摘要 :
Though more and more hospitals adopt PACS in Taiwan, they all meet the same problem of system integration. The Integrating the Healthcare Enterprise (IHE) association proposes an integrated technical framework and process profiles...
展开
Though more and more hospitals adopt PACS in Taiwan, they all meet the same problem of system integration. The Integrating the Healthcare Enterprise (IHE) association proposes an integrated technical framework and process profiles to solve problems of heterogeneous system integration in medical environment for information sharing. Therefore, this paper reports the experience of a case hospital that successfully applied IHE framework to integrate its HIS, RIS and PACS in Taiwan. This paper indicates that using the IHE can help evaluate the integration ability of PACS vendors, enhance staffs ability, shorten the PACS implementation time, reduce the cost, and reserve system's expansibility. The case hospital was able to successflly implement it's PACS because of executive's full support, using the standard, and providing complete training to reduce user's resistance. This paper not only shares the experiences of IHE adoption of a case hospital but also summarizes key factors to implement PACS successfully. Again, this paper confirms that standard is helpful to integrate heterogeneous system.
收起
摘要 :
A virtual medical imaging department is an innovative and demanding organizational model, to the extent that the underlying goal is to achieve a continuous and advanced organizational integration of human and physical resources, c...
展开
A virtual medical imaging department is an innovative and demanding organizational model, to the extent that the underlying goal is to achieve a continuous and advanced organizational integration of human and physical resources, clinical data, and clienteles. To better understand the kind of benefits offered, we conducted a survey of three groups of users—radiologists, radiological technologists, and medical specialists—working in a five-site virtual organization. We received 127 valid questionnaires, for an overall response rate of 66%. The assessments vary according to the use made of the system. The scores for system quality and the quality of the data produced were markedly higher for intra-hospital use (respectively 7.9 and 8.7 out of 10) than for inter-hospital use (5.4 and 7.0). Despite the negative assessments they made of inter-hospital use, users maintained a positive attitude toward some type of virtual organization of medical imaging. Indeed, the score for Overall satisfaction with the system was very high, 8.9 out of 10. Moreover, the scores for Intended future use of the system were very high for both intra-hospital use (8.9) and inter-hospital use (8.7). We also found significant differences in perceptions among user groups.
收起
摘要 :
A challenge for many clinical users is that a patient may receive a diagnostic imaging (DI) service at a number of hospitals or private imaging clinics. The DI services that patients receive at other locations could be clinically ...
展开
A challenge for many clinical users is that a patient may receive a diagnostic imaging (DI) service at a number of hospitals or private imaging clinics. The DI services that patients receive at other locations could be clinically relevant to current treatments, but typically, there is no seamless method for a clinical user to access longitudinal DI results for their patient. Radiologists, and other specialists that are intensive users of image data, require seamless ingestion of foreign exams into the picture archiving and communication system (PACS) to achieve full clinical value. Most commonly, a clinical user will depend on the patient to bring in a CD that contains imaging from another location. However, a number of issues can arise when using this type of solution. Firstly, a CD will not provide the clinical user with the full longitudinal record of the patient. Secondly, a CD often will not contain the report associated with the images. Finally, a CD is not seamless, due to the need to manually import the contents of the CD into the local PACS. In order to overcome these limitations, and provide clinical users with a greater benefit related to a patient's longitudinal DI history, the implementation of foreign exam management (FEM) at the local site level is required. This paper presents the experiences of FEM in practice. By leveraging industry standards and edge devices to support FEM, multiple sites with disparate PACS and radiology information system (RIS) vendors are able to seamlessly ingest foreign exams within their local PACS as if they are local exams.
收起
摘要 :
In the era of health information exchanges, there are trade-offs to consider when sharing a patient's medical record among all providers that a patient might choose. Exchange among in-network partners on the same electronic medica...
展开
In the era of health information exchanges, there are trade-offs to consider when sharing a patient's medical record among all providers that a patient might choose. Exchange among in-network partners on the same electronic medical records (EMR) and other integrated information systems is trivial. The patient identifier is common, as are the relevant departmental systems, to all providers. Difficulties arise when patient records including images (and reports) must be shared among different networks and even with the patients themselves. The National Institutes of Health (NIH) challenged Radiological Society of North America (RSNA) to develop a transport method that could supersede the need for physical media (for patients or other providers), replace point-to-point private networks among providers, and enable image exchange on an ad hoc basis between arbitrary health networks without long legal delays. In concert with the evolving US health care paradigm, patient engagement was to be fundamental. With Integrating Healthcare Enterprise's (IHE's) help, the challenge has been met with an operational system.
收起
摘要 :
Health-care facilities around the world are evolving in order to provide more efficient health-care services. This involves adopting new technologies to achieve projected productivity goals. The developments through information te...
展开
Health-care facilities around the world are evolving in order to provide more efficient health-care services. This involves adopting new technologies to achieve projected productivity goals. The developments through information technologies, facilitate the mechanisms in many areas such as the health-care systems. This study proposes Service-Orientated Architecture (SOA) to provide an integrated system to support effective communication among previously disconnected systems. This was applied in a health-care enterprise responsible for blood collection and distribution. The results of the study show that by combining databases, knowledge bases and regulations with SOA feeds, remarkable improvements can be obtained, compared to previously used systems.
收起
摘要 :
Background: To integrate electronic health records (EHRs) from diverse document sources across healthcare providers, facilities, or medical institutions, the IHE XDS.b profile can be considered as one of the solutions. In this res...
