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Ireland’s National Health Service Selects QICS™ for Radiology Quality Improvement Programme

In the first national program of its kind, McKesson Qualitative Intelligence and Communication System (QICS™) has been selected to provide an ICT solution to support Ireland’s national Health Service Executive as part of the implementation of the National Quality Improvement Programme in Radiology which uses a systems approach to Quality Improvement. The National QI Programme is sponsored by the Quality Improvement Division of the Health Service Executive and led by the Faculty of Radiologists, Royal College of Surgeons in Ireland (RCSI) in collaboration with the Royal College of Physicians in Ireland (RCPI). The QI Programme aims to improve patient care with improved accuracy of diagnoses. The solution will be deployed at 46 of the nation’s hospitals performing a total of almost 4 million exams annually.

“QICS will help Radiologists to turn what had largely been a manual and paper-based process into an automated and seamless electronic workflow,” said Dr Jennifer Martin, Quality Improvement Division, of Ireland’s Health Service Executive (HSE). “By capturing, analysing and acting on the data stored in the radiological images, we can further advance the strides we have made in communication, care delivery, efficiency and patient safety.”

The rollout of QICS to the nation’s public hospitals will enable Ireland, through the National QI Programme to set intelligent national targets for consultant (attending) radiologists to drive improvements. Additionally, QICS will track and evaluate consults between physicians; including the identification and tracking of specific critical, urgent and significant findings and the time sensitive transmission of these reports to other consultants. By converting findings into an electronic format, physicians will be able to share results with colleagues while mapping statistical trends. Additionally, the National QI Programme plans to create targets for quality metrics for the most common QI workflows; Radiology Quality Improvement meeting management, peer review and critical results communications.

“We are very excited to be involved in helping Ireland’s national Health Service Executive in realising its commitment to a national radiology quality improvement program,” said Erkan Akyuz, president of McKesson Imaging & Workflow Solutions. “The commitment by the healthcare professional at both the national and local level is a testimony to their dedication to providing high quality healthcare to the citizens of Ireland.”

The first hospital, University Hospital Waterford, went live with QICS in June 2014. Dr. Anthony Ryan, Consultant Interventional Radiologist, UHW and Chair of the Faculty of Radiologists QA/PCS committee and the Radiology working group of the National QI programme, has been impressed with the software: “The software is excellent, its use fitting seamlessly into our workflow. From a patient care perspective, it allows us to document our reviews of each other’s work and discuss differences of Radiological opinion that could potentially alter a patient’s management. The ability to issue and track “alerts”, relaying critical results to other Consultants immediately, is a further key patient care feature.” Sixteeen hospitals are currently live, and the rollout process will continue throughout 2015.

This latest project is the extension of a long standing relationship between the Irish health service and McKesson. The company is the national provider for Ireland’s National Integrated Medical Imaging System (NIMIS) picture archiving and communication system (PACS) and radiology information system (RIS). NIMIS is a national effort for transforming the delivery of radiology services by implementing advanced medical technology at hospitals to help ensure patients are receiving the best diagnostic solutions available during treatment.

About the National QI Programmes

The National QI Programmes in Histopathology, Radiology and GI Endoscopy - Patient Centred, Clinician Led

Executive Summary

What are the QI programmes?

  • The QI programmes set out to develop a patient centred Quality framework within each department, using a systems approach to Quality Improvement, which routinely reviews performance and drives improvement, in key quality areas against intelligent targets. Ireland is the first country to successfully adopt such a national system, which is being hailed as a major breakthrough in patient diagnosis and care, and represents an excellent example of clinical leadership within the service.
  • Through the National Quality Improvement programmes in Histopathology, Radiology and GI Endoscopy the Faculty of Pathology RCPI, Faculty of Radiologists RCSI and the Conjoint Board of RCPI and RCSI working with the Health Service Executive have developed a national standardised approach to Quality Improvement for histopathology, radiology & endoscopy services.
  • The Programmes improve patient safety, reduce clinical risk and enhance patient care by assuring the accuracy, timeliness and completeness of diagnoses.

Status

  • The National QI Programme in Histopathology has now published aggregate national data for 32 public and private hospital laboratories. Quality targets have been set and published for three quality activities.
  • The National QI Programmes in GI Endoscopy and Radiology are currently in the roll-out phase of the ICT solution with all departments expected to be reporting on the central database - National Quality Assurance Intelligence System (NQAIS) by 2015 and 2016 respectively.

Background & Benefits

  • The Programmes arose following concerns arising from a number of high profile cancer misdiagnoses in 2006/08. They reduce to a minimum the risk of such misdiagnoses occurring again by capturing data on the activities as they are being carried out, providing reports to clinicians for review of their department performance against national aggregate performance and intelligent targets to allow early identification of potential errors and facilitate further improvement.
  • They support quality improvement at clinical level by making real, relevant information available to clinicians and front line staff about their department activities, identifying inconsistencies/divergences and reducing potential errors.
  • Improving the accuracy, quality and completeness of diagnoses will also then improve the timeliness of any necessary treatments for patients.
  • They give the patient, the public, and the HSE greater confidence in the diagnosis of illnesses such as cancer - regardless of whether they attend a public or private or large or small hospital.

How the Programmes work

  • Each programme measures a number of key quality areas using Key Quality Indicators (KQI), for example: the timeliness of processing and reporting of studies, accuracy and completeness of this reporting & peer review.
  • QI Data collection is supported by ICT solutions developed by the programme in conjunction with HSE ICT and workflow integrated where possible.
  • QI Data is reported on the National Quality Assurance Intelligence System (NQAIS) developed by the programme with Health Intelligence Ireland (HII).
  • NQAIS facilitates units to monitor their own performance in a way that allows them to identify areas for improvement, in a timely way, and take action, that should include informing the unit’s governance structures locally, regionally and nationally for supportive assistance.

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