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The benefits of hospital-wide picture archiving and communication systems: a survey of clinical users of radiology services.

This paper describes one element of a broad evaluation of a hospital-wide picture archiving and communication system (PACS): an assessment of the views of users of the radiology service, their major causes of dissatisfaction with the service, the incidence of image unavailability, and the consequences of images being unavailable. The principal research design was a "before and after" comparison at Hammersmith Hospital, as the hospital site introducing PACS. Several other hospitals were included in this survey, for comparison. Questionnaires were distributed several times before PACS was operational at Hammersmith, and on one occasion after. The overall response rate was 54%. The main pre-PACS radiology-related problem areas were: the non-availability of images, the non-availability of written reports when clinically required, and the time devoted by junior staff to image searching. PACS greatly reduced the perceived problem of image non-availability. But Hammersmith's problems with the availability of radiological reports still remained when PACS was operational. The time junior doctors spent in image-searching was dramatically reduced by the introduction of PACS.

Attitude of Health Personnel↗

Real-time notification of laboratory data requested by users through alphanumeric pagers.

The authors developed a novel feature in their clinical information systems, which allows clinicians to request notification about laboratory results. Clinicians who are expecting a particular laboratory result for a particular patient can request a report of the result via an alphanumeric pager as soon as the result is filed into the patient database. This feature has gained popularity and is heavily used in both inpatient and outpatient settings, at a rate of about 2,300 times per month. This event-monitor-based feature illustrates one way that information technology can be applied to improve communication in health care.

Clinical Laboratory Information Systems↗

Nurses, pagers, and patient-specific criteria: three keys to improved critical value reporting.

At LDS Hospital, we have developed and evaluated a computerized critical value reporting system based on digital pagers. Criteria used to identify critical values are patient-specific. An evaluation of the system was conducted from October 23, 1993 to January 21, 1994. Results showed that 100% of all critical values (497 values in the form of 335 alerts) were reported to clinicians within an average of 38.6 minutes, and that 51% of all alerts were received within 12 minutes. Data also showed that 92% of the alerts were considered valid, that 76% were communicated directly to the primary care nurse, and that 67% of the time nurses were previously unaware of the critical value(s).

Artificial Intelligence↗

Facsimile machines for medication order transmission.

The use of facsimile machines for medication order transmission has improved turnaround time and provided benefits for the Department of Pharmacy Services and the hospital. As a result of this program pharmacists have more time and more opportunities to improve drug therapy because they no longer have to travel to patient care units or handle patient charts for the purpose of order entry. Pharmacists will have even more time when technicians have been fully trained to carry out medication order entry. Important also is the ability for nurses to FAX rather than hand carry urgently needed orders to the pharmacy satellites. The use of FAX machines in this manner lowers the cost of patient care and makes this technology available for other purposes as well. It is becoming increasingly clear that pharmacists, as well as others, can utilize modern technology such as this to maintain and improve services in the presence of a cost-containment environment.

Competitive Bidding↗

Prepaid convenience.

Consider prepaid calling cards as a new tool in your marketing arsenal. Your hospitality facility may be considering the sale and distribution of prepaid phone cards to provide more convenience to patients or as a replacement to traditional calling cards for mobile employees. Prepaid phone cards represent a new twist and many advantages for long distance calling.

Hospital Communication Systems↗