[Cost effectiveness and patient benefit of digital image management systems for radiology]. / Wirtschaftlichkeit und Patientennutzen digitaler Bildmanagementsysteme für die Radiologie.

In many countries today, politicians are faced with the difficulty of having to reduce the overproportional increase in the cost of healthcare. In this context the contribution of medical technology to costs in the total spent are nearly always overestimated and its potential for savings underestimated. Based on international studies, investment and subsequent running costs for large, high-tech systems for diagnosis and therapy will be shown to account for only about 1% of the total cost of healthcare. Impressive examples of the application of computed tomography, magnetic resonance tomography and digital angiography deliver statistics regarding valid patient benefits and efficiency of modern diagnostic imaging systems. Studies about related therapeutic possibilities of angioplasty and extra-corporal lithotripsy demonstrate the overall economic advantages of modern medical technology. Arising from the positive results due to the use of such equipment, the additional cost savings potential to be expected by networking these digital modalities with one another, as well as with other information and communications technology systems, will be analysed. The results will be assessed and compared to experience gained from routine clinical operation of such integrated systems. 72% of the total turnover of the Medical Engineering Group of Siemens AG for diagnostic imaging modalities in 1991/1992 arose from digital imaging modalities, and this percentage is expected to continue to increase. This paper will concentrate on these modern digital methods.

Rationale for a community strategy in the field of information and communications technologies applied to health care.

The challenge for Europe in the field of information and communications technologies applied to health care is that of addressing positively the problem of the widening gap between the expectations of the citizens of the type of care that can be made available and the limited resources to provide that care. If the expectations of the population are to be fulfilled, it will be necessary to find innovative ways of delivering health services and to do it more efficiently than has yet been the case. Advanced information and communications technologies will be important tools for Member States to achieve the levels of efficiency required. Based on the results of the Community AIM Exploratory Action, further collaborative work is required at EEC level to create an Integrated Health Information Environment (IHE) allowing essentially for integration, modularity and security.

Computer-assisted radiology--requirements and solutions for digital diagnostic imaging.

More and more digital imaging equipment is used in the daily routine of radiology departments. Computerized diagnostic equipment provides new capabilities for radiologists. It provides improvement of the work flow within the department, of the exchange of information between radiologists and referring physicians, and the exchange of information between radiologists specialized in specific diagnostic procedures. This exchange of information has to be performed locally within the department, between different buildings belonging to one department or between widely separated buildings in different hospital. The penetration of 'computer-assisted radiology' makes the organization of an imaging department and the information to be handled within it more and more complex. Specific requirements result from this increasing complexity. To meet these requirements, Siemens has developed technical solutions for integrated digital diagnostic imaging. These solutions allow the functional integration of physically separated systems such as multiple computed tomography (CT) units or CT plus magnetic resonance (MR) units belonging to one department, centralized archiving, hard-copy generation and image display, rapid access to images from multiple locations and effective image communication for intensive care units, child care units and trauma patients. Some of these requirements are discussed and the corresponding products are described. It is shown how these solutions will migrate to future comprehensive picture archiving and communication systems (PACS) configurations.

The PACS project in the radiology department of the LKH-Graz.

The PACS-project of Graz was started two years ago in cooperation with Siemens Erlangen. The system environment consists of three CT-devices (DR2, DR3, DRH) connected to an Ethernet-based LAN (CTnet), which is linked to a second Ethernet via a MicroVAX II. This computer works as a gateway, as an image-converter and as an archive. All CT-images of one device (DRH) are transmitted to the PACS system. The images are organized in patient-oriented folders. The physician is able to make reports about those examinations for which he is responsible. The availability of tools for secondary image processing during the reporting session (windowing, zooming, displaying statistic information, etc.) and further image-functions should make the PACS system more convenient for the physician than film-based images. After reporting, all scans which are relevant for the diagnosis (according to the physician's opinion) are selected, automatically reorganized in folders and transmitted to the archive. This needs about one to two minutes per examination. Some internal data-structures and further future aspects concerning the improvement of reliability and user acceptance are mentioned.

[Two-year clinical experience with Mevamatic 3--development of a verification and protocol system for irradiation units]. / Zweijährige klinische Erfahrungen mit der Mevamatic 3--Weiterentwicklung eines Verifikations- und Protokolliersystems für Bestrahlungsanlagen.

Since 1983 the computerized record and verify system Mevamatic 3 was tested in connection with the linear accelerator Mevatron 77 (Siemens Company). In consequence of the software development the handling of the system was improved for the clinical routine with the result of a fully utilizable system. The topics of this report are the description of the hardware, the functions of the system, the software development and some possibilities for improvements in the future.

[Digital image information systems in radiology--status and developmental trends]. / Digitale Bildinformationssysteme in der Radiologie--Stand und Entwicklungstendenzen.

A digital image information system is expected to increase the efficiency of image acquisition and reporting. In addition to the requirements of the radiology department the requirements of the wards and the theatres must also be taken into account. The image information system has to be linked with the administrative work flow throughout the department. Therefore, it must provide interfaces to a radiology management system. In the United States such an image information system is referred to as "Picture Archiving and Communication System" = PACS. A suitable systems concept and the requirements of a real system are pointed out. The available technical solutions are discussed as well as the probable trends of future developments.