he Netherlands has been developing its National Breast Screening Service since 2016. Against the background of 1 in 7 women likely to develop breast cancer in their life time, it has long been known that early detection requires less invasive treatment and produces a more successful outcome. These were key parameters in the tender documentation that was administered under the BK2020 Programme and implemented in June 2019.
The Dutch breast cancer screening programme requires 2,9 million to be screened every 2 years, between the age of 50 and 75. It equates to 59 mobile and 10 permanent screening centres being set up across five Dutch screening organisations to offer screening as locally as possible; with images distributed to be read in 13 different locations (42 different workstations and over 5,000 examinations per day) - a large volume of digital images and reports are generated. Mammography equipment, screening centres, reporting establishments, data warehouse facilities and referral centres hence all need to connect seamlessly and be capable of fully interoperating.
The tender specifications call for an architecture based on IHE XDS and XDS-I, the widely used IHE Profiles for sharing images and reports. It also stresses the need for each supplier to participate in an IHE Connectathon to ensure compliance to the latest IHE Profile version.
Paul Hoogland, the BK2020 Programme Manager, said “It was essential that all modality suppliers, PACS / IMS suppliers and their electronic client files were fully compliant and continue to be so. We used the IHE Gazelle test tools to ensure 100% conformity for each stage of the imaging and information chain. With all workstations and reporting locations connected through a single Exchange Portal we made the specifications totally transparent but non-negotiable”. He added, “We have an annual referral rate of 2.5% of women who require further examination and it is hence essential that all images and reports are available quickly and accurately at the hospital where further examinations / procedures take place. We have also eliminated paper transactions from this entire chain. The workflow of the five screening organisations has been aligned to enable all-important benchmarking. Women are receiving a rapid turnaround and follow up, treatment can be scheduled and commenced quicker meaning better outcomes and increased survival rates. It is a win-win for everyone”.
The use of the IHE Profiles and IHE Connectathon testing has ensured the Dutch government in saving money, having accurate data at all times, enabling the Dutch Health Council to clearly decide its direction of strategy. Above all it is giving patients significantly better outcomes and standard of care.
For further information on the BK2020 programme email Paul Hoogland.