SEARCH · PubMed Health

Results for “Workflow”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,531 records · Page 85Linked to original sources

PubMedDate not supplied

Improving medical imaging report turnaround times.

Southern Ohio Medical Center (SOMC), a 232-bed community-based teaching hospital, is equipped with state-of-the-art equipment such as 2 16-slice computed tomography (CT) scanners, 3 MR scanners, 3 ultrasound scanners, 2 digital mammography units, and 3 nuclear medicine cameras. One hundred twenty-six employees--ranging from support personnel to technologists along with 7 board-certified radiologists--staff the medical imaging department. Procedure volume is approximately 164,000 per year and is performed in all American College of Radiology (ACR)-accredited modalities. Filmless since 1998, SOMC's medical imaging department has resulted in productivity gains to the estimated 164,000 procudures for fiscal year 2005. The catalyst for the department is a robust picture archiving and communication system (PACS). Working with the radiologists, staff, and transcription services, turnaround time was reduced to from 13 hours to 9 hours from exam start to report sign off. Additional technology intervention was essential to further decrease report turnaround time. SOMC served as a beta site for a radiology information system (RIS). The new RIS has allowed the medical imaging department to move from a paper department to a "pseudo paperless" department. Orders, history sheets, consents, and other forms are scanned into the RIS for staff and radiologist use. Requisitions are no longer printed, and staff has access to review workstations to ensure that patients are called back into the department for procedures. This new workflow has also reduced paper traffic within the department. The last piece of the technology puzzle to improve report turnaround time was voice recognition technology. From its implementation, voice recognition enhanced the RIS technology. All of the radiologists began to use the product as soon as it was available. They perform all the editing and corrections either by voice command or by manual typing. The medical imaging department has noted that voice command corrections and editing are more efficient for the radiologist. The overall impact on decreased radiology report turnaround times is not only seen in medical imaging, but also has a global affect within the hospital. SOMC plans to realize a reduction length of patient stays, and a faster process for plotting the course of patient treatment, e.g., faster visits from emergency department (ED) physicians to patients.

Diagnostic Imaging↗

PubMedDate not supplied

Perspectives on speech recognition technology.

Speech recognition technology is used in all sorts of applications. However, for radiology, the issues are more complex than merely being able to dial a contact from an address book. In addition, radiologists have been hesitant to embrace the technology, with some preferring the status quo. Speech recognition technology has dramatically improved over the past several years, and they generally have been broadly commercialized. However, the use of speech recognition for composition of text reports or email has had only limited acceptance. The overriding reasons appear to be that most computer users prefer not to talk to their computers. They have learned to compose text documents via a "type-and-organize" methodology rather than composing the document "in their heads" and dictating. Radiologists are still required to dictate their reports, whether it is digitally, into an analog tape recording device or via a speech recognition system. The benefits extend to the radiologist's patients, and to the radiologist's employers--the hospitals or imaging centers--but it could be said that there is little direct benefit for the radiologist There is a belief that systems should focus more on improving radiologist efficiency rather than emphasizing cost savings and turnaround time. Integration with existing systems is critical. But any technology, in order for it to be well accepted by the primary user, needs to benefit that user. Before selecting any speech recognition technology a radiology administrator should do some research and find answers to several questions that address the basics of speech recognition technology and the companies that provide this technology. In addition, the radiology administrator must ensure that the facility is prepared to implement the technology and address any workflow- or culture-related issues that may arise. There are a number of opportunities for improvement in speech recognition radiology applications. These include the ongoing need for improvement recognition rates, the need to streamline integration with picture archiving and communication system (PACS) and radiology information system (RIS) technologies, and the general need to improve the user interface. In addition to these improvements, one can expect an increased adoption of structured reporting technologies within radiology. These techniques allow easier automated extraction of content and more flexible communication and organization of data (such as communication to electronic medical record systems).

Diffusion of Innovation↗

PubMed2004

Making the business case for hospital information systems--a Kaiser Permanente investment decision.

Further evidence in favor of the clinical IT business case is set forth in Kaiser Permanente's cost/benefit analysis for an electronic hospital information system. This article reviews the business case for an inpatient electronic medical record system, including 36 categories of quantifiable benefits that contribute to a positive cumulative net cash flow within an 8.5 year period. However, the business case hinges on several contingent success factors: leadership commitment, timely implementation, partnership with labor, coding compliance, and workflow redesign. The issues and constraints that impact the potential transferability of this business case across delivery systems raise questions that merit further attention.

Capital Expenditures↗

PubMedDate not supplied

From telepathology to virtual pathology institution: the new world of digital pathology.

