exoPACS Breast Module
Who should read this?
This is for users at the coal-face of service delivery who are involved in service design, development and use, particularly around implementation of Full-Field Digital Mammo (FFDM)
- Regional Breastscreening Managers
- Mammography/Radiology Business Managers
- Senior Mammographers
- Consultant Radiologists
- Consultant Surgeons
- GPs
What are the key benefits of using this module?
- Reduce Costs – huge case-releasing savings against all other storage options
- Improve Image Availability – images, wherever taken, are automatically pulled to wherever they are needed, including for surgery, radiotherapy, chemotherapy, MDT or follow-up screening
- Reduce Clerical Burden – image retrieval is automatically triggered, and intelligent rules ensure image delivery to the correct location, such as local screening workstation follow-up screening, or main PACS for surgery. This reduces the burden on clerical staff.
- Achieve Freedom – achieve interoperability and avoid vendor lock-in using international standards to encourage selection of best-of-breed systems
What are the main features of this module?
- A vendor neutral fully DICOM conformant archive
- Reporting pre-fetch feature, making priors available for reporting
- Sympomatic pre-fetch feature, making priors available for referral or treatment
- Area-wide sharing, allowing both automated pre-fetch and image availability from/to other centres across a region.
- DICOM and IHE XDS-I conformance
Reduce Costs – Storage of Breastscreening Studies, Separate from PACS
[If your site already has a breastscreening archive from another vendor then this breast partition would not be required, or charged for. Please jump further below to review the workflow benefits that our Breast Module brings, independent of archiving.]
To provide long-term storage for breastscreening studies, exoPACS integrates with all your Digital Mammography modalities, storing the data in a dedicated Breast ‘partition’. The partitioning allows breastscreening data to be kept cleanly separated from any data from other modules that on your exoPACS installation.
Mammography reporting continues unchanged, in most cases this is usually performed on the modalities’ reporting workstation(s).
Keeping Breastscreening studies separate from Main PACS means that all screening exams are archived in industry-standard yet low-cost storage, whilst only the 5%1 that are recalled for assessment are sent into PACS, which has significantly higher storage costs.
Benefits
- huge cash-releasing savings against all other storage options
- long term, secure, robust archiving of all screening data
- screening data fully integrated into the Trust’s backup and fail-over mechanisms full access, recall, and control of data
Automatic Pre-Fetch of Priors for Reporting, including from External Screening Centres
Previous exams are also loaded onto the reporting workstation(s), and this is done automatically.
Reporting Pre-fetch occurs when a study is received into exoPACS; prior breast exams are automatically pushed by exoPACS from the Breast partition (or other vendor’s archive) to the reporting workstation(s).
Through either XDS-I or integration with the corresponding Breast Module on bbRad, prior breast exams taken anywhere else in the screening region are also pulled automatically and forwarded into the reporting workstation(s).
Because the studies fetched are limited to breastscreening, this sharing use-case will be under existing explicit patient consent forms and data sharing agreements. Patients that dissent to share are labelled as such so that no region-wide pre-fetch is executed for such patients.
Benefits
- huge cash-releasing savings against all other storage options
- improved quality of reporting, through availability of all available priors
- reduced clerical/administrative overhead, as priors are pre-fetched automatically
- screening data fully integrated into the Trust’s backup and fail-over mechanisms
- full compliance with information governance and caldicott requirements
Automatic Pre-fetch of priors for Recall and/or Treatment. Including availability on PACS, and Including Studies from External Screening Centres
Symptomatic Pre-fetch occurs when a patient becomes symptomatic. PAS notifies exoPACS of events, such as a patient’s attendance. Attendances for breast clinics, surgery, radiotherapy or for chemotherapy are filtered by exoPACS’ Breast Module, triggering pre-fetch from the local exoPACS partition.
Through integration with the corresponding Breast Module on bbRad, prior breast exams taken anywhere else in the screening region are also pulled automatically and forwarded into the reporting workstation(s).
In both cases the priors are forwarded into the breast workstation(s), and the Main PACS, making them available to the clinician for busy clinics, surgery, radiotherapy or chemotherapy as required. This approach means that all screening exams are archived in industry-standard yet low-cost storage, whilst only the 5%2 that are recalled for assessment are sent into Main PACS, which has significantly higher storage costs.
Like Reporting Pre-fetch, this Symptomatic Pre-fetch workflow is equally available standalone against non-exoPACS archives.
Because the studies fetched are limited to breastscreening, this sharing use-case will be under existing explicit patient consent forms and data sharing agreements. Patients that dissent to share are labelled as such so that no region-wide pre-fetch is executed for such patients.
Benefits
- huge cash-releasing savings against all other storage options
- improved quality of reporting, through availability of all available priors
- reduced clerical/administrative overhead, as priors are pre-fetched automatically
- screening data fully integrated into the Trust’s backup and fail-over mechanisms
- full compliance with information governance and caldicott requirements
Breast Studies Available for Pre-Fetch for External Hospitals. For Screening, Recall and/or Treatment, Performed at External Hospitals
exoPACS makes breast studies available for other hospitals to pre-fetch from you. For example, if you have successfully performed surgery on a patient with breast cancer, in subsequent years she may have breastscreening performed at an external hospital. exoPACS makes your post-operative imaging available to that screening service.
Security and confidentiality are obviously essential. Breastscreening studies are identified as such by exoPACS on acquisition. Because of this, we are able to make prior studies available for prefetch by external hospitals, whilst restricting those external hospitals to only breastscreening studies. This applies even if the studies are stored in another vendor’s PACS such as mixed in with other studies on your Main PACS.
Furthermore, this prefetch is triggered only by patient attendances – there is no facility for external hospitals to ‘browse’ your data.
And finally, because bbRad’s Breast Module does not rely on VPNs, there is no need to join networks together, thus avoiding increased IT administration and security overhead.
Benefits
- improved quality of care, through availability of all available priors
- reduced clerical/administrative overhead, as priors are pre-fetched automatically
- full compliance with information governance and caldicott requirements
Future-proofing, Ownership and Control of Data
Cypher IT provide the software, installation and on-going support services for exoPACS; the Trust provides the hardware, including disk storage and associated redundancy or fail-over. By separating software supply from hardware supply, Trusts are able to procure disk space strategically across multiple services (eg shared on a SAN or NAS), and in particular, much more cost-effectively. This enables us to offer a value proposition far exceeding that of traditional PACS vendors’ storage proposals.
exoPACS is an XDS-I archive (the conformance statement is in exoPACS Technical Details). This means that an IHE XDS-I compliant viewer from any vendor can be used to view studies on exoPACS. The XDS-I configuration, like the configuration of DICOM nodes, is open for your administrators to use; we do not password protect or otherwise restrict customer access to these areas. Thus we do not restrict access to or control of your own data. Furthermore, because access mechanisms are based on IHE standards, the mechanism to access the data is future-proofed.
The reason we don’t restrict access is because Cypher IT’s approach is to earn income by providing software and services that solves problems and adds value; we are a healthcare software company rather than a service or man-days company. Because of this we empower our customers to administer their own system and their own data.
Finally, because the hardware and disk storage is provided by the Trust, then as well as being better value for you to procure, it also allows you to integrate exoPACS easily into your IT strategy. exoPACS can be delivered as a virtual server, and storage can be on a SAN or NAS that is shared with other hospital systems. It can therefore be backed up, replicated, and made available for failover in the same way as other systems’ data, simplifying your IT design, administration and business continuity planning.
Benefits
- cost savings realised through the use of virtualisation and distributed storage
- integrated backup, replication and business continuity
- simplified IT administration