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El Sistema para el Almacenamiento, Transmisión y Visualización de Imágenes Médicas XAVIA PACS, desarrollado por la Universidad de las Ciencias Informáticas, se utiliza en múltiples instituciones de salud de Cuba. El propósito de estas herramientas es manejar la imagen médica, por lo que no gestionan la información que se capta en los servicios de diagnóstico por imágenes, entre los que se encuentran los datos del paciente, del estudio imagenológico y el informe diagnóstico. En este trabajo se exponen los resultados del desarrollo de un sistema informático para la gestión de la información imagenológica integrado al sistema XAVIA PACS para garantizar el control automatizado de la información en los servicios de diagnóstico por imágenes. Para el desarrollo previsto fue determinante la necesidad de reutilizar el código fuente ya implementado en el sistema XAVIA PACS; se seleccionó Microsoft.NET Framework, ASP.NET 3.5, C# 3.5 como lenguaje de programación, PostgreSQL como sistema de gestión de Base de Datos. Adicionalmente, fueron tenidos en cuenta la portabilidad, el procesamiento complejo interno, la facilidad de la instalación, y la facilidad del cambio. El sistema desarrollado automatiza la gestión de las listas de trabajo en los servicios de diagnósticos por imágenes, la gestión de la información del paciente, las citaciones, la planificación del trabajo de las modalidades médicas, y especialistas de radiología. La implantación del sistema desarrollado en diferentes instituciones de salud que emplean el sistema XAVIA PACS, validó la pertinencia y aplicabilidad del mismo(AU)
The XAVIA PACS Medical Images Storage, Transmission and Visualization System, developed by the University of Computer Sciences is used in multiple Cuban health institutions. The purpose of these tools is to manage the medical image, so they do not manage the information that is captured in the diagnostic imaging services, among which are the patient's data, the imaging study and the diagnostic report. This article presents a computer system for the management of imaging information integrated into the XAVIA PACS system to ensure automated control of information in diagnostic imaging services. For the planned development, the need to reuse the source code already implemented in the XAVIA PACS system was decisive; Microsoft.NET Framework, ASP.NET 3.5, C # 3.5 were selected as the programming language, PostgreSQL as the Database management system. Additionally, portability, complex internal processing, ease of installation, and ease of change were considered. The developed system automates the management of work lists in diagnostic imaging services, the management of patient information, appointments, work planning of medical modalities, and radiology specialists. The implementation of the system developed in different health institutions that use the XAVIA PACS system, validated its relevance and applicability(AU)
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Humans , Male , Female , Software Design , Software , Diagnostic Imaging/methods , Image Interpretation, Computer-Assisted , Radiology Information SystemsABSTRACT
Los informes estructurados contextualizados cumplen tres características fundamentales: tienen una estructura uniforme que responde una pregunta clínica, son el producto de listas de chequeo estandarizadas o de árboles de conocimiento previamente concertados con equipos clínicos multidisciplinarios y se construyen a partir de cuadros de selección de atributos incorporados en los sistemas de informe electrónicos, adicionalmente, el atributo contextualizado hace referencia a la capacidad del informe de responder las preguntas clínicas de la situación actual del paciente, otorgando información relevante de forma concisa y clara a los médicos tratantes. Dentro de las principales ventajas de migrar hacia el informe estructurado se encuentran la uniformidad y la alta calidad del informe, el aumento en la concordancia intra e interobservador, así como la reducción de las tasas de error diagnóstico y una mejora significativa en la comunicación con los médicos tratantes. Se presenta una revisión temática que abarca las características esenciales del informe estructurado contextualizado, los argumentos a favor y en contra de este, los pasos recomendados para su implementación y las oportunidades de mejora hacia el futuro.
Structured reporting in radiology fulfill three fundamental characteristics: they have a uniform structure that answers a clinical question, they are the product of standardized checklists or of knowledge trees previously arranged with multidisciplinary clinical teams, and they are incorporated in option-selection boxes available in electronic reporting systems. Among the main advantages of migrating towards structured reporting are the uniformity and high quality of the report, the increase in intra and interobserver concordance, as well as the reduction of the diagnostic error rates and a significant improvement in communication with the clinical practitioner. This thematic review covers the essential characteristics of the structured report, the arguments for and against it, the recommended steps for its implementation, and the future opportunities for improvement.
