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At least 415 records · Page 23Linked to original sources
PubMed2006

A balanced evaluation perspective: picture archiving and communication system impacts on hospital workflow.

Around the world, hospitals are faced with both budget and regulatory pressures, forcing them to re-examine the way clinical practice is carried out. Proposed technologies that provide workflow enhancements include Picture Archiving and Communications Systems (PACS); however, is PACS really effective in improving hospital workflow and the flow onto patient care, and how should this be evaluated? An acknowledged and successful approach for organizational evaluation is the Balanced Scorecard (BSC), providing the fundamental features for assessing organizations from various perspectives. In this research, the impact of PACS on the workflow of a large public hospital in Melbourne, Australia, is examined using an adapted version of the BSC. Empirically, this model was applied as an evaluation instrument through a series of in-depth interviews with PACS users. Results show that PACS did improve hospital workflow considerably and that the organizational alignment of PACS in hospitals is an important critical success factor.

Efficiency, Organizational↗
PubMed1999

Evaluation of a hospital picture archiving and communication system.

OBJECTIVES: To establish the net costs to the hospital and the broad range of benefits associated with a hospital-wide picture archiving and communication system (PACS) that comprised digital acquisition, storage and transmission of radiological images via a hospital-wide network to 150 workstations. METHODS: 'Before and after' comparisons and time series analyses at Hammersmith Hospital (London, UK), and comparison with five other British hospitals where PACS was not being installed. The cost analysis considered implementation costs and changes in key elements of hospital running costs, including the impact of changes in the length of inpatient stays. A range of benefit measures were investigated, including image availability, avoidance of repeat imaging, avoidance of exposure to radiation, patient turn-round speed, time from examination to image availability in intensive care, avoidance of diagnostic 'errors' by casualty doctors, the additional diagnostic value of PACS-based images and clinician satisfaction. RESULTS: The annual equivalent capital cost of the PACS was 1.7 million Pounds (annual equivalent replacement cost: 0.8 million Pound). Overall, the PACS substantially increased running costs. No convincing evidence of a PACS-induced change in length of inpatient stay was found. PACS was associated with some improvements in the performance of the radiology department: improved image availability (97.7% versus 86.9%), lower repeat imaging rate (7.3% versus 9.9%) and 20% lower total radiation doses for examinations of the lateral lumbar spine. No improvements were identified in the quality of the radiology reporting service. Benefits outside radiology included shorter time from examination to image availability for routine uses in intensive care (19 versus 37 minutes), and a lower rate of diagnostic 'errors' in casualty (0.65% versus 1.51%). High levels of satisfaction with PACS were found amongst both providers and clinical users. CONCLUSIONS: PACS was almost universally preferred by users and brought many operational and clinical benefits. However, these advantages came at a significant capital and net running cost.

Cost-Benefit Analysis↗
PubMed1993

Interfacing aspects between the picture archiving communications systems, radiology information systems, and hospital information systems.

Information relevant to radiological applications is commonly managed by several autonomous medical information systems including hospital information systems (HIS), radiological information systems (RIS), and picture archiving and communications systems (PACS). In this report, we explain the need to coordinate these systems and to provide some framework in which they can exchange information. In the first half of this report, we describe the integration of a PACS system into a hospital operation. Next, we present the interfacing methods between the HIS and the RIS, and between the RIS and the PACS. Two methods are further detailed for the communication between the RIS and the PACS (1) the triggered database to database transfer, and (2) the query protocol. The implementation of the first method successfully allows RIS reports, procedure and patient demographic information to be displayed at the request of the user along with the associated images at a PACS workstation. The query protocol allows a PACS to dynamically query RIS information. It will be eventually integrated into the design of a scientific multimedia distributed medical database system built on top of the HIS, the RIS, and the PACS.

Academic Medical Centers↗
PubMed1993

Improving customer relations and telephone response in Abbott Northwestern Hospital's laboratory department.

PROJECT: Improve the Laboratory's phone answering process. Principals: Clinical and administrative laboratory staff and a telecommunications specialist. Process Improvement Method: Modification of model used by the National Demonstration PROJECT on Quality Improvement in Healthcare. Timeline: May 1991-present. RESULTS reported here: August 1991-July 1992. The team is currently reviewing a computerized voice processing system that will take requests to reprint lab reports, take outpatient lab orders directly from doctors' offices, and provide test results and information on test tube specification for specific blood tests. Key Findings or Improvements: More than half the calls to the Laboratory needed to be transferred to Microbiology. Alternative communication systems such as a computerized voice answering system and the hospital's computer network could be used in place of phones to transmit information to and from the Laboratory. RESULTS: With the installation of an automated answering system, calls to Microbiology are automatically re-routed and the number of incoming calls to the Laboratory have dropped. More lab requests and reports are being handled by computer.

Consumer Behavior↗
PubMed1998

Development of a clinical event monitor for use with the Veterans Affairs Computerized Patient Record System and other data sources.

We are developing an event monitor to operate with the Veterans Affairs Computerized Patient Record System (CPRS). The event monitor is designed to receive messages when important patient events such as posting of new results, patient movement, and orders occur. Our design separates the event monitor from CPRS itself, using communication via a network connection to receive HL7 messages, to access other data needed to run rules, and to communicate with providers by message display, electronic mail and other mechanisms. Results from operation of the event monitor using patient data in our test account show that a wide variety of data can be accessed by the event monitor with acceptable response times.

Computer Communication Networks↗
PubMed1992

Eligibility rules for special emergency paging--FCC. Final rule.

This action modifies 90.38 of the Commission's Rules by expanding the eligibility of end users to which special emergency paging licensees can provide service. Hospital paging systems could not be used to inform participants in an organ donor program of the availability of a suitable organ. The Commission has decided that patients actively awaiting an organ transplant should be eligible under the Special Emergency Radio Service to receive paging service.

Emergency Medical Service Communication Systems↗