Luxith,

Luxemburg

The four Luxembourg hospital groups went operational with the archive between June 9 and July 9, 2021. Despite the Covid-19 pandemic, the implementation went smoothly, due to the careful planning and full participation of all the stakeholders.

“The workshops that were part of the competitive dialogue process played a big part in the project’s success. Whether we were discussing use cases or very technical aspects of the infrastructure, the right players were always there, including from the hospitals.

This enabled a lot of transparency on what the hospitals wanted, and what the technology would allow. If a hospital asked for something that wasn’t possible, the vendors’ experts could explain why.

This was key for managing expectations in a project with multiple stakeholders,” Géraldine describes.

“It was not always an easy process,” adds Christophe. “When you bring several experts into a discussion, they need to find ways to listen to each other and think beyond their own area of expertise. There are many different perspectives in a large-scale and complex project such as this one, and each is valid.”

“Whenever you have a major IT project, there will be surprises, but we were prepared for them. For example, the evolution of imaging towards more precision scanning impacted imaging volumes beyond our forecasts. But mostly our expectations and projections were confirmed.”

The archive is not a single repository in which all images from all the hospitals are pooled. Instead, each hospital has its own, separate space within the single VNA. Images are thus not shared directly between hospitals. Instead, each archive is linked to the eSanté health portal, and image sharing goes through the patient’s DSP.

“This was a purposeful choice, ‘security by design’,” says Christophe. Even before the passing of the GDPR, the Luxembourgian stakeholders were highly focused on ensuring data privacy and security. “Our expectations and requirements went beyond what was common at the time. We needed a pioneering approach – which we got.”

The hospitals are already feeling some of the benefits of the shared archive and easier image sharing. “Previously, when hospitals shared an image from one PACS to another, the image actually moved from the first hospital’s PACS to reside on the second hospital’s PACS, which meant the originating hospital lost control over it.

As a temporary solution, and to comply with the GDPR, we used image cloning. But that was really a band-aid. Now, with ANIM, doctors and patients can access the patients’ images easily and securely, without any extra effort from the hospital. In addition, the hospitals have freed up archiving infrastructure in their own systems, which they can use for other, value-added purposes.” There are still some areas for future development, Christophe emphasizes. “With the current sharing system, physicians in one hospital cannot do side-by side comparisons with images from another establishment. Also, only recent images may be shared. This has nothing to do with the solution itself; it is to ensure data privacy and comply with the GDPR. For oncology in particular, access to more historical images would have been a big benefit. But both of these will be solved over time.”

He concludes, “I don’t want to say the project is ‘finished’, because it is intended to advance and expand; there are always new needs to consider and to meet. Furthermore, the imaging sector in Luxembourg is evolving, and we will have to be ready for the changes. But certainly, this was the big goal we had been working towards for quite a while. It is a major accomplishment.”