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Humans , Radiology Information Systems , Medical Informatics , Diagnosis, Computer-AssistedABSTRACT
OBJECTIVE: To survey care providers' preference between structured reporting (SR) and free-text reporting (FTR) for appendiceal computed tomography (CT) in adolescents and young adults. MATERIALS AND METHODS: An ethical committee approved this prospective study. The requirement for participant consent was waived. We distributed the Likert scale-based SR form delivering the likelihood of appendicitis across 20 hospitals through a large clinical trial. In the final phase of the trial, we invited 706 potential care providers to participate in an online survey. The survey questions included usefulness in patient management, communicating the likelihood of appendicitis, convenience, style and format, and overall preference. Logistic regression analysis was performed for the overall preference. Three months after the completion of the trial, we checked if the use of the SR was sustained. RESULTS: Responses were analyzed from 594 participants (175 attendings and 419 trainees; 225 radiologists, 207 emergency physicians, and 162 surgeons). For each question, 47.3–64.8% of the participants preferred SR, 13.1–32.7% preferred FTR, and the remaining had no preference. The overall preference varied considerably across the hospitals, but slightly across the departments or job positions. The overall preference for SR over FTR was significantly associated with attendings, SR experience for appendiceal CT, hospitals with small appendectomy volume, and hospitals enrolling more patients in the trial. Five hospitals continued using the SR in usual care after the trial. CONCLUSION: Overall, the care providers preferred SR to FTR. Further investigation into the sustained use of the SR is needed.
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Adolescent , Humans , Young Adult , Appendectomy , Appendicitis , Emergencies , Logistic Models , Prospective Studies , Radiology Information Systems , SurgeonsABSTRACT
Objective To study the frequencies of diagnostic exposure and distribution of examined patients in Jiangsu province and to evaluate the frequencies of commom diagnostic exposure and CT examination by investigating public hospitals in Jiangsu. Methods Public hospitals in 4 counties ( districts) were sampled, and the information of examined patients on sex, age, diagnostic type and exposure category were gathered through radiology information system ( RIS ) of the sampled hospitals. Results A total of 728196 records of diagnostic procedures were gathered from the sampled hospitals. Among them 479024 records were on common diagnostic procedures, whereas 249172 records were on CT diagnostic procedures. The sex ratio was relatively balanced. the above 40 years of age group amounted for 62% the highest proportion, among the three age groups. The diagnostic frequencies in level Ⅱ hospitals contributed the highest proportion although 70% of the sampled hospitals were level I hospitals. Such diagnostic procedures as barium enema and mammography were highly distributed in level Ⅲ hospitals. Diagnostic frequencies were estimated in 2015 at 303 common diagnostic examinations and 173 CT diagnostic procedures per 1000 persons in Jiangsu province. Conclusions Frequencies of diagnostic radiology in Jiangsu became increased since the last investigation of medical exposure examinations during the Ninth Five-year Plan, which was a challenge for health care. It is important to mobilize more resources in protection against medical radiation exposure.
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Objective To study the frequencies of diagnostic exposure and distribution of examined patients in Jiangsu province and to evaluate the frequencies of commom diagnostic exposure and CT examination by investigating public hospitals in Jiangsu. Methods Public hospitals in 4 counties ( districts) were sampled, and the information of examined patients on sex, age, diagnostic type and exposure category were gathered through radiology information system ( RIS ) of the sampled hospitals. Results A total of 728196 records of diagnostic procedures were gathered from the sampled hospitals. Among them 479024 records were on common diagnostic procedures, whereas 249172 records were on CT diagnostic procedures. The sex ratio was relatively balanced. the above 40 years of age group amounted for 62% the highest proportion, among the three age groups. The diagnostic frequencies in level Ⅱ hospitals contributed the highest proportion although 70% of the sampled hospitals were level I hospitals. Such diagnostic procedures as barium enema and mammography were highly distributed in level Ⅲ hospitals. Diagnostic frequencies were estimated in 2015 at 303 common diagnostic examinations and 173 CT diagnostic procedures per 1000 persons in Jiangsu province. Conclusions Frequencies of diagnostic radiology in Jiangsu became increased since the last investigation of medical exposure examinations during the Ninth Five-year Plan, which was a challenge for health care. It is important to mobilize more resources in protection against medical radiation exposure.
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Objective:To analyse the dataflow and clinical flow in Suzhou municipal hospital radiology information system and picture archiving system, presents a set of system integration messages, and describes the effect of each message for the communication. Methods: Follow the framework of IHE and HL7 protocol, the paper uses standard messages to integrate two different systems for patient and study status communication. The integration can meet clinical users’ requirements.Results: Based on many years practice, the integration reached designed target.Conclusion: With further research on standard, the seamless system integration between different systems can help customer to make full use of each system and save more cost in system purchase.
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Background: Radiology Information System (RIS) coordinates the organizational processes and administrative based on information. The present study was an attempt towards a performance assessment of the RISs used in general Isfahan hospitals. Methods: This study was descriptive cross-sectional in nature. Its statistical population consisted of the general teaching hospitals of Isfahan city (Iran). Due to the limitedness of the population of study, the sample size was the same as the population size. The data were collected using a self-designed checklist produced based on the royal college of radiologists’ guidelines, i.e. input components (13 items), process components (10 items) and output components (8 items). The researcher collected the data through observation and interview. The validity of the checklist was assessed by the health information system field’s valid authorities. Finally, the gathered data were put into SPSS 16 software and analyzed using descriptive statistics. Results: Among the RIS in the hospitals, Kashani, Isa Ibn Maryam and Nour & Ali Asghar had the highest rank for input components (mean score = 30.79%). As for process components, Al-zahra, Kashani and Isa Ibn Maryam gained the highest position (mean score = 38.9%). Finally, Al-zahra and Kashani hospitals with a mean score of 66.66% enjoyed the highest rank for output components. Conclusion: RIS must be capable of satisfying a number of requirements including satisfying the medical needs of the patients, producing the reports, image and report processing, patients’ appointment scheduling, the procedures for receiving and administrating the orders and other radiology procedures.
