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Eliot Siegel

Publications and source records attributed to Eliot Siegel.

13 recordsLinked to original sources
PubMed2006

Radiology reporting: returning to our image-centric roots.

OBJECTIVE: Despite extraordinary advances in imaging and information technologies, the form and content of radiology reporting has changed little in the discipline's more than 100-year history. In this commentary, we outline the challenges that have confronted innovations such as speech recognition and structured reporting and call for a radical rethinking of the reporting process. By combining new applications with the expanding power of radiology and hospital information systems, the attention of the radiologist--and his or her referring colleagues--could be more focused on the image and its meaning. CONCLUSION: One promising result of such a change in focus could be improved and more reliable communication, already an area of heightened concern in the imaging community. Moreover, such a shift away from the printed word to image-centered content could lead to benefits in shared image viewing; more streamlined and timely reporting; data mining of aggregate results; and image archives, and, ultimately, enhancement of the consultative value of the radiologist's contribution to patient care and treatment.

Communication↗
PubMed2005

Docetaxel followed by hormone therapy in men experiencing increasing prostate-specific antigen after primary local treatments for prostate cancer.

PURPOSE: Prostatectomy or radiation for localized prostate cancer (PC) can fail in up to 15% to 30% of patients. The purpose of this study was to determine feasibility, tolerability, and outcome of docetaxel followed by hormone therapy in men experiencing an increasing prostate-specific antigen (PSA) after their primary local treatments for PC. PATIENTS AND METHODS: Men with increasing serum PSA after prostatectomy or/and radiation were eligible. Serum PSA had to be > or = 4 ng/mL and serum testosterone had to be in the noncastrate range. Treatment included docetaxel 70 mg/m2 every 3 weeks for up to six cycles, followed by total androgen suppression (luteinizing hormone-releasing hormone agonist plus bicalutamide) and peripheral androgen blockade (finasteride plus bicalutamide) for 12 to 20 months. RESULTS: Thirty-nine men were enrolled; 32 had PSA-only failure, seven also had clinical metastasis. Baseline median PSA was 13.7 ng/mL. Serum PSA decreased > or = 50% in 17 of 35 patients (48.5%) and > or = 75% in seven of 35 patients (20%) with docetaxel. The PSA decreased to a median of 0.1 ng/mL with subsequent hormone therapy. In 28 of 33 patients the PSA increased (median, 0.41 ng/mL) at a median follow-up of 2.3 months after treatment. In contrast, in five of 33 men the PSA remains at 0.1 ng/mL at a median of 18.9 months after therapy; three of these five men had soft tissue metastasis at entry but remain in complete remission. The most common grade 3 to 4 toxicity was neutropenia (61.5%). CONCLUSION: Docetaxel followed by hormone therapy of limited duration may provide disease control in subgroups of men experiencing failure after local treatments for PC.

Aged↗
PubMed2004

Addressing the coming radiology crisis-the Society for Computer Applications in Radiology transforming the radiological interpretation process (TRIP) initiative.

The Society for Computer Applications in Radiology (SCAR) Transforming the Radiological Interpretation Process (TRIP) Initiative aims to spearhead research, education, and discovery of innovative solutions to address the problem of information and image data overload. The initiative will foster interdisciplinary research on technological, environmental and human factors to better manage and exploit the massive amounts of data. TRIP will focus on the following basic objectives: improving the efficiency of interpretation of large data sets, improving the timeliness and effectiveness of communication, and decreasing medical errors. The ultimate goal of the initiative is to improve the quality and safety of patient care. Interdisciplinary research into several broad areas will be necessary to make progress in managing the ever-increasing volume of data. The six concepts involved are human perception, image processing and computer-aided detection (CAD), visualization, navigation and usability, databases and integration, and evaluation and validation of methods and performance. The result of this transformation will affect several key processes in radiology, including image interpretation; communication of imaging results; workflow and efficiency within the health care enterprise; diagnostic accuracy and a reduction in medical errors; and, ultimately, the overall quality of care.

Humans↗
PubMed2002

SCAR Radiologic Technologist Survey: analysis of technologist workforce and staffing.

One of the greatest dilemmas facing medical imaging departments today is the worsening personnel crisis in the radiologic technologist (RT) workforce. As the volume and complexity of medical imaging studies continues to increase, an unprecedented imbalance exists between RT supply and demand. A number of etiologic factors have been postulated to contribute to this RT shortage including decreasing morale, perceived inadequacies in compensation, decreasing number of training programs, and limitations in the career ladder. Previous studies have cited improved technologist productivity as imaging departments successfully transition from film-based to filmless operation. This study was undertaken to address the impact of digital technologies (information systems, PACS, digital radiography) on technologist productivity, in an attempt to determine whether these technologies can be used to positively affect the existing RT workforce imbalance. A total of 112 facilities participated in this nationwide study, with representation of imaging providers that paralleled the demographic profile of the marketplace as a whole. Survey results indicate the existing RT staffing shortage is greatest within academic and rural-based hospitals and is most severe in the area of general radiography, which accounts for 65-70% of imaging department volumes. For general radiography alone, respondents report an average shortage of 2 RT full-time equivalents (FTE's) per institution, when comparing the number of budgeted RT FTE's versus the actual number of RT FTE's. Preliminary results indicate that at this time, RT staffing shortages are not affected by the presence or absence of digital information technologies. Additional research is planned through a five-year longitudinal data collection, to better delineate the complex relationship that exists between implementation of digital technologies and RT staffing.

