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Clinical services assessment and reengineering: Lessons learned

JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 127-129页

作者： Lyche, DK Richardson, RR Maliff, RP Romlein, J Norton, GS InformaTech Inc ITI Frederick MD 21703 USA

Healthcare enterprises often "acquire and install" picture archiving and communications systems (PACS) without examining many of the care delivery processes and information flows that will be affected. Many times these unexamined factors can delay or be the cause of failure of the PACS project. This article presents issues that were worked through as part of a PACS clinical services assessment and reengineering analysis for several US military medical treatment facilities, Copyright (C) 1999 by W.B. Saunders Company.

关键词：阿拉斯加卫生保健提供夏威夷医院信息系统/组织和管理医院军队/经济学医院军队/组织和管理组织方针人员配备和时间安排质量保证卫生保健放射学信息系统/分类放射学信息系统/经济学放射学信息系统/组织和管理技术评估生物医学工艺学放射学电信人类

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Bridging the gap: Linking a legacy hospital information system with a filmless radiology picture archiving and communications system within a nonhomogeneous environment

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 96-98页

作者： Rubin, RK Henri, CJ Cox, RD McGill Univ Ctr Hlth Dept Diagnost Radiol Montreal PQ Canada

A health level 7 (HL7)-conformant data link to exchange information between the mainframe hospital information system (HIS) of our hospital and our home-grown picture archiving and communications system (PACS) is a result of a collaborative effort between the HIS department and the PACS development team. Based of the ability to link examination requisitions and image studies, applications have been generated to optimise workflow and to improve the reliability and distribution of radiology information. Now, images can be routed to individual radiologists and clinicians;worklists facilitate radiology reporting;applications exist to create, edit, and view reports and images via the internet;and automated quality control now limits the incidence of "lost" cases and errors in image routing. By following the HL7 standard to develop the gateway to the legacy system, the development of a radiology information system for booking, reading, reporting, and billing remains universal and does not preclude the option to integrate off-the-shelf commercial products. Copyright (C) 1999 by W.B. Saunders Company.

关键词：计算机通信网络数据库管理系统诊断显像医院信息系统/组织和管理信息存储和检索因特网质量控制放射学信息系统/仪器和设备放射学信息系统/组织和管理系统综合远程放射学工作负荷量人类

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Information technology as tool for change

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INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS 1999年第1-3期56卷 135-139页

作者： Itkonen, P Federat Municipalities N Karelian Hosp Dist Joensuu 80210 Finland

It looks that networking welfare thinking and implementations of network projects only follow the development of data transfer possibilities. It is a danger that seamless chain of care in health care is just a data transferring generator based on easy connections, only creating needs for new data transferring This is an 'illusion of core skills' that does not extend to the development of the contents of services. Easy access to the system makes more contacts and need for more also clinical services. New needs for data transfer burden the personnel with unnecessary information and networking functional model does not emancipate them to use their substantial skills. It means more costs and it is also a danger that normal life will be medicated. Public sector cannot finance all these new possibilities and consequences of modern technology. Does all this create a new combination of public and private sector and push them to allocate responsibilities in developing work? If the public and private sectors do not find the balance in controlling this development, also actors outside health care get to influence the choices and health care loses its autonomy. It becomes a business means for companies producing data transfer and network services. From the prioritisation point of view this is not a good vision for financing and delivery of health care services either in public or private sector. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.

关键词：芬兰医院信息系统/组织和管理医学信息学应用组织改革转诊和会诊人类

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MULTIMEDIA COMMUNICATIONS IN HEALTH-CARE

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES-SERIES 1992年第1期670卷 257-268页

作者： REIS, H BRENNER, D ROBINSON, J NYNEX SCI & TECHNOL INC CAMBRIDGE MA 02139 USA

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Process reengineering: The role of a planning methodology and picture archiving and communications system team building

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 28-31页

作者： Carrino, JA Unkel, PJ Shelton, P Johnson, TG Harvard Univ Brigham & Womens Hosp Sch Med Dept Radiol Boston MA 02115 USA Joint Imaging Technol Project Off Ft Detrick MD USA Int Radiol Grp Dallas TX USA Wilford Hall USAF Med Ctr Lackland AFB TX 78236 USA

The acquisition of a picture archiving and communications system (PACS) is an opportunity to reengineer business practices and should optimally consider the entire process from image acquisition to communication of results. The purpose of this presentation is to describe the PACS planning methodology used by the Department of Defense (DOD) Joint Imaging Technology Project Office (JITPO), outline the critical procedures for each phase, and review the military experience using this model. The methodology is segmented into four phases: strategic planning, clinical scenario planning, installation planning, and implementation planning. Each is further subdivided based on the specific tasks that need to be accomplished within that phase. By using this method, an institution will have clearly defined program goals, objectives, and PACS requirements before vendors are contacted. The development of an institution-specific PACS requirement should direct the process of proposal comparisons to be based on functionality and exclude unnecessary equipment. This PACS planning methodology is being used at more than eight DOD medical treatment facilities. When properly executed, this methodology facilitates a seamless transition to the electronic environment and contributes to the successful integration of the healthcare enterprise. A crucial component of this methodology is the development of a local PACS planning team to manage all aspects of the process. A plan formulated by the local team is based on input from each department that will be integrating with the PACS. Involving all users in the planning process is paramount for successful implementation. Copyright (C) 1999 by W.B. Saunders Company.

