St. Mary’s Hospital, Vunapope

SonicDICOM PACS Cloud can reduce healthcare disparities in remote areas

St. Mary’s Hospital, Vunapope - Dr. Chris Arthur, Honorary Medical Officer

The high availability of SonicDICOM PACS Cloud has helped to reduce health care disparities in Papua New Guinea, where 85% of the population lives in rural areas, and has enabled access to digital high quality images from remote locations. We asked Dr. Chris, Honorary Medical Officer of St. Mary’s Hospital, about the changes.

Healthcare Challenges in Papua New Guinea

Papua New Guinea is a low-income nation characterised by a rugged terrain and a very dispersed population, 85% of whom live in remote and rural settings. Consequently, access to diagnostic radiology is difficult. Many individuals live far away from diagnostic facilities located in the main townships, which means that a visit to a regional centre with Xray facilities must make maximum use of the Xray images. Patients may not be able to return to central healthcare facilities and so distribution of X-ray results to the referring doctors in remote locations is critical.

Dr. Chris Arthur, Honorary Medical Officer

Making X-ray images available

St. Mary’s Hospital Vunapope, in Kokopo, the capital of East New Britain recently acquired a Siemens MULTIX IMPACT X-ray machine. However, we discovered early after the installation of the X-ray that there were problems with access to X-ray images when patients returned to clinics for follow up. In the past a hard copy X-ray film was available but these were often lost or difficult to retrieve. The hospital does not have a hardware local network based PACS system for viewing X-rays. Furthermore, it was impractical to give patients a copy of their X-ray images on a USB or CD disc. As a “workaround solution” images were being shared by photographing the X-ray monitor and sharing images over Media platforms such as WhatsApp in a format not dedicated for medical imaging. This resulted in significant loss of image quality potentially leading to misdiagnosis.

Found the ideal Cloud PACS

The need for access to high quality digital images available in remote rural locations led me to explore various cloud packs solutions. Cellular networks are fairly widespread even in remote locations and in many places there are satellite dishes for internet access. Hence it has been my experience that most health centres have now been able to access X-rays taken at the centralised health facilities where the X-rays are taken. Internet access costs Papua New Guinea is poor and for this reason others had dismissed the idea of setting up a cloud PACS service. However, in recent years cellular networks with at least 3G or 4G capacity are available even in many remote locations. During a trial of cloud PACS services we discovered that cloud PACS solutions could work.

Sharing images and clinical reviews

We also use the X-rays to facilitate patient review at clinical meetings, handover and case review. We purchased a large screen 4K television and we can now display the previous days X-rays to facilitate clinical review and case discussion. We also wanted to make images available across the whole Province for X-ray image access on patients referred to or from another facility such that the referral clinicians could review the X-ray online.

Why SonicDICOM Cloud PACS?

After testing and trialing various commercial cloud-based services and comparing pricing and usability, I chose SonicDICOM PACS Cloud. Firstly, the option of a hardware based local network PACS was very expensive and required a very good functioning local hospital network which we do not have. Furthermore a local network based PACS can only be viewed from within the hospital network but by using a cloud PACS the images can be viewed anywhere with an internet connection.

Easy installation, fast image display

Firstly, the option of a hardware based local network PACS was very expensive and required a very good functioning local hospital network which we do not have. Furthermore a local network based PACS can only be viewed from within the hospital network but by using a cloud PACS the images can be viewed anywhere with an internet connection. I tested 3 different Cloud PACS services and I thought that the Sonic DICOM cloud PACS provided the best option from cost and functionality and did not require any additional hardware unlike one other provider.

Of the seven Cloud PACS servers, the hospital uses a server in Singapore, which is the closest to Papua New Guinea. Due to this geographic distance, there was some lag with image display on line but overall it was acceptable with most images loading within 20 seconds.

Accessibility from anywhere resolves geographical difficulties of PNG

The Cloud PACS has the capability to provide on-line access to X-rays anywhere within the Province of East New Britain. This is important because patients move between facilities and previously it was difficult to share Xray images between referring and referral hospitals. This has been overcome with Cloud PACS and even provides a pathway to make Xray images available nationwide. This is important since there are only 2 tertiary referral hospitals in PNG and so many patients who are referred to a national referral hospital can now have their X-rays available to the referral specialists.

Backup Storage Eliminates Anxiety Due to Power Outages

Another important aspect is that SonicDICOM provides backup storage for all of our X-rays. Frequent power outages and unstable power supplies in PNG sometimes lead to corruption of data on the local computers.

Excellent assistance of the support team

St. Mary’s hospital does not have a dedicated IT support staff and so the installation and troubleshooting had to be done by me. I have only moderate computer skills and I could not have completed the setup of the cloud PACS without technical support from SonicDICOM support staff. All of my questions were answered and there was always rapid and comprehensive support from SonicDICOM.

Favorite function of SonicDICOM PACS Cloud

I really like the ability to view digital quality X-rays from anywhere in the world and this allows me to seek advice from international colleagues. I value the ability to load non-DICOM files into a patients file set. This allowed me to upload clinical images of a patient as well as pathology reports and put them side by side in a multiple window arrangement. This greatly facilitates a multi-disciplinary review or other team meeting. It is also great for teaching purposes when trying to do clinico-pathological correlations.

St. Mary’s Hospital, Vunapope

Location	KOKOPO, East New Britain, Papua New Guinea
	Provincial Health Service Cheif Executive Officer: Dr. Ako YAP
	Catholic Church Health Services, Chief Executive Office: Sr. Maria Posanek