Multimedia PACS networks healthcare services on the Balearic
8 April 2008
All public hospitals and about 80 primary health centres
in the Spanish
region Islas Baleares are building the foundation of a health
service network which is unique in Europe for its scope and depth of
Using a master patient index, Balearic doctors can
access patient data and medical results anytime. Via a web-viewer
solution they are able to retrieve digital data, films and
radiological images wherever they are located.
The centralised multimedia archive solution in the Son Llatzer Hospital at Palma de
Mallorca offers radiology images, extracts of endoscopy treatments,
dermatology patient images or data out of ophthalmology exams to all
This is all based on GE’s Centricity PACS with an advanced
infrastructure and DICOM
capabilities. Effective processes not only cut down on costs but
also can reduce a patient’s stay in the hospital.
The success story of the Balearic Islands ehealth project began
in 2001 with the building of the Son Llatzer Hospital and the
plan for a digital operation throughout the site.
To lead innovative ideas to success requires more than just
With Luis Alegre Latorre, Director Asistencial IB-Salut and Miguel
Cabrer, eHealth Advisor, the project found the support of two
visionaries who were able to recognize trends and implement them
successfully. Within five years they developed the Son Llatzer RIS/PACS
project into a regional ehealth solution with
referrer’s portal and a central multimedia archive.
Latorre comments: “The success of this project demonstrates that you can
streamline processes and save costs in healthcare with the help of
modern IT solutions.” The realisation of this vision is a result of
good cooperation between all parties involved and a professional
project implementation by GE Healthcare.
From PACS to ehealth
Following the implementation of the radiology
solution, the chief medical officers and the hospital
management of Son Llatzer recognized the enormous advantages of an
enterprise-wide digital image and data distribution in radiology.
"Nobody needs to wait a long time anymore for radiological data. Via
intranet, all images are available on demand, immediately, and no
matter where you are in the building. The wish for a similar
solution in dermatology came up fast,” said Miguel Cabrer.
Just at that moment the national healthcare policy in Spain
changed. In 2002, the central administration of public
hospitals was delegated to the regions by the national government.
The Islas Baleares region — as did all other
regions in Spain — founded IB-Salut, their own healthcare
enterprise, which directly reports to
the regional Ministry of Health and Consumer Service. All regional
health services received a budget to ease the start into the new
For Luis Alegre Latorre, this meant the expansion of
the Centricity RIS/PACS into a regional ehealth project. Based on
the positive experiences with this solution in Son Llatzer hospital he was convinced it would be successful.
“In the meantime, the University Hospital Son Dureta, the Manacor
Hospital as well as the Can Misses Clinics in Ibiza and one hospital
in Menorca were endowed with a standardised Centricity RIS/PACS
solution. Moreover, a total of about 80 primary health centres (PHCs)
are connected to the network,” says Luis Alegre Latorre, who is
to share the success of this investment. The remaining hospitals are
about to be equipped.
One central databank for all patient images
The total healthcare network on the islands achieved a depth of
integration, which is
unique across Europe. Usually ambulatory exams in Spain are provided
in so-called primary health centres, where various medical specialists take care
of the population.
Via an online portal, doctors of PHCs have direct access to the
electronic documents of
their patients. The Baleares already use a master patient index,
which allows physicians
in any PHC to retrieve electronic records of any registered patient.
In reality this means
that an inhabitant of Menorca who unfortunately has an accident, for
example, in Mallorca
or Ibiza, easily releases all personal, relevant medical data in all
PHCs and clinics at the
push of a button.
Dr Carmen Martinez:"With
our modern worklist management any
clinician or GP can send an examination request to the RIS."
In the radiology department of Dr Carmen Martinez, Cap d'Unitat de
conventional films and images never existed. In Son Llatzer,
the radiologists work
on integrated RIS/PACS workstations. The moment they dictate the
medical results, the speech-recognition system assures that the report is finished
soon after the treatment, saving time and money.
Minutes after a radiological exam, images and subsequent diagnosis
are available throughout the total network of the community. Exam requests also
come directly via the web, no matter if it is for in- or out-patients transferred from a PHC.
A little more than
one million people live on the Balearic Islands and profit
enormously from the
integrated network of their healthcare system. Clinics and PHCs
have already started
projects to further improve patient care.
During a stroke every second counts. The University Hospital San Dureta is the only
medical centre of the region with a special department for stroke
patients. Thanks to the
centralised image archive, the ‘stroke unit’ specialist can already
prepare an exam for the
suffering person while he/she is still in transit to San Dureta.
The Dermatology Institute in Son Llatzer established a
teledermatology project with a
selected primary health centre. For example, a primary health
eczema, converts the data into a DICOM (digital imaging and
medicine) compatible format, sends it digitally to the PACS and
finally transfers the
image to dermatologist Dr Rosa Teberner Ferrer at the Son Llatzer
Retrieving images within a
second makes the work of dermatologist Dr Rosa Taberner
Ferrer much more efficient.
image we can immediately decide if the patient needs to visit us or
can be further
examined by his private practitioner,” said Rosa Teberner
Ferrer, from her first and
very positive results of the study. The main advantage she derives
from this network is
the digital image archive. Previously, when slides
she rarely had the possibility to compare images of older skin
diseases during an exam.
Today the dermatologist is able to not only compare different images
with a few clicks on
her screen, but is also able to consult a huge dermatology images
tremendously improves her daily work routine.
Telemedicine reduces costs
Dr Carlos Dolz reviewing
Her colleague Dr Carlos Dolz from the Endoscopy Department also
greatly appreciates the advantages of the digital image archive.
From any of the 550 computers in the hospital, he can easily
retrieve digital images and videos of endoscopy sequences via GE
Healthcare’s Web-Viewer. Moreover, he can easily compare endoscopy
images. This increases the safety of diagnoses. Dr
Carlos Dolz commented, “Thanks to the multi-media PACS, images and
medical records are available ubiquitously. This is the decisive
advantage of a digital workflow.”
Intelligent image data management beyond radiology and cardiology
is still a future wish in many other European countries. In
Mallorca, Menorca and Ibiza this is already reality. Doctors archive
the different images of dermatology or endoscopy findings by means
of a so called ‘DICOMizer’ in a DICOM format, a standard protocol
for medical applications. The Medical Images Organiser (MIO) by C2C
helps to allocate the specific patient information to the
The digital workflow in Son Llatzer drives efficiency and
profitability. JM Campuzano Casasayas, Director Gerente says,
“Modern IT solutions are a key factor for the success of a
healthcare enterprise. IT improves the whole cycle of care a patient
goes through during his stay in the hospital and thus significantly
helps to save costs and time.”
The investment truly pays off, according to the hospital manager.
This is especially the case when all clinical work steps are
following the digital workflow as in Son Llazer. In other European
hospitals ward physicians still show radiological films to their
patients. Thanks to Web-Viewer, in Son Llatzer, a doctor is able to
bring his small laptop directly to the patient’s bedside where he
explains the medical findings.
Luis Alegre Latorre said: "With the regional solution on the
Balearic Islands, IB-Salut demonstrates that ehealth not only
functions but pays off.”