Metro North Health

Metro North Health faced a significant challenge. The Australian health service’s clinical imaging was fragmented across more than a dozen departmental systems, creating information silos that hindered a complete patient view.

With 4 billion images and 1.3 petabytes of data, Metro North Health — the largest of 16 hospital and health services in Queensland — needed a scalable, unified solution. Metro North implemented a comprehensive enterprise imaging strategy featuring Hyland Acuo, NilRead and PACSgear to transform its imaging landscape.

The health service now provides almost 18,000 users with secure, real-time, zero-footprint access to a complete patient imaging record from any device — anywhere. This has streamlined clinical workflows and paved the way for advanced AI integration and improved diagnostic capabilities.

Metro North Health serves 20% of Queensland’s population across seven hospitals and numerous community facilities. Historically, its clinical imaging was managed in silos.

With at least 12 picture archiving and communication systems (PACS) for specialties such as radiology, cardiology and ophthalmology, clinicians lacked a unified view of a patient’s imaging history.

“I’m not interested in radiology images. I’m interested in the 10,000 images I get every year for burn patients from Torres Strait down to Lismore,” Metro North Chief Digital Health Officer Dr. Jason Brown said.

This fragmentation created significant issues:

• Incomplete patient picture: Clinicians had to log in to multiple systems to access different images for the same patient, a time-consuming and inefficient process that could delay critical care decisions.

• Unsupported and insecure systems: Many PACS were “boxes under desks” —unsupported, not backed up and noncompliant with modern security standards.

• Massive data scale: The archive was growing exponentially, already holding more than 4 billion images and 13.5 million studies, with a growth rate of 193 terabytes per year.

• Identity management complexity: The health service had to reconcile patient data from 150-plus patient administration systems, each with its own unique identifier.

“We needed a universal viewer which can be accessed from wherever you are quickly with high quality diagnostic imaging. This is the Netflixing of medical imaging,” Brown said.

> Learn more | How connected data can help improve patient outcomes

Metro North Health embarked on a five-year journey to modernize its imaging infrastructure, partnering with Hyland to implement a solution centered on three core technologies:

Acuo

Hyland’s vendor neutral archive (VNA) solution became the central repository for all clinical imaging — consolidating data from every specialty. Acuo ingests and manages images from radiology, cardiology, oral health, ophthalmology, digital operating theaters and more.

> Acuo in action | Hyland is at heart of health system’s imaging infrastructure

NilRead

To solve the access problem, Metro North deployed Hyland’s zero-footprint universal diagnostic viewer. NilRead allows clinicians to securely stream any image from the VNA to any device —desktop, tablet or mobile — without downloading large files.

PACSgear

For nontraditional imaging such as endoscopy and wound care photos, Hyland's image capture workflow engine provides encounter-based workflow generation, ensuring even visible light images are captured and stored with the correct patient demographics.

A critical success factor was tackling the challenge of patient identity. Metro North Health’s imaging solution integrates with the statewide enterprise master patient index (EMPI), which contains records for more than 10 million individuals. This links the 150-plus patient identifiers, creating a “one patient, one imaging” solution and ensuring a complete, accurate record for every individual, Brown said.

The ecosystem is hosted across two data centers with solid-state drives for instantaneous recall and a secure DMZ for authorized external access.

The enterprise imaging solution has delivered transformational outcomes for Metro North Health, empowering clinicians and creating new opportunities for innovation.

Unified, seamless access

More than 17,900 users across 26 sites have anywhere, anytime access to a complete patient imaging record via a single interface.

Enterprise-wide consolidation

Imaging from eight major clinical service areas, including statewide cardiology and stroke services, is centralized in the VNA. Radiology now accounts for only a quarter of the total imaging footprint.

AI-powered diagnostics

Unified data has enabled the integration of AI tools such as Harrison.ai Radiology. In the first three months, the tool helped identify missed incidental lesions on chest X-rays, prioritizing reviews that might have otherwise taken weeks.

Enhanced clinical workflows

Specialty departments such as ophthalmology have connected more than 18 modalities, providing a complete view of a patient’s journey across multiple sites. Digital operating theaters can capture and store video and stills directly in the patient record.

Massive scalability and performance

The system manages 4 billion images, 13.5 million studies and 1.3 PB of data with high performance and reliability, growing at 193 TB per year.

“Every image has the potential to deliver future clinical value. Deleting them not only carries hidden costs; it risks losing insights that could support diagnoses, research and improved patient outcomes,” Metro North Health Lead Architect David Anderson said. “By treating images as vital assets, we ensure they remain available — a decision that is both clinically smarter and more cost-effective than discarding them.”

Metro North’s enterprise imaging platform provides a foundation for continuous innovation. Next, the health service plans to extend the value of its rich data repository.

Future projects include:

• External provider access: Metro North will enable general practitioners and other private providers to view images through a secure health provider portal.

• Visible light imaging at scale: The health service will launch a mobile app that allows clinicians to use their devices to securely capture wound photos and other visible light images directly into the VNA.

• Enhanced AI and research: Metro North will leverage its massive de-identified dataset to train and validate new AI algorithms, unlocking its potential for research and predictive modeling.

• Specialty-specific workflows: The health service plans to create custom hanging protocols and summary pages to further streamline diagnostic workflows for specialties such as cardiology and wound care.

By building a bold, clinician-driven enterprise imaging strategy, Metro North Health has solved its immediate challenges and created a scalable platform to drive the future of integrated, data-driven healthcare.