Information and Communications Technologies
Radiology Information System
Wakefield Radiology uses Radiology Manager (Radman), a radiology information system (RIS) "developed specifically for the New Zealand Radiology Marketplace" 2 by Custom Made Solutions. This system computerises all of the patient details, working papers, reports, and other documents that were previously kept in blue folders. It also allows for scheduling of patient appointments, invoicing for procedures, and includes a security option whereby certain patients' files can be restricted so that only medical staff with a fob reader and password can access them. Consistent with their claim to be in the forefront of radiology, Wakefield Radiology is the only site in New Zealand with this cutting edge software. The RIS is used for all of the services performed at Wakefield Radiology.
Digital Imaging Technology
All of the radiology services offered by Wakefield Radiology are now film-less except for mammography. The technology they use is computerised radiology. This involves using a digital phosphor rather than traditional film, generating a computer image that can then be manipulated by the radiographer. Before computerised radiology, teleradiology was the technology used. Here, traditional methods are used to generate images, and the film is then digitally scanned to create an electronic copy of the images. This method is inferior to computerised radiology as the scanning of film inevitably results in lost detail, but it does allow much easier distribution of images (through computers and the Internet) than traditional methods. Teleradiology is still used at the Masterton branch of Wakefield Radiology because bandwidth problems between Masterton and other branches mean that computerised radiology is not feasible.
Picture Archiving and Communication System
A picture archiving and communication system (PACS) allows Wakefield Radiology to view, store, and distribute images electronically. An image can be produced in one location, transferred electronically to a different location for a radiologist's interpretation, and then sent on to a medical practitioner via the Internet.
Internet
A problem that must be addressed with digital imaging technology is the size of the electronic images created. Whilst a typical word processing document like this case study may be around 100KB, a typical radiology image may be several hundred times this size - sometimes hundreds of megabytes in size. Moving these images around, both within a site and between sites requires distribution networks with very high capacity. The packet header alone for a DICOM image is 1MB, illustrating the huge bandwidth needs for radiology practices that have gone digital. It also has to be undertaken on networks where privacy must be absolutely guaranteed due to the highly personal nature of the medical images being moved. According to Trevor, "broadband is essential [for the business], but very expensive". Wakefield Radiology uses Wellington's CityLink network with a 100Mbps connection linking its city and Newtown sites to satisfy their high bandwidth needs. This is an astonishingly high bandwidth connection capacity compared to the needs of most businesses, but is essential given the volume and size of the images the firm transmits every day. Without the CityLink backbone, the electronic environment of Wakefield Radiology would not have been economically viable.
Unfortunately, the CityLink network does not extend out of the central Wellington region, so alternative connections have to be used to link the Johnsonville and Masterton Rooms with the CityLink "portal" campus at Lambton Quay. The Johnsonville Rooms are connected to the network by a TelstraClear fibre link. This dedicated line allows a private and secure link between the CityLink campuses and the Johnsonville branch, with a connection speed of 10Mbps. This has just become economic with the line rental price reducing. Prior to that, radiologists were linked to the Johnsonville rooms by an unreliable wireless connection. Because of the need for speed, this technology has been chosen over Jetstream. The Masterton Rooms, however, are linked by a Jetstream ADSL 2Mbps connection. Problems encountered with this connection include lost packets, much lower speed, and the asymmetrical nature of the ADSL product, but at current prices a private line is considered too expensive given the volume of information that travels to and from the Masterton branch.
Website
Wakefield Radiology has a comprehensive website, with information about the organisation and the services they offer. The website contains locations and maps of each of their six branches, contact details and pictures of their key staff, descriptions of their technology and equipment, schedules of procedure costs, and frequently asked questions. This information is very useful for patients and others who wish to gather information not only about the firm, but also about radiology technology, equipment, and procedures.
The primary intention in developing the website was to increase awareness about Wakefield Radiology services and to distribute information, including costs and pre-imaging instructions, to patients and referring practitioners. It also enables referring practitioners and the general community to receive news updates about the practice. Its implementation was an integral part of the practice's strategy to provide a high-tech, leading edge image to patients and referrers.
In order to keep the website at the "cutting edge", information on it is maintained and reviewed on a monthly basis. Trevor says that there have been real increases in both client and public awareness of the practice since the website has been operational, and that it has contributed to the measurable increase in market share that the business has enjoyed. In Trevor's assessment, the gains in increased competitiveness and market share have more than justified the costs.
Back to Top