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PubMed1984

Radiology 1984. A conflict of high technology and high cost.

Radiology is confronted now by exciting but challenging times. The excitement derives from dramatic technological advance; the challenge from the economic constraints on health care delivery. The large and growing expense of providing health care is readily apparent and high technology medicine can too easily be blamed for the growth. The pressures for improved service at no extra cost will demand much of the negotiating skills of our specialty and our ability to survive administrative confusion and fragmentation. Equally, manpower planning is a feature of modern medicine. Often this is done from inadequate data and as a specialty we must continue to think constructively about our own future in this context, not least in recognizing the contribution of women to our specialty. Forces also to be recognized are decentralization, electronic information transfer, concerns about radiation exposure and litigation. Not least we need to be better able to define our specialty as its scope is now changing rapidly. For the future I hope that we can be part of the development of the controls which we must inevitably face; we should lead in instituting cost-accounting in our departments; we must be at the leading edge of technological change in both imaging and data transfer, and we must be both more business-like as well as act effectively as the patient's advocate. Radiology has an important and growing responsibility in patient care and most of the technological advances both improve that care and can be justified economically. I am proud to be a radiologist in 1984.

Canada↗
PubMed1989

Mini-micro-mainframe computer marriage: combining technologies in a radiology results reporting system.

The minicomputer-based information system in the Department of Radiology at the Medical College of Georgia Hospital and Clinics was placed in service in February, 1982. This system represents a sizable investment in minicomputer hardware in addition to more than 6 years of software customization. One serious deficiency in the original system was the lack of a radiology results reporting facility. Several options were considered to provide the department with this capability. The most obvious option was retiring the existing system and replacing it with one of a number of commercial products already offering results reporting. In-house development of a reporting facility lent itself more readily to microcomputers than to the existing minicomputer system. Due to system customization, economic and time constraints, it was decided to merge an in-house developed microcomputer-based report module into our existing minicomputer system. The minicomputer was able to communicate with and transfer files to and from both micro and mainframe systems. Combining technologies allowed us to continue taking advantage of our sizable investment in money, time, and customization while providing a microcomputer-based report module. Radiology reports are now typed on microcomputer word processors and bulk transferred to the minicomputer. The minicomputer provides access to both unapproved and approved reports on system terminals throughout the department. It also enhances reports by merging patient demographics and registration information. Using existing communications facilities to the hospital mainframe system, reports are provided throughout the institution.

Computer Communication Networks↗
PubMed1979

Diagnostic radiology: geography of a high technology.

A survey was made of the manpower employed, facilities available and utilization of radiology in countries in tropical Africa and Southeast Asia. The data obtained are compared with those from industralized societies in temperate climates. The level of use of radiographic services varied by a factor as high as 40. The differences between the level of radiology manpower available could be over a hundredfold and for x-ray technologists, many hundred times. The concentration of services in capital cities is characteristic of many tropical societies. Measures to improve radiologic health care in tropical countries, with particular emphasis on rural areas, are discussed. The main need is for availability of radiodiagnosis close to the primary care level in rural areas to deal with the important clinical problems of trauma, chest infections, and obstetrics. Simplification of equipment and employment of technicians with short training can help relieve maldistribution of services.

Africa↗
PubMed1996

Cost modeling as a technology assessment tool for radiology department capital equipment acquisitions.

Changes reshaping the healthcare delivery system impact capital equipment acquisition decisions within radiology departments. During an era of rapid technological advancement, acquisition decisions often favor new imaging technology with an emphasis on volume and revenue increases. With a slowdown or plateau in new imaging technology and significant changes in the healthcare delivery structure, greater emphasis is now being given to productivity and quality improvement investments. Such investments are aimed at reducing labor and material operating costs through capital investment in electronic alternatives, such as the digital viewing and storage of diagnostic images in lieu of film. This shift in emphasis presents a dilemma for radiology departments because it is often more difficult to show a quality and productivity improvement justification. One approach is to use a formal ¿technology assessment¿ (TA) process wherein a manager considers changes in processes, labor, equipment, space, and consumables, and then assesses that impact on cost, utilization, quality of care, and other factors. A cost model is a useful tool in this process. A review of a number of real world experiences demonstrates the benefits of more timely and informed capital equipment investment decisions. While the direct savings may not entirely offset such investments, TA analysis also evaluates in tangible benefits that may not be quantifiable in economic terms. Both tangible cost savings and intangible benefits need to be weighed against the net investment in a new technology.

Capital Expenditures↗