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The process of converting to a near filmless operation at the University of Utah, Department of Radiology

JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 41-46页

作者： Freeh, M Baune, D Univ Utah Med Ctr Dept Radiol Ctr Adv Med Technol Salt Lake City UT 84132 USA

The Department of Radiology at the University of Utah Health Sciences Center has made the transition from a traditional film-based department to a near filmless operation. The University of Utah is a large teaching hospital and the transition from film in an educational facility will be discussed. This transition has had its difficulties and its success is dependent on the support of departmental leadership and hospital administration. We have had more than 100 years of experience with film, and current procedures were efficient given the limitations of the medium. While motivated by the traditional reasons for moving to a picture archival and communications system (PACS), such as film savings, unavailable films, and faster reports, we found the intangibles to be the larger issue, as well as a source for the largest benefits. This report will discuss the implementation process and the affect it had on all areas of the hospital, including its impact on hospital physicians, radiologists, file room personnel, and technologists. Procedure changes to the flew of patients, film, and electronic images will also be described. This process cannot be viewed as a onetime change, but must be viewed as a continuous process as areas of improvement are identified and new and improved technologies are developed. Copyright (C) 1999 by W.B. Saunders Company.

关键词：诊断显像医院管理医院大学/组织和管理领导病案医务人员医院动机放射学放射科医院/组织和管理放射学信息系统/组织和管理放射学信息系统/发展趋势工艺学放射学/发展趋势犹他 X线胶片人类

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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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Integrated radiology information system, picture archiving and communications system, and teleradiology - Workflow-driven and future-proof

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 199-200页

作者： Shieh, YY Roberson, GH Texas Tech Univ Hlth Sci Ctr Dept Radiol Lubbock TX 79430 USA

The proliferation of integrated radiology information system/picture archiving and communication system (RIS/PACS) and teleradiology has been slow because of two concerns: usability and economic return. A major dissatisfaction on the usability issue is that contemporary systems are not intelligent enough to support the logical workflow of radiologists. We propose to better understand the algorithms underlying the radiologists' reading process, and then embed this intelligence into the software program so that radiologists can interact with the system with less conscious effort. Regarding economic return issues, people are looking for insurance against obsolescence in order to protect their investments. We propose to future-proof a system by sticking to the following principles: compliance to industry standards, commercial off-the-shelf (COTS) components, and modularity. An integrated RIS/PACS and teleradiology system designed to be workflow-driven and future-proof is being developed at Texas Tech University Health Sciences Center. Copyright (C) 1999 by W.B. Saunders Company.

关键词：算法人工智能计算机系统诊断显像预测投资放射学放射学信息系统/经济学放射学信息系统/组织和管理软件系统综合远程放射学得克萨斯用户计算机接口工作负荷量人类

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Clinical services assessment and reengineering: Lessons learned

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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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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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Reengineering the picture archiving and communication system (PACS) process for digital imaging networks PACS

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 59-61页

作者： Horton, MC Lewis, TE Kinsey, TV USN Joint Imaging Technol Project Off Ft Detrick MD 21702 USA

Prior to June 1997, military picture archiving and communications systems (PACS) were planned, procured, and installed with key decisions on the system, equipment, and even funding sources made through a research and development office called Medical Diagnostic Imaging Systems (MDIS). Beginning in June 1997, the Joint Imaging Technology Project Office (JITPO) initiated a collaborative and consultative process far planning and implementing PACS into military treatment facilities through a new Department of Defense (DoD) contract vehicle called digital imaging networks (DIN)-PACS. The JITPO reengineered this process incorporating multiple organizations and politics. The reengineered PACS process administered through the JITPO transformed the decision process and accountability from a single office to a consultative method that increased end-user knowledge, responsibility, and ownership in PACS. The JITPO continues to provide information and services that assist multiple groups and users in rendering PACS planning and implementation decisions. Local site project managers are involved from the outset and this end-user collaboration has made the sometimes difficult transition to PACS an easier and more acceptable process for all involved. Corporately, this process saved DoD sites millions by having PACS plans developed within the government and proposed to vendors second, and then having vendors respond specifically to those plans. The integrity and efficiency of the process have reduced the opportunity for implementing nonstandard systems while sharing resources and reducing wasted government dollars. This presentation will describe the chronology of changes, encountered obstacles, and lessons learned within the reengineering of the PACS process for DIN-PACS. This is a US government work. There are no restrictions on its use.

