The regional medical imaging interoperability network which serves 4-Million patients throughout Yorkshire, the Humber and North Lincolnshire

What it is

Yorkshire Imaging Collaborative (YIC) is the natural evolutionary step in medical imaging integration to provide quality radiology services to contemporary patient users.

Through the symbiosis of our two parallel programmes of activity we are able to create a consistent and high quality medical imaging service across a the largest geographical footprint in the UK.

• Transformation Programme: defines the culture and visionary direction of our service through engagement with senior leaders and medical experts
• Technology Programme: strategising, procuring and deploying the technology required to realise our transformational goals

The Masterplan

We have set out a comprehensive and ambitious Masterplan™ to reimagine the radiology service in our region by considering 3 main domains of transformation

• Common Practices
• Shared Core Services
• Processes and Workflows

Our beginnings

In 2016 YIC set about to replace the Picture Archiving and Communication Systems (PACS) of 8 Trusts simultaneously by contracting at scale with Agfa Healthcare to deploy their Enterprise Imaging platform to our Trusts. This enormous undertaking took place between Q2-2017 and Q3-2020 resulting in organisations aligned in core PACS technologies.

Technology

Choosing good technology, supplied by good industry partners has always been central to our success. Our technology programme team work closely with these partners to achieve smooth deployments in our member Trusts with as little disruption to clinical services as possible. By working in this way, YIC apply learning from each deployment to the next making even the most challenging of rollouts within reach.

A close working relationship between the technology programme team and the transformation team ensures that the YIC vision is always honoured in the design of the clinical IT systems. This makes sure that our tech choices solve genuine clinical problems and that our processes are not driven by the technology we use.

In May 2020 our regional clinical image and report sharing network (Xero Exchange Network) became fully operational during the early peak of the COVID-19 pandemic. Agfa and YIC worked closely to prioritise this work in anticipation of an increased need for telemedicine and the wide-area transfer of patients to Nightingale Hospitals.

The YIC team were seconded to NHS England to fulfil the medical imaging deployment of NHS Nightingale Yorkshire & The Humber which at the point of opening was already fully integrated to the regional record sharing solution. This has since been put to great benefit in opening the first of kind diagnostic imaging centre in Harrogate, allowing >3000 patients safe access to CT scans during the pandemic year.

In January 2021 YIC chose Intelerad as a new technology partner to help realise the ultimate vision of a regional patient timeline of medical imaging with associated reports. Their sophisticated workflow integration solutions will also allow YIC to replace private outsourced radiology reporting with a wholly NHS owned insource reporting network. The benefits from this transformation are extensive and far reaching.

Transformation

Our core vision is to improve processes and facilitate great clinical care by ensuring that medical images and reports are always available at the point of care wherever a consultation takes place. Although we could never have anticipated the value prior to 2020, our success has resonated in the era of remote consultation and the inability of patients to travel for care. It has forced us as a profession to challenge ancient paradigms of presence and migrate towards a more eclectic mixture of technology driven remote medicine adhering to the same underlying principles of good care.

Shared Core Services

Procuring large scale infrastructure together as a region makes sense in a healthcare system where 97% of patients receive care in region (data: 2017 YIC via GE Finnamore).

By operating services which scale well centrally as a region, greater benefit can be derived than with each hospital attempting to procure their own solutions and provide their own staff. This does not work for all services, but our early workshop style consultations identified the elements which scale well.

• Articifial Intelligence for enhanced disease detection
• Artificial Intelligence Business Analytics
• Distributed online messaging (Microsoft Teams)
• Remote meeting videoconferencing (Zoom, and now Microsoft Teams)
• A central Programme Support Team

Common Practices

Our programme is firmly rooted in its clinical underpinnings and is led by a Consultant Radiologist (Dr Daniel Fascia). Dan’s vision has always been that the experts remain the leading light in the direction of the service and the core design of its needs. YIC provide all of the support and infrastructure required to allow experts to be just that and not need to think about things like planning meetings, creating agendas and documents.

At the heart of our common practices we aim to standardise things which need to be, particulary tasks and documents which are tedious and repetitive but carried out by all hospitals. Through the adoption of a minimum data set approach we are not sufficiently prescriptive to restrict our organisations in their individuality but we promote the achievement of minimum standards.

Special Interest Groups

Special Interest Groups (SIGs) are regarded as our leading light. These groups of expert radiologists and radiographers, and a separate group for Service Managers meet to discuss topics with a need for standardisation or improvement. They share ideas and review evidence to shape and drive forward minimum standard data sets for

• Patient Advice Documents
• Scanning Protocols
• Reporting Standards and Templates
• Procedural Documents

We allow our SIGs to self direct whilst they are able to make autonomous progress but also ask them to review important topics nominated by the regional Medical Directors Forum (example: Cauda Equina Syndrome, Suspected Physical Abuse of Children)

Process & Workflow

The enormity of our transformation activity requires us to make changes to policies far beyond our area of expertise such as employment terms and contracts of working. Our extended relationship with hospital executive management departments enables progress in these challenging arenas such that traditionally difficult obstructions to progress are tackled.

• Cross site working governance
• Cross site credentialling of doctors and radiographers
• Remote working contract
• Payroll for cross site working