Economic analysis of a filmless system based on the hospital information system.

A filmless system (FLS) based on a picture archiving and communication system (PACS) equipped with UNIX work- stations and a local area network (LAN) specialized for viewing radiographs has not been deemed acceptable, for reasons of economics. However, personal computers (PCs) have recently become more powerful, to the point where PCs approach UNIX workstations in terms of capabilities. As a result, a PC-based image viewing workstation (IVW) has sufficient functions for practical use. Diagnostic resolution is not equal to that of film, but is comparable. Since the hospital information system (HIS) includes many PC terminals connected by a LAN, the cost problem can be resolved by using these PC terminals as the IVWs. In order to investigate the practicability of this idea, two types of FLSs using HIS facilities were designed: one is a system based on the use of high-resolution cathode ray tubes (H-CRTs), and the other is based on the use of conventional CRTs and radiologist reports, minimizing the number of H-CRTs. The total costs of the two systems were analyzed. As a result, the former FLS was found to be about 15% more expensive than the latter, which was less expensive than a film-based system (FBS). However, whether the FLS is more profitable than the FBS from the viewpoint of hospital management strongly depends on the medical insurance system.

Fast image accessing based on an analysis of the picture archiving and communications system in Kochi Medical School.

A large-scale picture archiving and communication system was developed by Kochi Medical School. Using JPEG to achieve 90% compression, this system was capable of storing several years worth of CT and MR examination records and eliminated the bottleneck in conventional systems caused by slow data access in the filing system. Under the new system, access of image files from client PCs was checked for bottlenecks. The image file retrieval from the image database on the server was found to require the longest time. Two methods were considered to eliminate this bottleneck. One was a multiimages filing into a file. Another was an image transmission with multiparallel transmission sessions, which is proposed in this article. By adopting the latter method, the system can transmit 50 CT images from the image database server to a client PC in about 10 s.