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In 1999, the Performance Improvement Committee of the Diagnostic Imaging Services of Texas Children's Hospital identified the need for smoother integration of the picture archiving and communications system (PACS) technology into ...
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In 1999, the Performance Improvement Committee of the Diagnostic Imaging Services of Texas Children's Hospital identified the need for smoother integration of the picture archiving and communications system (PACS) technology into the workflow of the rest of the department. An effort was then launched to document prevalent issues, as well as to define the processes needed to implement a department-wide program to acquaint the staff with this new technology. The department's application trainer, with the guidance of the Performance Improvement Committee, spearheaded the design and implementation of the PACS training program and has continued to develop it during the past 2 years. This article describes the format and components of the PACS training modules now in use, and details some of the positive effects of this effort.
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The need for specialized individuals to manage picture archiving and communications systems (PACS) has been recognized with the creation of a new professional title: PACS administrator. This position requires skill sets that bridg...
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The need for specialized individuals to manage picture archiving and communications systems (PACS) has been recognized with the creation of a new professional title: PACS administrator. This position requires skill sets that bridge the current domains of radiology technologists (RTs), information systems analysts, and radiology administrators. Health care organizations, however, have reported difficulty in defining the functions that a PACS administrator should perform-a challenge compounded when the tries to combine this complex set of capabilities into one individual. As part of a larger effort to dene the PACS professional, we developed an extensive but not exclusive consensus list of business, technical, and behavioral competencies desirable in the dedicated PACS professional. Through an on-line survey, radiologists, RTs, information technology specialists, corporate information officers, and radiology administrators rated the importance of these competencies. The results of this survey are presented, and the implications for implementation in training and certication efforts are discussed.
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The purpose of this study was to determine whether it would be possible to minimise the delay that occurs between the time a radiological image becomes available for viewing on PACS and the time that it is actually seen by the req...
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The purpose of this study was to determine whether it would be possible to minimise the delay that occurs between the time a radiological image becomes available for viewing on PACS and the time that it is actually seen by the requesting physician. The study was conducted at Sir Charles Gairdner Hospital in Perth Western Australia. Participants in the study were all junior doctors. The first part of the study measured the current time delay between images being available on PACS and actually being viewed. In the second part of the study, the doctors were notified by a paging system when the images were available. The reduction in time delay was then compared. Following pager notification, the mean average time delay reduced from a mean of 180.02 min (95 % confidence interval (CI), 135.1 to 225 min) to a mean of 33.94 min (95 % CI, 24.1 to 43.8 min; P < 0.0001). The study has demonstrated that it is possible to modify clinicians' usage of PACS; however, there remain questions regarding the sustainability of such an intervention and the impact that this may have on overall patient outcome. There may be potential for integration of the rapidly expanding technologies such as tablets, iPads and iPhones in order to automate this type of notification and this may be a focus of future research.
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The purpose of this study was to determine whether it would be possible to minimise the delay that occurs between the time a radiological image becomes available for viewing on PACS and the time that it is actually seen by the req...
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The purpose of this study was to determine whether it would be possible to minimise the delay that occurs between the time a radiological image becomes available for viewing on PACS and the time that it is actually seen by the requesting physician. The study was conducted at Sir Charles Gairdner Hospital in Perth Western Australia. Participants in the study were all junior doctors. The first part of the study measured the current time delay between images being available on PACS and actually being viewed. In the second part of the study, the doctors were notified by a paging system when the images were available. The reduction in time delay was then compared. Following pager notification, the mean average time delay reduced from a mean of 180.02 min (95 % confidence interval (CI), 135.1 to 225 min) to a mean of 33.94 min (95 % CI, 24.1 to 43.8 min; P < 0.0001). The study has demonstrated that it is possible to modify clinicians’ usage of PACS; however, there remain questions regarding the sustainability of such an intervention and the impact that this may have on overall patient outcome. There may be potential for integration of the rapidly expanding technologies such as tablets, iPads and iPhones in order to automate this type of notification and this may be a focus of future research.
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Picture Archive and Communication System (PACS) is a globally adopted concept and plays a fundamental role in patient care flow within healthcare institutions. However, the deployment of medical imaging repositories over multiple ...
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Picture Archive and Communication System (PACS) is a globally adopted concept and plays a fundamental role in patient care flow within healthcare institutions. However, the deployment of medical imaging repositories over multiple sites still brings several practical challenges namely related to operation and management (O&M). This paper describes a Web-based centralized console that provides remote monitoring, testing, and management over multiple geo-distributed PACS. The system allows the PACS administrator to define any kind of service or operation, reducing the need for local technicians and providing a 24/7 monitoring solution.
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The purpose of this study is to verify objectively the rate of slice omission during paging on picture archiving and communication system (PACS) viewers by recording the images shown on the computer displays of these viewers with ...
