Scheduling: if your RIS cannot, perhaps your HIS can.

As the services radiology departments provide have proliferated--new modalities, additional procedures--the scheduling process has become more complex. Radiology departments have been criticized by referring physicians and their staff for difficulties they encounter when scheduling patients for procedures. In light of managed care and increased competition for outpatient services, scheduling systems should be designed with the referring physician's office as the prime customer. Vanderbilt University Medical Center (VUMC) has devised a collaborative, hospital-wide system for scheduling. The same system is used by The Vanderbilt Clinics, which refer a significant number of outpatient procedures to VUMC. The radiology department has tailored the system to its technical requirements, and clinic staff members can access the system directly to schedule patient appointments. Minor adjustments were made during implementation of the process. Now, appointments are made efficiently by the clinic staff, and other systems, such as the film library, are benefiting from better information and organization. VUMC has changed the scheduling process of the radiology department to reach the customers who actually promote the radiology practice. Communication between the department and the clinics has improved and a spirit of teamwork is growing.

Writing a PACS program statement.

Medical telecommunications is becoming a necessity for maintaining the quality of care and delivering services on a timely basis in the current environment of cutting services and specialists to reduce costs. (Vanden Brink 1994). Picture archiving and communications systems (PACS) and teleradiology are increasingly viable because there is easier connectivity among modalities and manufacturers. Agreement on the DICOM Standard is one step toward greater connectivity. Two-thirds of the 350 radiology administrators, radiologists, hospital administrators and MIS directors interviewed for the 1994 IMACS/PACS Tracking Study believe that the use of image telecommunication technology is growing. In 1993, Vanderbilt University Medical Center (VUMC) formed a committee to evaluate the need for PACS and to compile a program statement. The principal purpose of the program statement is to provide fundamental information that can be understood easily by individuals outside the radiology department. It outlines the benefits of PACS and includes a financial analysis of the purchase and installation of a system. Key elements of the program statement include a description and analysis of the existing film library system, advantages of PACS, implementation plan, financial proforma and integration with the hospital information system. These and other topics are covered in detail in the following article.

MDA-image: an environment of networked desktop computers for teleradiology/pathology.

MDA-Image, a project of The University of Texas M. D. Anderson Cancer Center, is an environment of networked desktop computers for teleradiology/pathology. Radiographic film is digitized with a film scanner and histopathologic slides are digitized using a red, green, and blue (RGB) video camera connected to a microscope. Digitized images are stored on a data server connected to the institution's computer communication network (Ethernet) and can be displayed from authorized desktop computers connected to Ethernet. Images are digitized for cases presented at the Bone Tumor Management Conference, a multidisciplinary conference in which treatment options are discussed among clinicians, surgeons, radiologists, pathologists, radiotherapists, and medical oncologists. These radiographic and histologic images are shown on a large screen computer monitor during the conference. They are available for later review for follow-up or representation.