Enterprise Medical Imaging Platform (EMIP) now at all major metropolitan WA health system hospital sites

The Medical Imaging Replacement Program (MIRP), a major ICT initiative led by Health Support Services (HSS), has introduced a new and contemporary Enterprise Medical Imaging Platform (EMIP) at all major metropolitan WA health system hospital sites.

In October 2023 Royal Perth Hospital (RPH) went live with the EMIP, the last of nine hospitals scheduled to adopt the new platform, and the conclusion of a years-long project. This is a momentous and exciting change for our medical imaging practitioners and the WA health system.

The conclusion of this project ushers in a new era of health care. Better patient journeys, streamlined operations and improved collaboration are just some of the benefits of transitioning to the EMIP. We are proud of the work HSS does to support WA public hospitals in delivering world class clinical care, and of the monumental, collaborative effort of WA Health employees across all HSPs who made this project a success.

The new Platform replaces the existing Picture Archiving and Communication System / Radiology Information System (PACS/RIS) which has reached the end of its life, while also providing additional functionality and clinical efficiencies.

The EMIP provides advanced imaging capability, enabling our radiologists and clinicians to view images in new and different ways and with more options for remote access.

The Medical Imaging Replacement Program began in 2017 with an extensive 17-month long tender process, resulting in a $47.2 million contract being awarded to Canon Medical Systems ANZ Pty Limited to deliver a suite of 12 clinical applications to form the EMIP solution. Canon subcontracted Intelerad to provide the PACS, Kestral to provide the RIS and DesAcc to migrate 20 years of historical data.

The solution was designed, built, and tested under the leadership and support of a range of expert clinicians and clinical subject matter experts, released from their day-to-day clinical and system administrator roles within the WA health system to work on the project build team.

Speaking to the advantage of having site-based subject matter experts, Paul Belcastro, Deputy Chief Medical Imaging Technologist for Royal Perth Bentley Group, said “The success of the EMIP rollout at East Metropolitan Health Service was due to the commitment and dedication of the EMIP team and a healthy appetite to learn with a positive attitude from the RPH team. Championed by Commissioning Lead (and RPH Radiologist and PACS Administrator) Chad Vickers, his expert team members, both technical, clerical and IT provided support to our onsite leaders to facilitate a big change in a short time with minimal disruption to our service.”

The EMIP solution brings many benefits to the WA health system, including enhanced system stability and improvements to support systems for health care responsiveness. Better access and mobility enable off-site review of medical images and reports by on-call and remote clinical staff, resulting in a better patient journey through the health care system. The solution also provides image and report viewing capability across whole of Health, including WA Country Health Service and Public-Private hospitals such as St John of God Midland.

The EMIP has also paved the way for a central medical imaging repository from which clinicians will be able to access patients’ stored images easily. Thanks to an arrangement with major private radiology providers, this will include medical imaging performed in the private sector. This enhancement should lead to fewer repeat x-rays and scans being ordered – reducing patient inconvenience and exposure to unnecessary radiation.

The introduction of state-of-the-art voice recognition software for radiology reporting has significantly improved efficiency leading to an overall reduction in time to availability of final reports.

This digitisation has seen turnaround times significantly improve. The overall median report turnaround time to finalised report being (across all sites and patient types) on weekdays has reduced to approx. 169 mins per imaging report. Prior to the EMIP implementation, finalisation could take up to two weeks or more. There have also been major reductions in unreported study backlogs since the introduction of the EMIP.  In some cases, reducing from >2000 reports pending finalisation to approximately 100 completed studies pending report finalisation.

"The enterprise medical imaging solution will not only meet medical imaging needs but the needs of all WA clinicians as we digitally transform our health services over the next 10 years,” said Prof. Peter Sprivulis, MIRP Executive Sponsor and WA Health Chief Clinical Information Officer.

Due to the size and complexity of the replacement system and the associated Health Service Provider (HSP) workflows, one big go-live across the WA health system was considered risky, therefore a staged commissioning approach was agreed upon.

Staggering the hospital go live dates ensured ongoing HSP involvement throughout the build process and allowed planning decisions regarding the commissioning approach to be made by the HSPs themselves.

The staged approached enabled the project team to provide focused and comprehensive support, preparation, and guidance to the hospitals through the new medical imaging solution and ensuring staff were comfortable and ready to adopt the solution by the go-live date. This included extensive and intensive training workshops, over 250 bespoke presentations to various hospital departments and one-to-one support and advice. The project team remained at each site for an additional few weeks following go-live to provide further support.

Mathew Melville, Chief Medical Imaging Technologist at Rockingham Hospital (RGH), the first site to go live with the new solution, said, “The HSS project team on site at RGH both leading up to and from go-live were incredibly knowledgeable and supportive to our team and the greater hospital clinicians.  The go-live environment was pleasant and, dare I say, made quite stress-free by having the HSS EMIP team so readily available across most of the day and night and being so skilled at teaching staff the solution as needed.” 

Multiple challenges were encountered and overcome, such as delivering a single integrated solution from a large consortium of vendors and the large infrastructure footprint (200+ servers, 500TB+ storage) required for the new solution, using a new Infrastructure as a Service (IaaS) platform.