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Getting it Right First Time (GIRFT) in Radiology

Radiology is part of the diagnostic pathway for almost every speciality and demand is growing. In November 2020, the Getting It Right First Time (GIRFT) Programme published its National Speciality Report for Radiology, which looked at how we could increase capacity in radiology within the constraints of COVID-19.

The report outlined the challenges found in radiology and set out a series of recommendations to improve services across the NHS. In this blog, we highlight the main takeaways from the report and discuss how we are addressing these with Cris and Cris Connect.

Delivering safe and respectful services to patients

Many radiology departments are delivering high-quality services in poor-quality environments with little space to adequately care for patients. The pandemic has further exacerbated the issue with social distancing now mandatory in waiting and treatment rooms.

To address the need for space while also ensuring continuity of care, our Patient Attend feature for Cris allows radiology departments to accommodate social distancing measures in line with COVID-19 guidelines. Patients can check-in for their appointments remotely and simply wait to be notified, removing the need to enter the hospital, or to sit in a waiting room until absolutely necessary.

Making imaging more convenient

The GIRFT report highlighted the benefits of delivering a patient-centred service, giving patients the ability to arrange a time and place to suit them and ensure optimum safety. There are also multiple benefits to the provider. Shorter wait times before scans leading to faster reporting not only enables earlier diagnosis and treatment, but also helps reduce pressure on emergency departments.

Cris Scheduler is a visual representation of a dynamic work list, enabling booking clerks, radiographers, and radiologists to see the journey of a patient as they move through the department, from arrival and examination to the time they left. Where enabled, the solution can also display availability across different hospitals, or across a diagnostic imaging network, allowing booking clerks to easily identify available appointments for primary or follow-up procedures from a wider pool of availability.

Making improvements in reporting

GIRFT made recommendations to increase the number of scans reported on from home to ensure faster results for patients.

Remote reporting breaks geographical boundaries and allows radiologists to review scans from remote locations, for example if they are working from home. Furthermore, our solutions enable radiologists and resources across different organisations to collaborate and maximise access to scarce or specialist skills, therefore optimising imaging and reporting capacity within a region. Our Cris and Cris Connect solutions can make this a permanent reality.

We also introduced Microsoft Teams integration within new Cris Vetting to allow radiologists to communicate directly with the referring clinician. The new feature also enables MDTs to meet virtually to discuss urgent matters, reducing delays in diagnosis and providing more efficient use of resources.

Cris Analytics is a highly customisable module that provides a web-based visual overview of radiology activity. It allows senior management to plan and make informed decisions based on criteria such as outstanding appointments, reporting turnaround times and DNAs, all of which are presented in a single dashboard. Unlike other Business Intelligence tools, which traditionally generate 24-hour snapshots, Cris Analytics provides real-time data from the department for up to the minute updates, and when deployed across a consortia or region, it supports cross-organisational planning.

New PACS and RIS that adhere to RCR guidelines

Supported by active customer engagement, our radiology industry experts ensure that Cris meets all relevant clinical and corporate standards, including RCR guidelines for reporting, peer review and image sharing.

Cris meets the vetting criteria set out by the RCR in Clinical Governance and Revalidation: A Practical Guide, which is in place to justify an investigation including appropriate use of imaging, radiation safety, and judicious use of resources. We are also introducing a 5- and 7-point checking system for patient identification to allows users to check and record the patient before proceeding.

Capital equipment purchase to reduce costs

The report mentioned the need to reduce costs on capital equipment purchases. We offer flexibility when it comes to contracting, including a managed service approach, where a customer is required to spread the cost of the initial capital purchase across a contract timeline to aid budgeting. Or we can offer a capital approach, where equipment is purchased at the outset, to keep ongoing costs to a minimum.

The key is to ensure there are no financial surprises along the way, therefore it is important to ensure systems are future proof with capacity for expansion, as services inevitably continue to grow, with options to refresh infrastructure at predetermined contract milestones.

Decision support tools

The report recommends that all referrers should adopt robust clinical pathways supported by clinical decision-making tools, which could also include the introduction of Artificial Intelligence (AI).

The authors acknowledge the potential of AI to improve care, accelerate diagnosis and free up staff time. According to the Topol Review, around 50% of radiology reporting could be supported by AI within the next decade.

We launched AI Connect to make the introduction of AI in radiology as simple and effective as possible. It enables hospitals to adopt different AI algorithms from a growing selection across multiple disciplines. This standardises the introduction of AI and provides seamless integration with existing reporting workflow to support workload prioritisation and help identify and manage priority cases.

Outsourcing vs insourcing

The NHS reportedly spends £120m per year on outsourcing, which is necessary because demand significantly outweighs reporting capacity. Since demand and complexity continues to grow, it is likely that some level of outsourcing will always be required. To assist in the process, we work with teleradiology companies, to provide integration and optimise the workflow between remote organisations. However, the NHS is motivated to reduce outsource spend, which is where Cris Connect can help, particularly with the establishment of sharing networks.

Underpinned by existing local PACS and RIS solutions, Cris Connect simply connects the dots to enable organisations to share capacity and specialist resources across and between regional networks. It supports better capacity management and optimal ways of working, therefore offering the potential to reduce outsourcing expenditure.

Getting It Right First Time (GIRFT) is a national programme designed to improve medical care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.