REACTS MAKES TELE-ULTRASOUND EASY AND EFFICIENT

Transcription

1 REACTS MAKES TELE-ULTRASOUND EASY AND EFFICIENT CIUSSS DE L EST-DE-L ÎLE-DE-MONTRÉAL Using Reacts, independent technologists at CSSS de la Pointe-de-l île can contact radiologists at Hôpital Maisonneuve-Rosemont in real time to review and discuss ultrasound exams. Better communication. Better efficiency. Better care.

2 Wait times for an appointment for an abdominal or pelvic ultrasound considerably exceeded standards for many years in East Montreal. The main hospitals, including Hôpital Maisonneuve-Rosemont (HMR), were unable to meet demand for this service within the service times recommended by the Ministère de la Santé et des Services sociaux (MSSS). CIUSSS DE L EST-DE- L ÎLE-DE-MONTRÉAL 2 Population served: Points of service: 43 Medical and specialized clinics: 71 Beds (short-term, long-term, mental health): Staff: Independent ultrasound technicians: 6 (variable) In December 2014, the MSSS proposed a solution: adding positions for independent technologists at Hôpital Maisonneuve-Rosemont, CSSS de la Pointe-de-l île (PDI), Hôpital Santa Cabrini, and CSSS du Cœur-de-l Île. Adding these technologists would increase the availability of abdominal and pelvic ultrasounds in this area, thus improving user satisfaction. This project, in line with the Centre de répartition des demandes de service (CRDS) ultrasound project, reduced the wait time for an ultrasound appointment from three years to only a few days. 1 What is an autonomous ultrasound practice? Following requests by the Ordre des technologues en imagerie médicale, en radio-oncologie et en électrophysiologie médicale du Québec (OTIMROEPMQ) and the Association des radiologues du Québec (ARQ), the MSSS introduced a certification process for an autonomous practice based on recognition of experience....

3 ... Wait time for an ultrasound appointment reduced from 3 years to a few days* The MSSS introduced a certification process in 2014; by 2018, there were approx. 350 certified independent technologists. The Reacts platform is certified by the MSSS and endorsed by the Canadian Medical Association. To be autonomous, a technologist must obtain/maintain an autonomous practice certification subject to conditions that include experience (determined minimum number of exams per year), external validation (letter from employer), and a minimum number of hours of ongoing professional training every year. In his or her day-to-day practice, the technologist works relatively independently, and a radiologist verifies the exam when necessary. *For the frontline clientele of East Montreal Island, referred by the CRDS and scheduled based on proximity. Lack of resources and technological constraints The arrival of autonomous technologists substantially improved the efficiency of the ultrasound service. But what were autonomous technologists to do when they needed the opinion of a radiologist during an exam at institutions without an on-site radiologist, like the CSSS PDI? In this case, outside radiologists (those at Hôpital Maisonneuve-Rosemont) needed to review the ultrasound exams....

4 ... The clinical need An efficient way for ultrasound technologists and radiologists to consult with each other remotely and to share high-quality ultrasound images in both real time and asynchronously. The technological need A collaborative solution that is easy to use, safe, affordable and that can reliably transmit live ultrasound images of adequate quality. To work around this constraint, the service thought of having a compact disc containing the ultrasound exam images delivered to the medical imaging department at the hospital. This turned out to be problematic because it meant the images were analyzed well after the exam was finished and the patient had left the CSSS. If the radiologist found that more images were required, a second exam had to be scheduled with the patient to obtain these. A solution for retransmitting the images through an orchestrating intermediary was developed by the Montreal Technocentre. This image routing system was effective for real-time analyses, but ultrasound videos could not be saved, and there remained the challenge of connecting two different PACS systems. To optimize the process, the Réseau universitaire integré de santé (RUIS) of Université de Montréal subsequently proposed the use of a videoconferencing system to connect the ultrasound system at the CSSS PDI to the Radiology Department at Hôpital Maisonneuve- Rosemont. This allowed the technologist to contact and share a live ultrasound exam with the hospital s radiologist in real time....