关键词：计算机系统诊断显像医院科室/组织和管理医院信息系统/组织和管理职业间关系组织目标放射科医院/组织和管理放射学信息系统/分类放射学信息系统/组织和管理系统综合人类

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CLINICAL-DATA RETRIEVAL AND ANALYSIS - IVE SEEN A CASE LIKE THAT BEFORE

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES-SERIES 1992年第1期670卷 133-140页

作者： CHUTE, CG Section of Medical Information Resources Mayo Clinic/Foundation Rochester Minnesota 55905

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Anatomy of picture archiving and communications systems: Nuts and bolts - Image acquisition: Getting digital images from imaging modalities

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 216-217页

作者： Andriole, KP Univ Calif San Francisco Dept Radiol Lab Radiol Informat San Francisco CA 94143 USA

Digital acquisition of data from the various imaging modalities for input to a picture archiving and communication system (PACS) is discussed. Essential features for successful clinical implementation including Digital Imaging and Communications in Medicine (DICOM) compliance, radiology information system (RIS)/hospital information system (HIS) interfacing, and workflow integration are detailed. Image acquisition from the inherently digital cross-sectional modalities are described, as well as digital acquisition of the conventional projection x-ray using computed radiography (CR), direct digital radiography (DDR), and film digitizers. Copyright (C) 1999 by W.B. Saunders Company.

关键词：诊断显像医院信息系统/组织和管理图像处理计算机辅助 X线影像增强放射摄影术放射学信息系统/组织和管理系统综合体层摄影术 X线计算机工作负荷量 X线胶片人类

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Parlaying digital imaging and communications in medicine and open architecture to our advantage: The new Department of Defense picture archiving and communications system

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 64-66页

作者： Cawthon, MA Brooke Army Med Ctr San Antonio TX USA

The Department of Defense (DoD) undertook a major systems specification, acquisition, and implementation project of multivendor picture archiving and communications system (PACS) and teleradiology systems during 1997 with deployment of the first systems in 1998. These systems differ from their DoD predecessor system in being multivendor in origin, specifying adherence to the developing Digital Imaging and Communications in Medicine (DICOM) 3.0 standard and all of its service classes, emphasizing open architecture, using personal computer (PC) and web-based image viewing access, having radiologic telepresence over large geographic areas as a primary focus of implementation, and requiring bidirectional interfacing with the DoD hospital information system (HIS). The benefits and advantages to the military healthcare system accrue through the enabling of a seamless implementation of a virtual radiology operational environment throughout this vast healthcare organization providing efficient general and subspecialty radiologic interpretive and consultative services for our medical beneficiaries to any healthcare provider, anywhere and at any time of the night or day. Copyright (C) 1999 by W.B. Saunders Company.

关键词：计算机系统诊断显像政府机构卫生服务易得程度医院信息系统/组织和管理医院军队/组织和管理因特网微型计算机军事科学放射学信息系统/组织和管理转诊和会诊远程放射学/组织和管理美国用户计算机接口人类

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Sophisticated hospital information system radiology information system picture archiving and communications system (PACS) integration in a large-scale traumatology PACS

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 99-102页

作者： Peer, S Vogl, R Peer, R Jaschke, W Univ Innsbruck Hosp Dept Radiol A-6020 Innsbruck Austria

Picture archiving and communications system (PACS) in the context of an outpatient trauma care center asks for a high level of interaction between information systems to guarantee rapid image acquisition and distribution to the surgeon. During installation of the Innsbruck PACS, special aspects of traumatology had to be realized, such as imaging of unconscious patients without identification, and transferred to the electronic environment. Even with up-to-date PACS hardware and software, special solutions had to be developed in-house to tailor the PACS/hospital information system (HIS)/radiology information system (RIS) interface to the needs of radiologic and clinical users, An ongoing workflow evaluation is needed to realize the needs of radiolgists and clinicians. These needs have to be realized within a commercially available PACS, whereby full integration of information systems may sometimes only be achieved by special in-house solutions. Copyright (C) 1999 by W.B. Saunders Company.

关键词：门诊医疗设施/组织和管理计算机通信网络计算机系统医院信息系统/组织和管理医务人员病人识别系统放射学放射学信息系统/组织和管理软件系统综合创伤诊治中心/组织和管理意识丧失人类

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INNOVATIVE DESK-TOP LEARNING TOOLS - IMPLICATIONS FOR RURAL HOSPITALS AND PHYSICIANS

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES-SERIES 1992年第1期670卷 76-90页

作者： OEFFINGER, JC HIEBELER, L SHERMAN, T GASKILL, M PORTANTE, T POLASEK, J LITTERER, K CUERO COMMUNITY HOSP CUERO TX 77954 USA SHEPPERD MEM HOSP BURNET TX 78611 USA

Innovative methods of providing workplace education for health care professionals may be a key to the survival of rural hospitals in America. Such methods must overcome time, distance, cost and organizational constraints, and take into account the structure of the learning experience. The Texas Hospital Education and Research Foundation has recently been involved in two programs that tested new approaches to worker education using distance-learning strategies. The projects--resource sharing among rural directors of nursing and training for cancer tumor registrars--used computer-conferencing technology. A new model using existing satellite, audio-conferencing, and computer-based instruction augmented by computer conferencing is proposed. The Computer-Related Assisted Distance Learning Enhancement (CRADLE) model integrates existing technologies to provide education to health care workers at their desktop. The Cancer Learning Center (CLC) tested peer collaboration, the primary component of the model. The ultimate goal is to have the system available to all tumor registrars in Texas, and to secure funding to implement rural nursing and rural high-school health occupations education projects. Current projects from set-up through results are presented.

关键词：计算机通信网络/经济学计算机通信网络/组织和管理计算机辅助教学/经济学计算机辅助教学/方法教育护理继续/经济学教育护理继续/组织和管理医院信息系统/经济学医院信息系统/组织和管理医院乡村/组织和管理病案管理员/教育模型组织管理人员医院/教育试点项目美国

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