Telepathology has left its childhood. Its technical development is mature, and its use for primary (frozen section) and secondary (expert consultation) diagnosis has been expanded to a great amount. This is in contrast to a virtual pathology laboratory, which is still under technical constraints. Similar to telepathology, which can also be used for e-learning and e-training in pathology, as exemplarily is demonstrated on Digital Lung Pathology (Klaus.Kayser@charite.de) at least two kinds of virtual pathology laboratories will be implemented in the near future: a) those with distributed pathologists and distributed (> or = 1) laboratories associated to individual biopsy stations/surgical theatres, and b) distributed pathologists (usually situated in one institution) and a centralized laboratory, which digitizes complete histological slides. Both scenarios are under intensive technical investigations. The features of virtual pathology comprise a virtual pathology institution (mode a) that accepts a complete case with the patient's history, clinical findings, and (pre-selected) images for first diagnosis. The diagnostic responsibility is that of a conventional institution. The Internet serves as platform for information transfer, and an open server such as the iPATH (http://telepath.patho.unibas.ch) for coordination and performance of the diagnostic procedure. The size and number of transferred images have to be limited, and usual different magnifications have to be used. The sender needs to possess experiences in image sampling techniques, which present with the most significant information. A group of pathologists is "on duty", or selects one member for a predefined duty period. The diagnostic statement of the pathologist(s) on duty is retransmitted to the sender with full responsibility. The first experiences of a virtual pathology institution group working with the iPATH server working with a small hospital of the Salomon islands are promising. A centralized virtual pathology institution (mode b) depends upon the digitalization of a complete slide, and the transfer of large sized images to different pathologists working in one institution. The technical performance of complete slide digitalization is still under development. Virtual pathology can be combined with e-learning and e-training, that will serve for a powerful daily-work-integrated pathology system. At present, e-learning systems are "stand-alone" solutions distributed on CD or via Internet. A characteristic example is the Digital Lung Pathology CD, which includes about 60 different rare and common lung diseases with some features of electronic communication. These features include access to scientific library systems (PubMed), distant measurement servers (EuroQuant), automated immunohisto-chemistry measurements, or electronic journals (Elec J Pathol Histol, www.pathology-online.org). It combines e-learning and e-training with some acoustic support. A new and complete database based upon this CD will combine e-learning and e-teaching with the actual workflow in a virtual pathology institution (mode a). The technological problems are solved and do not depend upon technical constraints such as slide scanning systems. At present, telepathology serves as promoter for a complete new landscape in diagnostic pathology, the so-called virtual pathology institution. Industrial and scientific efforts will probably allow an implementation of this technique within the next two years with exciting diagnostic and scientific perspectives.

Computer Communication Networks↗

PubMed2004

An ontological framework for the implementation of clinical guidelines in health care organizations.

The paper presents the outlines of an ontology of plans and guidelines, which is then used as the basis for a framework for implementing guideline-based systems for the management of workflow in health care organizations. The framework has a number of special features, above all in that it enables us to represent in formal terms assignments of work-items both to individuals and to teams and to tailor guideline to specific contexts of application in health care organizations. It is designed also to enable implementations to do justice to the fact that the processes carried out in health care organizations may deviate in different ways from the norms set forth in corresponding guideline definitions. This means that implementations built in conformity with the framework will be marked by a type of flexibility that might make them more likely to be accepted by healthcare professionals than are standard guideline-based management systems.

Medical Informatics↗

PubMed2005

Strengthening the links in the supply chain--some preventive medicine.

There are many links in the supply chain that can lead to a "break" in an organization's supply process. These breaks can waste professional and clinical time and take staff away from patient care activities. By paying attention to some key areas, designing efficient workflows, and monitoring supply usage, an organization can avoid the headaches of a supply process that doesn't optimize scarce labor resources. It also can lead to significant savings that go directly to the organization's bottom line. As with all hospital processes, some consistent and focused preventive medicine makes sense for its supply chain.

Cost Control↗

PubMed2005

[Research and development of a clinical laboratory information system].

A clinical laboratory information system consists of two parts--the information system and the management system. Its development is based on scientific and rational lab-workflow, consulting the international standard HL7 Protocol, and combined with barcode technique and instrument communication. The information system mainly manages the data which come from the whole lab testing process while the management system is dominating the lab office work and management decisions.

Clinical Laboratory Information Systems↗

PubMed2005

Applying a grid technology to protein structure predictor "ROKKY".

This paper describes a sub-project of BioGrid project called "HTC (High Throughput Computing) group." Generally, a protein structure prediction which requires large amount of computational resources is done by trial-and-error method. HTC group have been developing a high throughput computing system with a flexible workflow handling mechanism for a protein structure prediction. In this paper, we show how to apply our high throughput computing system to the protein structure predictor called "ROKKY."

