What key requirements did you specify
at the beginning of the ambitious telera-
diology project in Lower Austrian Hospital
We had two core requirements: We wanted a
location-independent direct access to diagnostic images and process data of all connected
institutions and their respective IT systems.
And we wanted a global work list that enables
doctors to work with their standard RIS using
not only clinical reports of their own site, but
to virtually zoom into all other sites’ systems
and work there without having to leave their
How long did you take to identify a suit-
The whitepaper “Teleradiology”, which was presented by the European Society of Radiology (ESR) in 2006, essentially outlined a
blueprint as to how this can be implemented based on IHE profiles.
However, at the time, there was no one on the market who could implement this, so the hospital holding started a process in 2009: We
modelled a system and looked for industry partners that were willing
to implement it. At the end there were only two contenders. GE was
awarded the contract.
Which special challenges had to be overcome?
As we didn’t want to copy images or clinical reports, but wanted
to implement a direct access, we needed streaming technologies,
which were available. However, what was needed as part of the project was the implementation of all RIS transactions in a 100 per cent
web-based system. Another challenge was that the system had to
be able to process different terminologies. We can’t tell our referring
physicians how to work. That’s why we had to develop a terminology
system that uses RSNA RadLex as ontology that can consistently
adopt the best features of other terminology systems.
What does the everyday life of a radiologist working with
data from across different sites look like?
Let’s take a primary care facility with an ordinary radiologist without
Can you give any more specific examples?
his own CT. For the diagnostic assessment of a trauma this radiolo-
gist would like a brain scan. He requests this as well as a chest X-ray
in his system. The middleware detects that parts of the order must
be performed elsewhere, splits the order, and assigns the different
components of the job to each respective lo-
cation where they can be performed. Overall,
the architecture is very well suited to implement
decentralised trauma networks, as they are pre-
dominantly used in countries with large areas
and low population. Due to streaming technol-
ogy multiple doctors can participate in the de-
cision-making process regardless of where the
patient is presently located. And after a patient
has been transferred, the respective doctors
can continue working exactly at the point where
treatment stopped before the transfer. This
increases productivity, but above all, it is of
enormous value for the patient.
A second specific example is oncological care, in which non-hospital
doctors and hospitals work closely together. This is facilitated by the
cross-institutional platform, especially because the doctor who treats
a patient face to face can immediately access all relevant medical results, including images. Finally, we also have traditional teleradiology
scenarios such as telediagnosis at night and on weekends. For this
we use the global work list that allows the diagnosis directly in the
connected systems, regardless of the radiologist’s whereabouts. The
doctor can also access his individual voice profiles from any location
and use it for any connected RIS.
What impact does the teleradiology platform have on pro-
ductivity and costs?
Overall, in view of the increasingly serious lack of doctors, I think the
discussion should be foremost about quality of care. And hopefully
we will soon be able to provide figures on that. In a scientific evaluation supported by the Federal Ministry of Health, we will examine
whether therapy costs are reduced because doctors have better access to clinically relevant findings, among other things.
The Lower Austrian Hospital Holding (Niederösterreichische Landeskliniken-Holding) has implemented a comprehensive
radiology collaboration system currently comprising four hospitals and several private outpatient centers in the “Waldviertel”
at the gates of Vienna. The system was jointly developed with GE Healthcare and is based on GE’s Centricity™ Solutions
for Enterprise Imaging. Project Manager Alexander Bernegger, Head of the staff function Information Technology at Horn
Hospital, which is part of the holding, considers this to be an international ground breaking solution that is particularly
relevant in times of demographic change.
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