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Objective To ascertain the frequency distribution of CT examinations in children.Method A wide range of information was collected through the radiology information system (RIS),including ID,sex,birth date,examination time,the examined part of body and other relevant ones related to children who underwent CT examinations between Jan 1,2012 and Dec 31,2012.The SAS software was used for data processing and statistical analysis.Results A total of 1 542 children underwent 1 670 examinations,of which 67％ were male.Head CT examination was the most frequent,accounting for 71.9％ of all CT examinations,and followed by the abdomen/pelvis examinations.The number of examinations of children undergoing the repetitive examination accounted for 6.4％; 51.7％ of the examinations was for trauma.The positive rate of CT examination was 51％,dependent upon the age and examined body parts to some extent.The younger patients had lower positive rate,and the positive rate of head CT examination was lower than those in other parts.Conclusions To reduce the possible cancer risk to be induced by the ionizing radiation from CT,justification of CT examination should be considered for children.
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OBJECTIVES: Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. METHODS: The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. RESULTS: Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. CONCLUSIONS: Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.
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Adoption , Confidentiality , Delivery of Health Care , Electronic Health Records , Hospital Information Systems , Information Systems , Management Information Systems , Quality of Health Care , Radiology Information Systems , Referral and ConsultationABSTRACT
PURPOSE: We created an 'AAPM TG18 Evaluation Tool' and we determined its usefulness for the quality control of a diagnostic monitor. MATERIALS AND METHODS: We created an evaluation tool (the AAPM TG18) for conducting quality control of a diagnostic monitor, and we evaluated the measurement items of the AAPM TG18 evaluation tool. The measurement items were geometric distortion, fixed quantity assessment and visual assessment of the veiling glare, and we carried out adjustment for the luminance meter 0% calibration, which was used to revise the diagnostic monitor DICOM LUT. RESULTS: With the AAPM TG18 Evaluation Tool, we measured the 2-dimensional length when evaluating the quantitative geometric distortions in the TG18-QC test pattern, and we measured the veiling-glare ring response function, which provided information regarding the spatial extent of the luminance spread, and this measurement of the can be performed using the TG18-GV pattern. Additionally, the AAPM TG18 Evaluation Tool can be used for sensor calibration to standardize the basic rate of 0% luminance when performing periodic calibration. CONCLUSION: The evaluation tool is a very useful for easily evaluating many of the examination items of the AAPM TG18 for performing quality control of a diagnostic monitor.
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Calibration , Computer Terminals , Glare , Organothiophosphorus Compounds , Quality Control , Radiology Information Systems , Total Quality ManagementABSTRACT
Objective To investigate the use of the minimizing picture archiving and communication system (mini PACS) in practical work and to realize the advent of filmless radiology Methods A PC based ethernet was set up The medical imaging equipments including CT, MR, digital fluoroscopy, DSA, and a laser camera were combined with the ethernet, and the digital imaging network (DIN) was integrated with the medical diagnostic imaging system (MDIS) In this way, the radiology information system (RIS) was established Through one of the PC workstations with a double network card, this RIS was connected to the hospital information system (HIS) Results The mini PACS has been repeatedly used for more than 2 years The system in Radiology department has been established and improved With the present digital imaging system, such functions as the acquiring, storing, transmitting, printing, and browsing of digital images have been put into practice, all in accordance with the manners of the digital imaging communication in medicine 3 0 (DICOM 3 0) Digital imaging and diagnostic reports were managed through Microsoft Access database Images may be kept on line in different kinds of equipment for 3-6 months All images have been recorded on CD R disks, so as to be kept off line permanently So far, over 32 700 reports have been stored in the database From mini PACS HIS terminals images and diagnostic information may be acquired on a limited scale Conclusion mini PACS needs only a low cost of investment and operation Its maintenance is simple and its performance is efficient The main functions of the PACS can mostly be achieved There lies a bright prospect for its use in small and medium hospitals
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Objective To build a set of inexpensive wireless wide area network PACS based on open source code.Methods To improve the open source code MyFreePACS on Internet.Results The basic function of PACS can be achieved in an economical way,using internet explorer to browse and deal with the DICOM Images,with the capability of such functions as displaying and managing of the pictures.It is possible to make rounds at patient bedside with wireless device and remote medical consultation with specialists through Internet.Conclusion It is possible to utilize the free open source code MyFreePACS on the internet to construct an economical PACS on Web in the medium and small-scale hospital.