Data Collection↗
PubMed2002

Workflow optimization: current trends and future directions.

In an attempt to maximize productivity within the medical imaging department, increasing importance and attention is being placed on workflow. Workflow is the process of analyzing individual steps that occur during a single event, such as the performance of an MRI exam. The primary focus of workflow optimization within the imaging department is automation and task consolidation, however, a number of other factors should be considered including the stochastic nature of the workload, availability of human resources, and the specific technologies being employed. The purpose of this paper is to determine the complex relationship that exists between information technology and the radiologic technologist, in an attempt to determine how workflow can be optimized to improve technologist productivity. This relationship takes on greater importance as more imaging departments are undergoing the transition from film-based to filmless operation. A nationwide survey was conducted to compare technologist workflow in film-based and filmless operations, for all imaging modalities. The individual tasks performed by technologists were defined, along with the amount of time allocated to these tasks. The index of workflow efficiency was determined to be the percentage of overall technologist time allocated to image acquisition, since this is the primary responsibility of the radiologic technologist. Preliminary analysis indicates technologist workflow in filmless operation is enhanced when compared with film-based operation, for all imaging modalities. The specific tasks that require less technologist time in filmless operation are accessing data and retake rates (due to both technical factors and lost exams). Surprisingly, no significant differences were reported for the task of image processing, when comparing technologist workflow in film-based and filmless operations. Additional research is planned to evaluate the potential workflow gains achievable through workflow optimization software, improved systems integration, and automation of advanced image processing techniques.

Efficiency, Organizational↗
PubMed2002

Changes in technologist productivity with implementation of an enterprisewide PACS.

The purpose of this report is to determine what effect filmless operation has on technologist productivity when compared with traditional film-based operation. Retrospective data on technologist productivity was collected from the study institution before and after implementation of PACS using workload reports and payroll records. Departmentwide technologist productivity was defined as the number of examinations per full-time equivalent (exams/FTE) and correlated with local and nationwide standards operating in traditional film-based operations. During film-based operation, technologist productivity was comparable between the study institution and nationwide standards, allowing for the unique examination volumes and modality mix. After implementation of a large-scale PACS, technologist productivity was found to increase 34% above that of national standards and 48% that of the local control site. Implementation of an enterprisewide PACS offers the potential to significantly improve departmentwide technologist productivity when compared with traditional film-based operation.

Efficiency↗
PubMed2002

Medical Image Resource Center 2002: an update on the RSNA's Medical Image Resource Center.

The Radiological Society of North America has launched a project called the Medical Image Resource Center (MIRC) to establish a community of Web-based libraries of imaging information, including teaching files, other educational materials, and research data. This system would enable radiologic professionals to create and publish such materials more easily and to gain more convenient access to new and existing materials. An overview of the project, a brief summary of the overall requirements and objectives, and a brief description of the progress and ongoing plans for MIRC are presented.

Humans↗
PubMed2002

Speech recognition interface to a hospital information system using a self-designed visual basic program: initial experience.

Speech recognition (SR) in the radiology department setting is viewed as a method of decreasing overhead expenses by reducing or eliminating transcription services and improving care by reducing report turnaround times incurred by transcription backlogs. The purpose of this study was to show the ability to integrate off-the-shelf speech recognition software into a Hospital Information System in 3 types of military medical facilities using the Windows programming language Visual Basic 6.0 (Microsoft, Redmond, WA). Report turnaround times and costs were calculated for a medium-sized medical teaching facility, a medium-sized nonteaching facility, and a medical clinic. Results of speech recognition versus contract transcription services were assessed between July and December, 2000. In the teaching facility, 2042 reports were dictated on 2 computers equipped with the speech recognition program, saving a total of US dollars 3319 in transcription costs. Turnaround times were calculated for 4 first-year radiology residents in 4 imaging categories. Despite requiring 2 separate electronic signatures, we achieved an average reduction in turnaround time from 15.7 hours to 4.7 hours. In the nonteaching facility, 26600 reports were dictated with average turnaround time improving from 89 hours for transcription to 19 hours for speech recognition saving US dollars 45500 over the same 6 months. The medical clinic generated 5109 reports for a cost savings of US dollars 10650. Total cost to implement this speech recognition was approximately US dollars 3000 per workstation, mostly for hardware. It is possible to design and implement an affordable speech recognition system without a large-scale expensive commercial solution.

Cost-Benefit Analysis↗
PubMed2002

Work flow redesign: the key to success when using PACS.

OBJECTIVE: Our objective is to emphasize the importance of work flow redesign, rather than filmless operation itself, to achieve cost reduction and improvement in productivity with picture archiving and communication systems (PACS). CONCLUSION: Our 8-year experience with PACS shows that the greatest benefit of the transition to a digital system has been the ability to use it as a tool to reengineer overall work flow, both in the imaging department and throughout the health care enterprise.

Efficiency, Organizational↗