Excellence and innovation in veterinary practice
Newmarket veterinary surgeons, Rossdale & Partners, are one of the world leaders in equine medicine and surgery. Over 53 years, the practice has expanded into a large first opinion, emergency and referral practice, diagnosing and treating valuable bloodstock and performance horses as well as well-loved horses and ponies used for pleasure purposes. The practice, located at the headquarters of the UK’s thoroughbred racing and breeding industries and now in rural Hertfordshire, offers 43 veterinary surgeons with broad and specialist equine veterinary expertise and employs over 120 lay staff.
“The introduction of Apple technology, OsiriX (a Mac-based open-source medical DICOM viewer) and our Eclipse practice management software throughout all our sites allows us to access client, horse, clinical, digital imaging and pathology information in the most time-efficient way, even remotely.”
Professor Sidney Ricketts, Rossdale & Partners
Rossdales Equine Hospital and Diagnostic Centre, at Exning, near Newmarket, sees an increasing number of referrals from veterinary surgeons locally, across the UK and other EU countries. At Beaufort Cottage Stables, in Newmarket, the ambulatory veterinary surgeons are regular visitors to racing yards, stud farms, livery and competition yards, and private stables. Also at the Newmarket site, Beaufort Cottage Laboratories provides a dedicated equine pathology service. Rossdales Hertfordshire, in Weston, Hertfordshire, opened in 2012, following a merger with a long-standing referral practice, and serves local pleasure and performance horses. Its surgical, medical and pathological referral needs are serviced at Newmarket.
Secure, efficient communication between the three sites and the distinct areas of the practice are of vital importance. Retired Senior Partner and now Consultant, Professor Sidney Ricketts, originally recognised that a solution was required that could link all the information processes into one system, whilst enabling instant information sharing within the practice and with clients. Working with IT solutions specialists Systems Support of Cambridge, Rossdales has gradually replaced, expanded and linked all of the practice’s varied computer systems to incorporate state of the art Apple technology.
Introducing Apple technology
“The introduction of Apple technology, OsiriX (a Mac-based open-source medical DICOM viewer) and our Eclipse practice management software throughout all our sites allows us to access client, horse, clinical, digital imaging and pathology information in the most time-efficient way, even remotely,” says Professor Ricketts. “This has helped us to improve the quality and efficiency of the services that we provide. OsiriX and Apple technology, with Eclipse, have helped revolutionise our working practices.”
Mac mini, iMac, Mac Pro and MacBook Pro are installed throughout the practice, as appropriate to the site and task. For mobile working, Rossdales issues field staff with the latest iPad or iPhone. The Apple product portfolio provides veterinary surgeons and staff instant access to their own password protected client information, animal details, clinical history, radiography and scan results, pathology reports, as well as billing and other routine data, from any workstation. Diagnostic work can be carried out on or off-site, with off-site results recorded on portable digital imaging equipment (e.g. radiography and ultrasound) and later downloaded onto the Eclipse picture archive and communications system (PACS). The migration from mostly PCs to mostly Macs, in clinical areas in particular, has been greeted positively by even the most sceptical members of staff. Professor Ricketts says that staff appreciate a short learning curve when new technology is introduced.
“Setting up Rossdales Hertfordshire within such a short timescale was made considerably easier. The equipment was easy to configure and, though new administration staff had not used Macs before, they adapted very quickly.”
Professor Sidney Ricketts, Rossdale & Partners
Sarah Powell, Andy Bathe, Sarah Boys Smith and Marcus Head are responsible for Rossdales Equine Diagnostic Centre and are experts in clinical diagnostics and orthopaedics. When a lame horse is referred for a definitive diagnosis and recommendation for treatment, they and other colleagues undertake a detailed clinical examination to identify the potential problem areas prior to carrying out diagnostic imaging. Sarah Powell is a European specialist in veterinary diagnostic imaging and partner responsible for Rossdales digital imaging services, which include radiography, ultrasonography, nuclear scintigraphy (bone scanning), magnetic resonance imaging (MRI), and computed tomography (CT). Any combination of these techniques can be used as appropriate to assist the accurate diagnoses of more complex conditions. Accurate definitive diagnoses are essential pre-requisites for effective treatment, the success of which can be observed by sequential monitoring and repeat imaging.
Rossdales clinicians use OsiriX, running on the Mac platform, to view images on any of the Mac workstations located throughout the practice. Images can be edited for maximum quality and clarity, labelled and archived via the Eclipse PACS system. They can be securely shared with other veterinary surgeons throughout the practice, with referring veterinary surgeons, and with clients. “OsiriX has completely changed the way we handle our diagnostic imaging,” says Marcus Head. “Retrieval of images from our PACS to any of our networked workstations allows side-by-side analysis of previous assessments and rapid, on-the-spot decision making. Clients enjoy being able to see how their horses progress with treatment, and the viewing quality on the Mac screens is excellent.
“The Retina display on the MacBook Pros is incredibly effective for image analysis. The more powerful processors combined with increased memory enable us to manipulate and render 3D images more quickly for pre-surgical planning.”
Marcus Head, Senior Associate, Rossdales Equine Diagnostic Centre
He continues: “I can take images with me on my iPad or laptop, or download them remotely over our web-based access system or VPN. We now deal with DICOM images at every step, so we’re always looking at the best data quality – exactly as it was intended to be seen, wherever we are.”
Where radiographic and ultrasonographic examinations are unable to provide the full picture, the exceptionally high quality of the images derived from CT and MRI scans enable Rossdales to make a diagnosis more accurately and treat patients more efficiently. CT slice images can be processed into 3D files, which can be reconstructed to show bone and/or soft tissue in precise detail, while MRI is excellent for providing further information about the soft tissues and also the chemistry of the bone.
“Using a MacBook Pro running OsiriX I can view and manipulate DICOM images of any modality from the comparatively relaxed working environment of my office rather than working from one of the busy radiology workstations located within the imaging suite,” says Sarah Powell, “DICOM studies can be pre-fetched from our PACS to my personal laptop, enabling large image data sets to be automatically downloaded and ready for viewing and manipulation when I return from carrying out the CT or MRI scan.”
But the system doesn’t just function to make radiologists’ lives easier. Powell continues: “Three-dimensional reconstruction of 2D CT slices is invaluable for illustrating complex anatomical areas to our surgical team. It also allows us to discuss complicated equine conditions with horse owners in one of the dedicated consulting rooms within the practice, rather than the more imposing environment of a medical imaging facility.
“The ability to download DICOM studies from the web-based PACS server allows me to retrieve, view and manipulate images whilst travelling abroad. The OsiriX application for iPhone and iPod touch enables me to carry salient images with me at all times for discussions with colleagues working within my speciality.”
Sarah Powell, Partner, Rossdales Equine Diagnostic Centre
Rossdales specialist surgeons, Professor Tim Greet, Richard Payne, Andy Bathe, Sarah Boys Smith and Lewis Smith agree that having Apple iMacs in their surgical suites is a great advantage to enable digital imaging studies of the surgical patients, immediately before, during and after surgery.
- Eclipse (4D)
- FileMaker Pro
- Microsoft Office for Mac