5 ... The solution Use of a secure, flexible, interactive, collaborative communication platform that allows the transmission of high-quality video streams. The technological component The Reacts platform was selected for its ability to transmit multiple high-quality video streams simultaneously and securely, in addition to offering an interactive set of collaboration tools, using existing equipment (computers, standard Internet connection, web cams, etc.). This live transmission of ultrasound exams by videoconferencing, together with image acquisition protocols specific to each clinical indication, meant that the autonomous technologists were able to practise independently and from a wider range of locations. When necessary, they could contact the assigned radiologist by videoconferencing in order to review the ultrasound images in real time. Adoption of the Reacts platform This operational model was initially useful and entailed certain benefits. Nonetheless, a number of impediments arose in short order, making it hard to deploy, adopt and use remote assistance by videoconferencing for ultrasound exams. The main challenges concerned the following points: the high cost of videoconferencing stations and technical support, mobility issues (i.e., the radiologist had to review the exam at a fixed station) and most critically, the suboptimal quality of the images transmitted live by the videoconferencing station was suboptimal, making it hard for radiologists to interpret them remotely. Given these limitations, the various stakeholders involved eventually agreed to retire the tele-ultrasound videoconferencing system; instead, patients were sent to Hôpital Maisonneuve-Rosemont when additional images were necessary....

6 ... The benefits Allows for rollout of a wide-scale, high-quality tele-ultrasound service easily, quickly and affordably with greater satisfaction among technologists and radiologists. Saving patients a trip for a second exam and reassuring them by ensuring that an expert can give his or her opinion live to optimize the quality of the ultrasound exam. After searching for a technological upgrade solution to relaunch the tele-ultrasound program, the team at CIUSSS de l Est-de-l Îlede-Montréal heard about the Reacts platform and its ability to simultaneously and securely transmit multiple video streams, in addition to affordably providing a series of interactive collaboration tools that are accessible from existing equipment (computers, standard Internet connection, web cams, etc.). Because Reacts is certified by the Ministère de la Santé et des Services sociaux and supported by the Canadian Medical Association, the platform met the project s security requirements. The Reacts solution allowed a significant reduction of costs and led to a wider-scale rollout of the tele-ultrasound service that was quick and easy. The Reacts solution also facilitated optimizing mobility by allowing radiologists to conduct Reacts tele-ultrasound sessions from their personal computer, tablet or mobile device. After a few trial sessions, the team at CIUSSS de l Est-de-l Île-de-Montréal decided to proceed with the implementation of the Reacts solution for their tele-ultrasound needs.

7 Reacts allows us to provide a high-quality tele-ultrasound service that is simple and easy to deploy. In addition to being affordable, it has helped us improve clinician satisfaction and provide better service. -- Janie Deschênes Division Head, Radiology HSCO IUSMM et Communauté CIUSSS de l Est-de-l Île-de-Montréal Hôpital Santa Cabrini Reintroducing tele-ultrasounds at CSSS PDI yielded direct benefits for patients, as they no longer had to return for a second exam, and reassured them because an expert was able to give a live opinion, thereby optimizing the quality of the exam. With its many benefits and advantages, use of the Reacts platform for tele-ultrasound will make it possible to roll out this virtual assistance modality in other areas of the province, which will improve the service offering and reduce wait times for an ultrasound appointment.

8 New program for medical ultrasound technologists A new college-level program for medical ultrasound technologists will be offered in Rimouski in the fall of The program will prepare students to become ultrasound technologists without first having to take the radiology technologist program. The introduction of this new program reflects the recognition by the Ministère de la Santé et des Services sociaux's recognition there is a growing need for more ultrasound technologists in order to improve service across the province. In this context, remote assistance and collaboration between independent technologists and radiologists through tele-ultrasound has come into its own and should grow significantly in the near future. Sources : 1) Janie Deschênes, Head of the Radiology Department, Hôpital Santa Cabrini, La télémédecine au service de l échographie, MedActuel, August ) Le Centre intégré universitaire de Santé et de Services sociaux de l Est-de-L île-de-montréal,

9 About Reacts Reacts (Remote Education, Augmented Communication, Training and Supervision), is a secure, integrated and collaborative platform created by Quebec-based Innovative Imaging Technologies Inc. (IIT). It was designed to suit the multiple collaboration needs of healthcare professionals and patients, and incorporates unique and unparalleled interactive features, such as augmented reality for remote virtual guidance, supervision and training. Reacts is presently deployed in 28 countries, across various medical disciplines in both clinical and educational settings, for applications ranging from secure messaging, remote wound care, tele-ultrasound, and teleconsultations, to interactive tele-surgical assistance and remote procedural supervision. Strategic partnerships include medical device manufacturers and healthcare innovation focused organizations such as Joule, a Canadian Medical Association company. For more information, visit:

10 Discover hyperpresence! Better communication. Better efficiency. Better care Innovative Imaging Technologies Inc. All rights reserved.