Computational Biology↗

PubMed2005

ProGenGrid: a grid-enabled platform for bioinformatics.

In this paper we describe the ProGenGrid (Proteomics and Genomics Grid) system, developed at the CACT/ISUFI of the University of Lecce which aims at providing a virtual laboratory where e-scientists can simulate biological experiments, composing existing analysis and visualization tools, monitoring their execution, storing the intermediate and final output and finally, if needed, saving the model of the experiment for updating or reproducing it. The tools that we are considering are software components wrapped as Web Services and composed through a workflow. Since bioinformatics applications need to use high performance machines or a high number of workstations to reduce the computational time, we are exploiting a Grid infrastructure for interconnecting wide-spread tools and hardware resources. As an example, we are considering some algorithms and tools needed for drug design, providing them as services, through easy to use interfaces such as the Web and Web service interfaces built using the open source gSOAP Toolkit, whereas as Grid middleware we are using the Globus Toolkit 3.2, exploiting some protocols such as GSI and GridFTP.

Computational Biology↗

PubMed2005

Grid requirements for the integration of biomedical information resources for health applications.

OBJECTIVES: The goal of this paper is to identify how Grid technology can be applied for the development and deployment of integration systems, bringing together distributed and heterogeneous biomedical information sources for medical applications. METHODS: The integration of new genetic and medical knowledge in clinical workflows requires the development of new paradigms for information management in which the ability to access and relate disparate data sources is essential. We adopt a requirements perspective based on the user needs we have identified in the development of the INFOGENMED system to assess current Grid technology against those requirements. RESULTS: The gap between Grid features and distributed biomedical information integration needs is characterized. Results from prospective studies are also reported. CONCLUSIONS: Grid infrastructures offer advanced features for the deployment of collaborative computational environments across virtual organizations. New Grid developments are in line with the problem of multiple site information integration. From the INFOGENMED point of view, Grid infrastructures need to evolve to implement structured data access services and semantic content description and discovery.

Computational Biology↗

PubMed2005

GEMSS: grid-infrastructure for medical service provision.

OBJECTIVES: The European GEMSS Project is concerned with the creation of medical Grid service prototypes and their evaluation in a secure service-oriented infrastructure for distributed on demand/supercomputing. Key aspects of the GEMSS Grid middleware include negotiable QoS support for time-critical service provision, flexible support for business models, and security at all levels in order to ensure privacy of patient data as well as compliance to EU law. METHODS: The GEMSS Grid infrastructure is based on a service-oriented architecture and is being built on top of existing standard Grid and Web technologies. The GEMSS infrastructure offers a generic Grid service provision framework that hides the complexity of transforming existing applications into Grid services. For the development of client-side applications or portals, a pluggable component framework has been developed, providing developers with full control over business processes, service discovery, QoS negotiation, and workflow, while keeping their underlying implementation hidden from view. RESULTS: A first version of the GEMSS Grid infrastructure is operational and has been used for the set-up of a Grid test-bed deploying six medical Grid service prototypes including maxillo-facial surgery simulation, neuro-surgery support, radio-surgery planning, inhaled drug-delivery simulation, cardiovascular simulation and advanced image reconstruction. CONCLUSIONS: The GEMSS Grid infrastructure is based on standard Web Services technology with an anticipated future transition path towards the OGSA standard proposed by the Global Grid Forum. GEMSS demonstrates that the Grid can be used to provide medical practitioners and researchers with access to advanced simulation and image processing services for improved preoperative planning and near real-time surgical support.

Access to Information↗

PubMed2002

[The development of 3D US system for treating target localization in focused ultrasound surgery].

Focused Ultrasound Surgery (FUS) is a promising minimally invasive technique in tissue ablation. Because of the high intensity at the ultrasound focus, a precise 3D-localization system is required to determine the site of the treating target in order to increase the efficiency and security of FUS. This paper represents a three dimensional ultrasound (3D US) localization system developed and its workflow. The system is mainly composed of imaging and image processing system, movement device and its controlling circuits, and position feedback device. The system has a maximum scan range of +/- 30 degrees with a resolution of 8 levels from 0.54' to 0.36 degrees. For a spherical shape like target, in theory, the maximum diameter is 160 mm the system can treat. The system can be used to localize precisely the treatment targets with general sizes in the suitable parts of the body in FUS.

Algorithms↗

PubMed2005

[IHE technical framework and its application].

Firstly, IHE technical framework is introduced in this paper, and the sub-framework of Schedule Workflow is also described. Secondly, the development of IHE in Japan and the formation of IHE-J are presented, and in combination with IDS system's practice in IHE-J, some ideas about developing IHE in China and the relative methods of implementation are discussed.

China↗

PubMed2005

Should your hospital implement wireless solutions?

