Computerized system links library with patient care.
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The Norfolk and Norwich University Hospital has incorporated a fully filmless Picture Archiving and Communication System (PACS) as part of a new hospital provision using PFI funding. The PACS project has been very successful and has met with unanimous acclaim from radiologists and clinicians. A project of this size cannot be achieved without learning some lessons from mistakes and recognising areas where attention to detail resulted in a successful implementation. This paper considers the successes and problems encountered in a large PACS installation.
In a previous report we described a second-generation hospital-integrated picture archiving and communication system (HI-PACS) developed in-house. This HI-PACS had four unique features not found in other PAC systems. In this report, we will share some of our clinical experiences pertaining to these features during the past 12 months. We first describe the usage characteristics of two 2,000-line workstations (WSs), one in the in-patient and the second in the out-patient neuroradiology reading area. These two WSs can access neuro-images from 10 computed tomographic and magnetic resonance scanners located two medical centers through an asynchronous transfer mode network connection. The second unique feature of the system is an intensive care unit (ICU) server, which supports three WSs in the pediatric, medical surgery, and cardiac ICUs. The users' experiences and requests for refinement of the WSs are given. Another feature is physician desk-top access of PACS data. The HI-PACS provides a server connected to more than 100 Macintosh users for direct access of PACS data from their offices. The server's performance and user critiques are described. The last feature is a digital imaging and communication in medicine (DICOM) connection of the HI-PACS to a manufacturer's ultrasound PACS module. The authors then outline the interfacing process and summarize some of the difficulties encountered. Developing an in-house PACS has many advantages but also some drawbacks. Based on experience, the authors have formulated three axioms as a guide for in-house PACS development.
A PSRO audit of laboratory performance can be achieved without additional manpower if tied into the communication and laboratory system of the hospital. Techniques are described which provide immediate physician feedback for education. Cumulative statistics are recorded for internal laboratory review and for validation of technical performance. Through proper system designs, significant improvements can be achieved which do decrease health care costs and optimize professional interaction.
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This article describes a method for organizing and staffing a hospitalwide patient transportation system in such a way as to minimize patient waiting times. The method stems from a quality improvement project and includes a centralized communication system, a queuing model to determine staffing requirements, and a computerized data collection and monitoring system. A case study demonstrates improvements in waiting times, costs, and customer satisfaction.
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Pharmacy bulletin boards are a new phenomenon in the world of health care. Many of the most successful were started barely more than a year ago. In this age of rapid change, finding ways to stay on the leading edge of technology will help you to succeed in managing your pharmacy, and will help make life much more interesting. Try calling some of these bulletin boards to find out if this is a form of technology on which you can capitalize. The box entitled "Walk Through of a Log-On," has been included for the novice as a primer.
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The optimization and redesign of business processes in hospitals is an important challenge for the hospital information management who has to design and implement a suitable HIS architecture. Nevertheless, there are no tools available specializing in modeling information-driven business processes and the consequences on the communication between information processing, tools. Therefore, we will present an approach which facilitates the representation and analysis of business processes and resulting communication processes between application components and their interdependencies. This approach aims not only to visualize those processes, but to also to evaluate if there are weaknesses concerning the information processing infrastructure which hinder the smooth implementation of the business processes.
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