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Biomedical subjects

Matthew D Ralston

Publications and source records attributed to Matthew D Ralston.

4 recordsLinked to original sources

Multidimensional analysis: a management tool for monitoring HIPAA compliance and departmental performance.

Most RIS and PACS systems include extensive auditing capabilities as part of their security model, but inspecting those audit logs to obtain useful information can be a daunting task. Manual analysis of audit trails, though cumbersome, is often resorted to because of the difficulty to construct queries to extract complex information from the audit logs. The approach proposed by the authors uses standard off-the-shelf multidimensional analysis software tools to assist the PACS/RIS administrator and/or security officer in analyzing those audit logs to identify and scrutinize suspicious events. Large amounts of data can be quickly reviewed and graphical analysis tools help explore system utilization. While additional efforts are required to fully satisfy the demands of the ever-increasing security and confidentiality pressures, multidimensional analysis tools are a practical step toward actually using the information that is already being captured in the systems' audit logs. In addition, once the work is performed to capture and manipulate the audit logs into a viable format for the multidimensional analysis tool, it is relatively easy to extend the system to incorporate other pertinent data, thereby enabling the ongoing analysis of other aspects of the department's workflow.

Computer Security↗

Progress toward paperless radiology in the digital environment: planning, implementation, and benefits.

A growing number of hospitals have installed PACS (Picture Archiving and Communications Systems) in order to improve patient care and to facilitate improved efficiencies. While eliminating films is commonly one of the first goals in planning a successful PACS implementation, eliminating the manual handling of paperwork can also produce a substantial benefit. We describe the process utilized at Maine Medical Center (MMC) to achieve a substantial degree of freedom from paperwork. Some of the benefits were expected, but some unexpected benefits also revealed themselves during this process.

Efficiency, Organizational↗

An organized pilot program promoting web access to picture archiving and communications system data: emphasis on offices outside the host institution.

A formal Pilot Program for Web-based access to a host picture archiving and communication system (PACS) can augment the transition to filmless radiology. Beyond the technical issues of PCs and networks, appropriate legal input and documentation is necessary. While it is important to be in line with overall institutional priorities with regard to online access strategies, it is important to recognize that the Radiology Department has the greatest stake in successfully going filmless, and that it is incumbent upon the Radiology Department itself to take on outreach efforts to the medical community at large. The MMC Web Access Pilot Project has been successful in helping key non-MMC offices overcome the issues associated with preparing for and mastering Web access to PACS images. The benefit has been mutual, and MMC is now able to provide better advice to new offices that are coming online, as well as sharpening its focus on logistical issues that need to be resolved if we are to eliminate film from medical practice.

Humans↗

Sharing of a single picture archiving and communications system among disparate institutions: barriers to success.

There has been a great deal of interest in sharing picture archiving and communications system (PACS) technology. Much of the discussion to this point has involved macro business/technical issues, such as cost for service, bandwidth, and storage technologies. In our own effort to share the Maine Medical Center PACS with other providers, we have found that the micro issues are just as important, including trust, cooperation, persistence, and dedication to fundamental change. It is not impossible to share a PACS, but a number of barriers must be overcome if the overall effort is to be successful. In this paper we present our experience with shared PACS technology by describing the impediments to sharing PACS among disparate institutions; explaining our early attempts to integrate "outside" images into our institutional PACS and the impediments that led to the failure of those early attempts; and suggesting a semi-quantitative means for calculating Likelihood of Success, based on lessons learned thus far. We also describe a new, multilevel effort at sharing our PACS, hoping to stimulate discussion of the barriers to success and to solicit input from PACS vendors and from fellow SCAR members.

Computer Communication Networks↗