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The purpose of this study is to verify objectively the rate of slice omission during paging on picture archiving and communication system (PACS) viewers by recording the images shown on the computer displays of these viewers with a high-speed movie camera. This study was approved by the institutional review board. A sequential number from 1 to 250 was superimposed on each slice of a series of clinical Digital Imaging and Communication in Medicine (DICOM) data. The slices were displayed using several DICOM viewers, including in-house developed freeware and clinical PACS viewers. The freeware viewer and one of the clinical PACS viewers included functions to prevent slice dropping. The series was displayed in stack mode and paged in both automatic and manual paging modes. The display was recorded with a high-speed movie camera and played back at a slow speed to check whether slices were dropped. The paging speeds were also measured. With a paging speed faster than half the refresh rate of the display, some viewers dropped up to 52.4 % of the slices, while other well-designed viewers did not, if used with the correct settings. Slice dropping during paging was objectively confirmed using a high-speed movie camera. To prevent slice dropping, the viewer must be specially designed for the purpose and must be used with the correct settings, or the paging speed must be slower than half of the display refresh rate.
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The purpose of this study is to verify objectively the rate of slice omission during paging on picture archiving and communication system (PACS) viewers by recording the images shown on the computer displays of these viewers with ...
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The purpose of this study is to verify objectively the rate of slice omission during paging on picture archiving and communication system (PACS) viewers by recording the images shown on the computer displays of these viewers with a high-speed movie camera. This study was approved by the institutional review board. A sequential number from 1 to 250 was superimposed on each slice of a series of clinical Digital Imaging and Communication in Medicine (DICOM) data. The slices were displayed using several DICOM viewers, including in-house developed freeware and clinical PACS viewers. The freeware viewer and one of the clinical PACS viewers included functions to prevent slice dropping. The series was displayed in stack mode and paged in both automatic and manual paging modes. The display was recorded with a high-speed movie camera and played back at a slow speed to check whether slices were dropped. The paging speeds were also measured. With a paging speed faster than half the refresh rate of the display, some viewers dropped up to 52.4 % of the slices, while other well-designed viewers did not, if used with the correct settings. Slice dropping during paging was objectively confirmed using a high-speed movie camera. To prevent slice dropping, the viewer must be specially designed for the purpose and must be used with the correct settings, or the paging speed must be slower than half of the display refresh rate.
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The purpose of this study was to determine if any of the factors radiologist, examination category, time of week, and week effect PACS usage, with PACS usage defined as the sequential order of computer commands issued by a radiolo...
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The purpose of this study was to determine if any of the factors radiologist, examination category, time of week, and week effect PACS usage, with PACS usage defined as the sequential order of computer commands issued by a radiologist in a PACS during interpretation and dictation. We initially hypothesized that only radiologist and examination category would have significant effects on PACS usage. Command logs covering 8 weeks of PACS usage were analyzed. For each command trace (describing performed activities of an attending radiologist interpreting a single examination), the PACS usage variables number of commands, number of command classes, bigram repetitiveness, and time to read were extracted. Generalized linear models were used to determine the significance of the factors on the PACS usage variables. The statistical results confirmed the initial hypothesis that radiologist and examination category affect PACS usage and that the factors week and time of week to a large extent have no significant effect. As such, this work provides direction for continued efforts to analyze system data to better understand PACS utilization, which in turn can provide input to enable optimal utilization and configuration of corresponding systems. These continued efforts were, in this work, exemplified by a more detailed analysis using PACS usage profiles, which revealed insights directly applicable to improve PACS utilization through modified system configuration.
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Considerable debate within the medical community has focused on the optimal location of information technology (IT) support groups on the organizational chart. The challenge has been to marry local accountability and physician acc...
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Considerable debate within the medical community has focused on the optimal location of information technology (IT) support groups on the organizational chart. The challenge has been to marry local accountability and physician acceptance of IT with the benefits gained by the economies of scale achieved by centralized knowledge and system best practices. In the picture archiving and communication systems (PACS) industry, a slight shift has recently occurred toward centralized control. Radiology departments, however, have begun to realize that no physicians in any other discipline are as dependent on IT as radiologists are on their PACS. The potential strengths and weaknesses of centralized control of the PACS is the topic of discussion for this month’s Point/Counterpoint.
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The Australia/New Zealand/Pacific (ANZ-PAC) Workshop on 'Biofouling Management for Sustainable Shipping' was held in Melbourne, Australia, 5-9 May 2013 (see Marine Scientist No. 42, February 2013, p. 11). Over 4 days, more than 10...
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The Australia/New Zealand/Pacific (ANZ-PAC) Workshop on 'Biofouling Management for Sustainable Shipping' was held in Melbourne, Australia, 5-9 May 2013 (see Marine Scientist No. 42, February 2013, p. 11). Over 4 days, more than 100 delegates from 10 countries listened to presentations from 48 speakers and engaged in constructive debate and discussion on the associated issues, both inside and outside of the formal sessions.
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