Advanced Medical Imaging Protocol Workflow—A Flexible Electronic Solution to Optimize Process Efficiency, Care Quality and Patient Safety in the National VA Enterprise (original) (raw)
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The Future of the Radiology Information System
American Journal of Roentgenology, 2013
R adiology departments were among the first clinical departments in health care to implement electronic systems as part of their clinical workflow, with the first such systems to assist radiology reporting processes appearing as early as the mid-1960s [1]. The early systems were information islands used to manage the operations of radiology independently of the hospital. This included managing the patient identification database and the ordering physician database, as well as tracking the patient through the steps of acquiring the images and tracking report interpretation. The advancements in radiology informatics to date, including integration of PACS and the radiology information system (RIS) into department workflow, have done much to increase departmental efficiency. Multiple groups have highlighted the decreased number of steps within the standard workflow when using these systems compared with traditional film-and-paper-based systems; this has led to departmental efficiency (higher volume of studies being performed and interpreted), improved customer service (via faster report turnaround time and ready availability of images for clinician review), and decreased costs. The fundamental advantages of these systems lie in their ability to keep massive amounts of data (of all types, including images, demographic and
International Congress Series, 2005
This review paper is based on the 2004 UCLA Seminar on Imaging and Informatics (http://www.radnet.ucla.edu/Arrowhead2004/) which is a joint endeavour between the UCLA and the CARS organization, focussing on workflow analysis tools and the digital operating room. Eleven specific presentations of the Arrowhead Seminar have been summarized in this review referring to redesigning perioperative and intraoperative care. D 2005 Published by Elsevier B.V. which many examples of clinical workflows were presented and discussed as regards their impact on radiological and surgical processes.
Radiology information system: a workflow-based approach
International journal of …, 2009
Purpose: Introducing workflow management technology in healthcare seems to be prospective in dealing with the problem that the current healthcare Information Systems cannot provide sufficient support for the process management, although several challenges still exist. The purpose of this paper is to study the method of developing workflow-based information system in radiology department as a use case. Method: First, a workflow model of typical radiology process was established. Second, based on the model, the system could be designed and implemented as a group of loosely coupled components. Each component corresponded to one task in the process and could be assembled by the workflow management system. The legacy systems could be taken as special components, which also corresponded to the tasks and were integrated through transferring non-work- flow-aware interfaces to the standard ones. Finally, a workflow dashboard was designed and implemented to provide an integral view of radiology processes. Result: The workflow-based Radiology Information System was deployed in the radiology department of Zhejiang Chinese Medicine Hospital in China. The results showed that it could be adjusted flexibly in response to the needs of changing process, and enhance the process management in the department. It can also provide a more workflow-aware integration method, comparing with other methods such as IHE-based ones. Conclusion: The workflow-based approach is a new method of developing radiology information system with more flexibility, more functioalities of process management and more workflow-aware integration. The work of this paper is an initial endeavor for introducing workflow management technology in healthcare.
A Workflow Component for Knowledge Management in the Field of Radiological Examinations
2000
In this paper we present a w ork ow component f o r t h e k n o wledge intensive task of reporting radiological images. Our component integrates the current developments in medical standards. It should act as an organizational memory for private radiological hospitals and help to train young physicians. We h a ve build a computer aided methodology to create standard examination protocols and the physician can use an assistant system during his daily work. Our approach helps to save t h e organizational knowledge of a private hospital.
Integrated communication: workflow enhancement in the digital diagnostic radiology department
International Congress Series, 2004
Numerous factors have an impact on the workflow efficiency in a typical Diagnostic Radiology Department. Enhancing workflow efficiency is especially critical given the current staffing levels of radiologists and radiology technical personnel. Our observation is that one factor that plays an increasingly important role in the adverse effect on technologist productivity is the availability of the supervising radiologist for consultation. Communication patterns were evaluated in our department. Based on our observation, it was determined that a more efficient mechanism of communication was necessary in order to reduce radiologists and technologists time commitments. It was determined that an online, internet-based communication system would be more valuable than a telephony-based system. An integrated communication system was identified and installed in the digital mammography setting. The time required for completion of diagnostic digital mammograms both without and with the communication system was evaluated. Technologist travel time was also evaluated. The impact of the integrated communication system was immediately noted by the technologists. A time saving of between 1.2 and 2.1 min was noted. An annual saving in technologist time of between 3 and 5 days could be realized. An improvement in patient care was noted. D 2004 CARS and Elsevier B.V. All rights reserved.
Journal of digital imaging, 2017
Numerous initiatives are in place to support value based care in radiology including decision support using appropriateness criteria, quality metrics like radiation dose monitoring, and efforts to improve the quality of the radiology report for consumption by referring providers. These initiatives are largely data driven. Organizations can choose to purchase proprietary registry systems, pay for software as a service solution, or deploy/build their own registry systems. Traditionally, registries are created for a single purpose like radiation dosage or specific disease tracking like diabetes registry. This results in a fragmented view of the patient, and increases overhead to maintain such single purpose registry system by requiring an alternative data entry workflow and additional infrastructure to host and maintain multiple registries for different clinical needs. This complexity is magnified in the health care enterprise whereby radiology systems usually are run parallel to other...
