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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 conception and deployment of cost effective Picture Archiving and Communication Systems (PACS) is a concern for small to medium medical imaging facilities, research environments, and developing countries' healthcare institutio...
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The conception and deployment of cost effective Picture Archiving and Communication Systems (PACS) is a concern for small to medium medical imaging facilities, research environments, and developing countries' healthcare institutions. Financial constraints and the specificity of these scenarios contribute to a low adoption rate of PACS in those environments. Furthermore, with the advent of ubiquitous computing and new initiatives to improve healthcare information technologies and data sharing, such as IHE and XDS-i, a PACS must adapt quickly to changes. This paper describes Dicoogle, a software framework that enables developers and researchers to quickly prototype and deploy new functionality taking advantage of the embedded Digital Imaging and Communications in Medicine (DICOM) services. This full-fledged implementation of a PACS archive is very amenable to extension due to its plugin-based architecture and out-of-the-box functionality, which enables the exploration of large DICOM datasets and associated metadata. These characteristics make the proposed solution very interesting for prototyping, experimentation, and bridging functionality with deployed applications. Besides being an advanced mechanism for data discovery and retrieval based on DICOM object indexing, it enables the detection of inconsistencies in an institution's data and processes. Several use cases have benefited from this approach such as radiation dosage monitoring, Content-Based Image Retrieval (CBIR), and the use of the framework as support for classes targeting software engineering for clinical contexts.
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The production of medical imaging is a continuing trend in healthcare institutions. Quality assurance for planned radiation exposure situations (e.g. X-ray, computer tomography) requires examination-specific set-ups according to s...
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The production of medical imaging is a continuing trend in healthcare institutions. Quality assurance for planned radiation exposure situations (e.g. X-ray, computer tomography) requires examination-specific set-ups according to several parameters, such as patient's age and weight, body region and clinical indication. These data are normally stored in several formats and with different nomenclatures, which hinder the continuous and automatic monitoring of these indicators and the comparison between several institutions and equipment. This article proposes a framework that aggregates, normalizes and provides different views over collected indicators. The developed tool can be used to improve the quality of radiologic procedures and also for benchmarking and auditing purposes. Finally, a case study and several experimental results related to radiation exposure and productivity are presented and discussed.
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As hospitals move towards providing in-house 24 × 7 services, there is an increasing need for information systems to be available around the clock. This study investigates one organization’s need for a workflow continuity soluti...
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As hospitals move towards providing in-house 24 × 7 services, there is an increasing need for information systems to be available around the clock. This study investigates one organization’s need for a workflow continuity solution that provides around the clock availability for information systems that do not provide highly available services. The organization investigated is a large multifacility healthcare organization that consists of 20 hospitals and more than 30 imaging centers. A case analysis approach was used to investigate the organization’s efforts. The results show an overall reduction in downtimes where radiologists could not continue their normal workflow on the integrated Picture Archiving and Communications System (PACS) solution by 94 % from 2008 to 2011. The impact of unplanned downtimes was reduced by 72 % while the impact of planned downtimes was reduced by 99.66 % over the same period. Additionally more than 98 h of radiologist impact due to a PACS upgrade in 2008 was entirely eliminated in 2011 utilizing the system created by the workflow continuity approach. Workflow continuity differs from high availability and business continuity in its design process and available services. Workflow continuity only ensures that critical workflows are available when the production system is unavailable due to scheduled or unscheduled downtimes. Workflow continuity works in conjunction with business continuity and highly available system designs. The results of this investigation revealed that this approach can add significant value to organizations because impact on users is minimized if not eliminated entirely.
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摘要 :
As hospitals move towards providing in-house 24×7 services, there is an increasing need for information systems to be available around the clock. This study investigates one organization's need for a workflow continuity solution ...
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As hospitals move towards providing in-house 24×7 services, there is an increasing need for information systems to be available around the clock. This study investigates one organization's need for a workflow continuity solution that provides around the clock availability for information systems that do not provide highly available services. The organization investigated is a large multifacility healthcare organization that consists of 20 hospitals and more than 30 imaging centers. A case analysis approach was used to investigate the organization's efforts. The results show an overall reduction in downtimes where radiologists could not continue their normal workflow on the integrated Picture Archiving and Communications System (PACS) solution by 94 % from 2008 to 2011. The impact of unplanned downtimes was reduced by 72 % while the impact of planned downtimes was reduced by 99.66 % over the same period. Additionally more than 98 h of radiologist impact due to a PACS upgrade in 2008 was entirely eliminated in 2011 utilizing the system created by the workflow continuity approach. Workflow continuity differs from high availability and business continuity in its design process and available services. Workflow continuity only ensures that critical workflows are available when the production system is unavailable due to scheduled or unscheduled downtimes. Workflow continuity works in conjunction with business continuity and highly available system designs. The results of this investigation revealed that this approach can add significant value to organizations because impact on users is minimized if not eliminated entirely.
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Over the past century technology has played a decisive role in defining, driving, and reinventing procedures, devices, and pharmaceuticals in healthcare. Cloud computing has been introduced only recently but is already one of the ...