展开
Background: To integrate electronic health records (EHRs) from diverse document sources across healthcare providers, facilities, or medical institutions, the IHE XDS.b profile can be considered as one of the solutions. In this research, we have developed an EHR/OpenXDS system which adopted the OpenXDS, an open source software that complied with the IHE XDS.b profile, and which achieved the EHR interoperability. Objective: We conducted performance testing to investigate the performance and limitations of this EHR/ OpenXDS system. Methodology: The performance testing was conducted for three use cases, EHR submission, query, and retrieval, based on the IHE XDS.b profile for EHR sharing. In addition, we also monitored the depletion of hardware resources (including the CPU usage, memory usage, and network usage) during the test cases execution to detect more details of the EHR/OpenXDS system's limitations. Results: In this EHR/OpenXDS system, the maximum affordable workload of the EHR submissions were 400 EHR submissions per hour, the DSA CPU usage was 20%, memory usage was 1380 MB, the network usages were 0.286 KB input and 7.58 KB output per minute; the DPA CPU usage was 1 %, memory usage was 1770 MB, the network usages were 7.75 KB input and 1.54 KB output per minute; the DGA CPU usage was 24%, memory usage was 2130 MB, the network usages were 1.3 KB input and 0.174 KB output per minute. The maximum affordable workload of the EHR queries were 600 EHR queries per hour, the DCA CPU usage was 66%, the memory usage was 1660 MB, the network usages were 0.230 KB input and 0.251 KB output per minute; the DGA CPU usage was 1%, the memory usage was 1890 MB, the network usages were 0.273 KB input and 0.22 KB output per minute. The maximum affordable workload of the EHR retrievals were 2000 EHR retrievals, the DCA CPU usage was 79%, the memory usage was 1730 MB, the network usages were 19.55 KB input and 1.12 KB output per minute; the DPA CPU usage was 3.75%, the memory usage was 2310 MB, and the network usages were 0.956 KB input and 19.57 KB output per minute. Discussion and conclusion: From the research results, we suggest that future implementers who deployed the EHR/OpenXDS system should consider the following aspects. First, to ensure how many service volumes would be provided in the environment and then to adjust the hardware resources. Second, the IHE XDS.b profile is adopted by the SOAP (Simple Object Access Protocol) web service, it might then move onto the Restful (representational state transfer) web service which is more efficient than the SOAP web service. Third, the concurrency process ability should be added in the OpenXDS source code to improve the hardware usage more efficiently while processing the ITI-42, ITI-18, and ITI-43 transactions. Four, this research suggests that the work should continue on adjusting the memory usage for the modules of the OpenXDS thereby using the memory resource more efficiently, e.g., the memory configuration of the JVM (Java Virtual Machine), Apache Tomcat, and Apache Axis2. Fifth, to consider if the hardware monitoring would be required in the implementing environment. These research results provided some test figures to refer to, and it also gave some tuning suggestions and future works to continue improving the performance of the OpenXDS.
收起
摘要 :
Picture Archiving and Communication System (PACS) is a mature technology in health care delivery for daily clinical imaging service and data management. Computer-aided detection and diagnosis (CAD) utilizes computer methods to obt...
展开
Picture Archiving and Communication System (PACS) is a mature technology in health care delivery for daily clinical imaging service and data management. Computer-aided detection and diagnosis (CAD) utilizes computer methods to obtain quantitative measurements from medical images and clinical information to assist clinicians to assess a patient’s clinical state more objectively. CAD needs image input and related information from PACS to improve its accuracy; and PACS benefits from CAD results online and available at the PACS workstation as a second reader to assist physicians in the decision making process. Currently, these two technologies remain as two separate independent systems with only minimal system integration. This paper describes a universal method to integrate CAD results with PACS in its daily clinical environment.
收起
摘要 :
Efficient communication among doctors who cooperatively support their patients is a prerequisite for implementing effective intersectoral treatment processes. In order to achieve this, IT is becoming increasingly important. With I...
展开
Efficient communication among doctors who cooperatively support their patients is a prerequisite for implementing effective intersectoral treatment processes. In order to achieve this, IT is becoming increasingly important. With IT systems doctors want to exchange information concerning a patient's case (e.g. doctors' letters, medication prescriptions, etc.). Furthermore, more and more IT-based applications that support the treatment process between patient and doctor (e.g. telemedicine solutions) are being developed. The development of the electronic case record (elektronische FallAkte) has yielded concepts and solutions for a structured case-based information exchange. Furthermore, it has led to infrastructure solutions that support service-based applications for telemedical applications. The "elektronische FallAkte" is an initiative of health institutions that have been organized into the association "Verein elektronische FallAkte". In this paper, concepts and realizations of the "elektronische FallAkte", as well as service-based applications on that infrastructure are described.
收起
摘要 :
Background: Strategic planning of information systems (IS) in healthcare requires descriptions of the current and the future IS state. Enterprise architecture planning (EAP) tools like the 3LGM(2) tool help to build up and to anal...
展开
Background: Strategic planning of information systems (IS) in healthcare requires descriptions of the current and the future IS state. Enterprise architecture planning (EAP) tools like the 3LGM(2) tool help to build up and to analyze IS models. A model of the planned architecture can be derived from an analysis of current state IS models. Building an interoperable IS, i.e. an IS consisting of interoperable components, can be considered a relevant strategic information management goal for many IS in healthcare. Integrating the healthcare enterprise (IHE) is an initiative which targets interoperability by using established standards.
收起
原文获取