Coordinating patient care within radiology and across the enterprise
Journal of the American College of Radiology : JACR, 2014
For the practice of radiology, the transition to filmless imaging operations has resulted in a fundamental transition to more efficient clinical operations. In addition, the electronic delivery of diagnostic studies to the bedside has had a great impact on the care process throughout the health care enterprise. The radiology information system (RIS) has been at the core of the transition to filmless patient care. In a similar manner, the electronic medical record (EMR) is fundamentally and rapidly transforming the clinical enterprise into paperless/digital coordination of care. The widespread availability of EMR systems can be predicted to continue to increase the level of coordination of clinical care within the EMR framework. For the radiologist, readily available clinical information at the point of interpretation will continue to drive the evolution of the interpretation process, leading to improved patient outcomes. Regardless of practice size, efficient workflow processes are ...
Paperless Protocoling of CT and MRI Requests at an Outpatient Imaging Center
Journal of Digital Imaging, 2008
We created our imaging center (IC) to move outpatient imaging from our busy inpatient imaging suite off-site to a location that is more inviting to ambulatory patients. Nevertheless, patients scanned at our IC still represent the depth and breadth of illness complexity seen with our tertiary care population. Thus, we protocol exams on an individualized basis to ensure that the referring clinician's question is fully answered by the exam performed. Previously, paper based protocoling was a laborious process for all those involved where the IC business office would fax the requests to various reading rooms for protocoling by the subspecialist radiologists who are 3 miles away at the main hospital. Once protocoled, reading room coordinators would fax back the protocoled request to the IC technical area in preparation for the next day's scheduled exams. At any breakdown in this process (e.g., lost paperwork), patient exams were delayed and clinicians and patients became upset. To improve this process, we developed a paper free process whereby protocoling is accomplished through scanning of exam requests into our PACS. Using the common worklist functionality found in most PACS, we created "protocoling worklists" that contain these scanned documents. Radiologists protocol these studies in the PACS worklist (with the added benefit of having all imaging and report data available), and subsequently, the technologists can see and act on the protocols they find in PACS. This process has significantly decreased interruptions in our busy reading rooms and decreased rework of IC staff.
Computers in imaging and health care: Now and in the future
Journal of Digital Imaging, 2000
Early picture archiving and communication systems (PACS) were characterized by the use of very expensive hardware devices, cumbersome display stations, duplication of database content, lack of interfaces to other clinical information systems, and immaturity in their understanding of the folder manager concepts and workflow reengineering. They were implemented historically at large academic medical centers by biomedical engineers and imaging informaticists. PACS were nonstandard, home-grown projects with mixed clinical acceptance. However, they clearly showed the great potential for PACS and filmless medical imaging. Filmless radiology is a reality today. The advent of efficient softcopy display of images provides a means for dealing with the ever-increasing number of studies and number of images per study. Computer power has increased, and archival storage cost has decreased to the extent that the economics of PACS is justifiable with respect to film. Network bandwidths have increased to aliow large studies of many megabytes to arrive at display stations within seconds of examination completion. PACS vendors have recognized the need for efficient workflow and have built systems with intelligence in the management of patient data. Close integration with the hospital information system (HiS)-radiology information system (RIS) is critical for system functionality. Successful implementation of PACS requires integration or interoperation with hospital and radiology information systems. Besides the economic advantages, secure rapid access to all clinical information on patients, including imaging studies, anytime and anywhere, enhances the quality of patient care, although it is difficult to quantify. Medical image management systems are maturing, providing access outside of the radiology department to images and clinical information throughout the hospital or the enterprise via the Internet. Small and medium-sized community hospitals, private practices, and outpatient centers in rural areas will begin realizing the benefits of PACS already realized by the large tertiary care academic medical centers and research institutions. Hand-held devices and the Worldwide Web are going to change the way people communicate and do business. The impact on health care will be huge, including radiology. Computer-aided diagnosis, decision support tools, virtual imaging, and guidance systems will transform our practice as value-added applications utilizing the technologies pushed by PACS development efforts.
Decision support systems for clinical radiological practice -- towards the next generation
British Journal of Radiology, 2010
The huge amount of information that needs to be assimilated in order to keep pace with the continued advances in modern medical practice can form an insurmountable obstacle to the individual clinician. Within radiology, the recent development of quantitative imaging techniques, such as perfusion imaging, and the development of imaging-based biomarkers in modern therapeutic assessment has highlighted the need for computer systems to provide the radiological community with support for academic as well as clinical/translational applications. This article provides an overview of the underlying design and functionality of radiological decision support systems with examples tracing the development and evolution of such systems over the past 40 years. More importantly, we discuss the specific design, performance and usage characteristics that previous systems have highlighted as being necessary for clinical uptake and routine use. Additionally, we have identified particular failings in our current methodologies for data dissemination within the medical domain that must be overcome if the next generation of decision support systems is to be implemented successfully.