A standards-based wireless patient monitoring technology can lead to significant improvements in productivity and workflow, provide the potential for reduced errors, and decrease the costs of patient care. A properly implemented wireless patient monitoring system can provide caregivers with increased access to vital patient information at all times. This will help health care institutions build a real-time care process, provide a continuous patient record across the continuum of care, and improve outcomes by creating an environment where clinicians can make evidence-based decisions.

Decision Making, Organizational↗

PubMed2005

Combining advanced networked technology and pedagogical methods to improve collaborative distance learning.

Making educational material be available on a network cannot be reduced to merely implementing hypermedia and interactive resources on a server. A pedagogical schema has to be defined to guide students for learning and to provide teachers with guidelines to prepare valuable and upgradeable resources. Components of a learning environment, as well as interactions between students and other roles such as author, tutor and manager, can be deduced from cognitive foundations of learning, such as the constructivist approach. Scripting the way a student will to navigate among information nodes and interact with tools to build his/her own knowledge can be a good way of deducing the features of the graphic interface related to the management of the objects. We defined a typology of pedagogical resources, their data model and their logic of use. We implemented a generic and web-based authoring and publishing platform (called J@LON for Join And Learn On the Net) within an object-oriented and open-source programming environment (called Zope) embedding a content management system (called Plone). Workflow features have been used to mark the progress of students and to trace the life cycle of resources shared by the teaching staff. The platform integrated advanced on line authoring features to create interactive exercises and support live courses diffusion. The platform engine has been generalized to the whole curriculum of medical studies in our faculty; it also supports an international master of risk management in health care and will be extent to all other continuous training diploma.

Cooperative Behavior↗

PubMed2005

Using mobile technology to improve healthcare service quality.

Improving healthcare service quality for illness of treatment, illness prevention and patient service is difficult for most hospitals because the hospitals are lack adequate resources and labor. In order to provide better healthcare service quality for patients, mobile technology can be used to manage healthcare in a way that provides the optimal healthcare service for patients. Pursuing utilization of mobile technology for better patient service, Taipei Medical University Municipal W. F. Teaching Hospital has implemented a mobile healthcare service (m-HS) system to increase healthcare service quality. The m-HS system improves the quality of medical care as well as healthcare service. The m-HS is a multi-functional healthcare management agent, meets the mobile tendency of the present society. This study seeks to discuss the m-HS architecture and workflow processes. We believe the m-HS does have the potential to improve healthcare service quality. Finally, the conclusions and suggestions for the m-HS are given.

Computer Systems↗

PubMed2005

Security infrastructure requirements for electronic health cards communication.

Communication and co-operation processes in the healthcare and welfare domain require a security infrastructure based on services describing status and relation of communicating principals as well as corresponding keys and attributes. Additional services provide trustworthy information on dynamic issues of communication and co-operation such as time and location of processes, workflow relations, integrity of archives and record systems, and system behaviour. To provide this communication and co-operation in a shared care environment, smart cards are widely used. Serving as storage media and portable application systems, patient data cards enable patient-controlled exchange and use of personal health data bound to specific purposes such as prescription and disease management. Additionally, patient status data such as the emergency data set or immunization may be stored in, and communicated by, patient data cards. Another deployment field of smart cards is their token functionality within a security framework, supporting basic security services such as identification, authentication, integrity, confidentiality, or accountability using cryptographic algorithms. In that context, keys, certificates, and card holder's attributes might be stored in the card as well. As an example, the German activity of introducing patient health cards and health professional cards is presented. Specification and enrolment aspects are on-going processes.

Communication↗

PubMedDate not supplied

Mastering the PACS RFP.

The level of a realized picture archiving and communications system (PACS) benefit is dependent upon a careful approach to choosing a vendor that will satisfy the specific requirements of an organization, including architecture, storage, networking, hardware specifications, user interfaces, and workflow. The request for proposal (RFP) process serves to provide a systematic approach to requesting, receiving, scoring, and awarding competitive bids for contracts. Typically, administrators (and vendors) must endure a very arduous process before a vendor is ultimately selected. This can take as much as 9, 12, or even 18 months. A significant problem with the legacy RFP is the length of time the process can take. If the decision point is determined to be 12 to 18 months in the future, much of the data in a fast-changing industry will be irrelevant right now. A dynamic RFP is conducted in 3 to 5 months, depending on the product or service being reviewed. This shortened timeline will provide a better chance of having the right people on the steering committee. A shorter timeline also increases the accuracy of the steering RFP decision. The dynamic RFP creates a level playing field that will enable the committee to select the right vendor. This level playing field can be created through weighting, on-site demonstrations, and vendor presentations.

Competitive Bidding↗