关键词：行政管理人员生物医学工程资本筹集计算机通信网络/分类计算机通信网络/经济学计算机通信网络/组织和管理计算机用户培训费用节省决策诊断显像效率组织在职培训职业间关系军事医学所有权放射学信息系统/分类放射学信息系统/经济学放射学信息系统/组织和管理系统综合人类

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Technology assessment and requirements analysis: A process to facilitate decision making in picture archiving and communications system implementation

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 62-63页

作者： Radvany, MG Chacko, AK Richardson, RR Grazdan, GW USA Med Mat Agcy Technol Support Div Ft Detrick MD 21702 USA Brooke Army Med Ctr Dept Radiol Ft Sam Houston TX 78234 USA

In a time of decreasing resources, managers need a tool to manage their resources effectively, support clinical requirements, and replace aging equipment in order to ensure adequate clinical care. To do this successfully, one must be able to perform technology assessment and capital equipment asset management. The lack of a commercial system that adequately performed technology needs assessment and addressed the unique needs of the military led to the development of an in-house Technology Assessment and Requirements Analysis (TARA) program. The TARA is a tool that provides an unbiased review of clinical operations and the resulting capital equipment requirements for military hospitals. The TARA report allows for the development of acquisition strategies for new equipment, enhances personnel management, and improves and streamlines clinical operations and processes. This is a US government work. There are no restrictions on its use.

关键词：资本筹集决策设备和供应医院/经济学卫生资源/经济学卫生资源/组织和管理医院军队/经济学医院军队/组织和管理人员管理医院放射学信息系统/经济学放射学信息系统/组织和管理技术评估生物医学人类

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Workflow Management Systems - A powerful means to integrate radiologic processes and application systems

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 214-215页

作者： Schmidt, J Meetz, K Wendler, T Philips Res Labs Div Tech Syst D-22335 Hamburg Germany

This presentation describes a research project investigating the suitability of model-based Workflow Management Systems (WfMS) to support radiological process. The following aspects are covered: process modeling, process enactment, and architecture of workflow-enabled application systems. Copyright (C) 1999 by W.B. Saunders Company.

关键词：管理信息系统过程评价(卫生保健) 放射科医院/组织和管理放射学信息系统/组织和管理工作负荷量人类

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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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Radiologist-patient interactions: Implications for picture archiving and communications systems and teleradiology

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 137-138页

作者： Williamson, EE Williamson, B Mayo Clin Rochester MN 55905 USA Mayo Clin Jacksonville Jacksonville FL 32224 USA

We analyzed radiologist-patient interactions and found that radiologic examinations can be classified into three categories: those involving direct interaction of the radiologist with each patient, those involving interaction of the radiologist with some of the patients, and those that do not involve interaction between the radiologist and the patient. We then analyzed the staff assignments of a large academic radiology practice and a moderate-sized radiology department. Both departments include a full range of inpatient and outpatient procedures. We concluded that about 50% of the radiologists in these practices could interpret examinations at a location independent of the site where the examination was performed. This type of analysis can be helpful in planning for the reengineering of radiology processes following implementation of picture archiving and Communications systems (PACS) and teleradiology. Copyright (C) 1999 by W.B. Saunders Company.

关键词：门诊医疗造影剂/投药和剂量诊断显像住院医院联合开业/组织和管理人员配备和时间安排医生病人关系放射学放射科医院/组织和管理放射学信息系统/组织和管理远程放射学人类

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