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Over the past century technology has played a decisive role in defining, driving, and reinventing procedures, devices, and pharmaceuticals in healthcare. Cloud computing has been introduced only recently but is already one of the major topics of discussion in research and clinical settings. The provision of extensive, easily accessible, and reconfigurable resources such as virtual systems, platforms, and applications with low service cost has caught the attention of many researchers and clinicians. Healthcare researchers are moving their efforts to the cloud, because they need adequate resources to process, store, exchange, and use large quantities of medical data. This Vision 20/20 paper addresses major questions related to the applicability of advanced cloud computing in medical imaging. The paper also considers security and ethical issues that accompany cloud computing.
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Picture Archiving and Communication Systems (PACS), alongside Radiological Information Systems (RIS) are nowadays widely disseminated, proven useful, hospital information systems components. The "Region Sans Film " ("Filmless Regi...
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Picture Archiving and Communication Systems (PACS), alongside Radiological Information Systems (RIS) are nowadays widely disseminated, proven useful, hospital information systems components. The "Region Sans Film " ("Filmless Region ") program was launched in 2009 by the French ministry of health in order to help the generalization to all healthcare structures such as hospitals or general physician practices, of PACS, RIS, and archiving of medical images. It is done by means of a mutualized service platform whom building and running has been entrusted to an industrial consortium. This platform implements the latest technologies of medical image processing and of cloud computing. It is built in order to support service-oriented enterprise architecture composed of one main layer of software services. This natively scalable platform is innovative because it is the first one which contains all the materials for the implementation of all services in the cloud. The corresponding SLA are defined in order to be adaptable to the needs of further health structures which could later join the platform by participating in its mutualized purchasing. The goal is not only to share the costs but also to deliver new images sharing services. New business processes/services around sharing of images such as teleradiology or access to the images produced in hospitals to the general practitioners are defined towards the exercise of real filmless radiology.
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The development of the World Wide Web has changed the way we think about information. Information on the web is distributed, updates are made asynchronously and resources come online and go offline without centralized control. Glo...
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The development of the World Wide Web has changed the way we think about information. Information on the web is distributed, updates are made asynchronously and resources come online and go offline without centralized control. Global networking will similarly change the way we think about and perform computation. Grid computing refers to computing in a distributed networked environment where computing and data resources are located throughout a network. In order to locate these resources dynamically in a grid computation, a broker or matchmaker uses keywords and ontologies to describe and specify grid services. However, we believe that keywords and ontologies can not always be defined or interpreted precisely enough to achieve deep semantic agreement in a truly distributed, heterogeneous computing environment. To this end, we introduce the concept of functional validation. Functional validation goes beyond the symbolic level of brokering and matchmaking, to the level of validating actual functional performance of grid services. In this paper, we present the functional validation concept in grid computing, analyze the possible validation situations and apply basic machine learning theory such as PAC learning and Chernoff bounds to explore the relationship between sample size and confidence in service semantics.
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Electrocardiogram (ECG) as one of the best methods to measure irregular heartbeats is a dispensable method for doctor to diagnose Acute Myocardial Infarction (AMI) patients. Most medical centers in Taiwan implement the reduction o...
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Electrocardiogram (ECG) as one of the best methods to measure irregular heartbeats is a dispensable method for doctor to diagnose Acute Myocardial Infarction (AMI) patients. Most medical centers in Taiwan implement the reduction of Door to Balloon (D2B) time, which is defined as the time interval starting when an Acute-Myocardial-Infarction patient arrives at the Emergency Department, and ending when a catheter guide wire crosses the culprit lesion as the acute-myocardial-infarction treatment on the patient in the cardiac catheterization room. Generally, when a patient with acute-chest pain is sent into a hospital (always to Emergency Department), the hospital will collect his/her ECG which needs to be evaluated by a cardiologist to ensure that the patient really has Acute Myocardial Infarction. Then the medical workers deliver the patient to the cardiac catheterization room to operate balloon angioplasty. In previous years, the cardiologist must utilize a PC to connect to the Intranet of the hospital and employ a special PACS (Picture Archiving and Communication System) image browser before he/she can check the patient's ECG. But this will prolong the D2B time since the doctor may stay outdoors and he/she needs some time to find a PC and network. Of course, if the PC has not installed the PACS image browser, the doctor has to download and install it. Consequently, the D2B time should be worsened, thus possibly impacting the patient's life. Therefore, in this paper, we introduce a Cloud-based Electrocardiogram System, with which cardiologists can directly utilize their smart phones to browse the patient's ECG so as to shorten the D2B time. This system has been online in a medical center in middle Taiwan for more than one year. The shortened D2B time is longer than 10 min, i.e., receiving fine results.
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The growing use of computer systems in medical institutions has been generating a tremendous quantity of data. While these data have a critical role in assisting physicians in the clinical practice, the information that can be ext...
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The growing use of computer systems in medical institutions has been generating a tremendous quantity of data. While these data have a critical role in assisting physicians in the clinical practice, the information that can be extracted goes far beyond this utilization. This article proposes a platform capable of assembling multiple data sources within a medical imaging laboratory, through a network of intelligent sensors. The proposed integration framework follows a SOA hybrid architecture based on an information sensor network, capable of collecting information from several sources in medical imaging laboratories. Currently, the system supports three types of sensors: DICOM repository meta-data, network workflows and examination reports. Each sensor is responsible for converting unstructured information from data sources into a common format that will then be semantically indexed in the framework engine. The platform was deployed in the Cardiology department of a central hospital, allowing identification of processes' characteristics and users' behaviours that were unknown before the utilization of this solution.
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