (HSE) in Ireland initiated the National Integrated Medical Imaging (NIMIS) Project. The initial aim of this project was to install a RIS / PACS solution into all publically funded hospitals in Ireland that currently did not have such systems (34 in total). This review sets out the current position with regard to the implementation of NIMIS throughout the Republic of Ireland, the impact this has had on improving patient care, and the lessons learned during the process.

The review gives insight to how NIMIS fits into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services, including insourcing and outsourcing radiology services and the capability of resource utilization monitoring. Increasingly, patients are moving between jurisdictions with service level agreements being discussed and agreed on the efficient provision of treatment for specialised areas. Inherent in the system specification and design is the use of the IHE XDS standard. The current NIMIS architecture is XDS enabled, allowing for cross border sharing of data.  

The implementation of NIMIS is a very significant milestone in the development of a national electronic health record, as a national image archive for the Health System. The project has set new standards in aspects related to large system procurement and implementation. The system, while very successful, has highlighted other gaps in the IT infrastructure in Ireland such as the current lack of implemented national Order Comms, Results acknowledgement, or Criticial Findings solutions.

Goff, Y, O'Hare, N, Morrissey, K, Bellew, J, Matthews, B, McKenna, K, Morrin, L, Duffy, D, Flatley, S, Smith, P, Implementing of a National RIS / PACS in Ireland.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011271.html