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First Prize
Moving equipment, not
patients: Use of mobile, digital radiography for nursing homes'
residents
Subtitle: Experiences with light- weight DR
equipment with hard disk or wireless transmission of images for reading
and reporting.
Author: Johan Castberg Hellund
Academic: MD
Job: Dept. of Radiology, Ullrval University Hospital
Adress: Kirkevn 166, 0407 Oslo
Country: Norway
Phone: +22151086
Email: jhellund@broadpark.no
Cowrither: EM Sager, S Oswold, F Laerum
Purpose:
1) To improve radiology services to nursing home residents. There are
three times as many beds in nursing homes (NH) as in all Norwegian
hospitals combined. Each resident has in average more than three chronic
diseases, 65% have dementia, and are hence more stressed by being moved
than other patients.
2) To assess logistics, quality and
safety in using a mobile, digital radiography (DR) system for diagnostic
x-ray services in NH, and survey the outcome of this kind of
radiological services.
Methods and Materials:
A prototype combination of Sedecal X-ray equipment with Canon
full-format digital detector (total weight 94kg) was carried around to
nursing homes on demand, in a Renault Kangoo car equipped with
wheel-chair ramp. The DR examinations were performed in the residents’
rooms. Encrypted image and referral sheet data where either WI-FI
uploaded via broadband Internet, or brought by USB-disk, to the
radiology department’s PACS for interpretation and reporting. The
referring physician returned questionnaires without patients’
identification in 125 out of the first 195 examinations. On the first
193 images an image quality assessment where made.
Results:
Since the start in Sept. 2004 780 patients from 46 nursing homes have
had more than 1000 examinations. The DR image quality was assessed to be
of satisfactory diagnostic quality, not significantly different from
controls taken with a fixed x-ray unit. The questionnaires revealed that
tentative diagnosis was verified in 58% and invalidated in 42 % of the
cases, with consequences to therapy in 85% and nursing in 71%. Because
of the residents’ serious impairments, 10% had no alternative to x-ray
examination bedside in their nursing home. 8% had to be hospitalised
after the examination. Expensive patient transportation with ambulance
or taxi to an outpatient radiology examinations, or hospitalisation,
where avoided in 90% of cases.
Conclusion:
Since the start late 2004 the service has increased in use, and after
almost 800 examined patients to date, data suggest that DR services have
proved to be a viable service, in benefit for the residents, less
expensive for society, and of good diagnostic quality.
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Second Prize
Sharing IT and human
resources to create a multicenter radiology department
Author: Alex Lopez Garcia
Academic: Msc
Job: UDIAT-CD
Adress: Parc Taulí, s/n
Country: SPAIN
Phone: + 34 93 693 33 22
Email: alopezg@cspt.es
Cowrither: Carles Rubies, Josep Fernandez, Joan Guanyabens, Silvia
Andujar, Isabel Pardo, Josep Valls, Emili Masoliver, Ibeth Villa
Introduction
This presentation aims to describe a cooperative venture between two
institutions to solve widespread problems (waiting lists, shortage of
radiologists, lack of expertise in specific areas, ...) by sharing
information and knowledge between two digitized diagnostic imaging
departments.
Since its inception in 1992, the UDIAT diagnostic imaging center has
made innovative use of new technologies, and its IT department, the
Digital Medical Image Center, develops and maintains software (PACS,
viewers, RIS, etc.) for the UDIAT and other centers.
The Hospital General de VIC (HGV) is a small, county hospital located
approximately 35 km from the UDIAT. Project I2CAT, the setting up of a
digital radiology network in the county, has enabled the HGV to digitize
all images generated in the county, whether at the hospital itself or in
associated primary care centers.
Problem
The current shortage of radiologists throughout Europe is more
pronounced in centers like the HGV located far from large cities, making
it difficult for them to attract radiologists, especially specialists
within the specialty. Traditionally, radiologists would travel to the
place where the image was acquired out to evaluate and report the
examination, which was both inconvenient and expensive.
Solution
A “virtual radiology department” was created to make use of the UDIAT’s
manpower and specialized knowledge by incorporating the HGV’s needs into
the UDIAT’s workflow. The UDIAT’s radiologists have access to all of the
patient’s clinical information, making this service much more than a
mere radiologic reporting service.
• The HGV’s informations
system (IS) sends a request for an examination report to the IDIAT’s IS
• The HGV sends the corresponding images to the UDIAT through
autorouting between PACS
• The radiologist at the UDIAT assesses and reports the
examinations using the UDIAT’s IS
• Once signed, the report is automatically sent from the
UDIAT’s IS to HGV’s IS
• The HGV’s IS incorporates the report into the database, where
users access it as if it had been elaborated by the center’s own IS
Throughout the entire process, users
work with their own IS, improving the learning curve and minimizing
problems.
Difficulties
• Ensuring secure connections for the exchange of information
between centers
• Achieving the required level of availability of the IS and
the wide range of hardware involved
• Reaching an initial consensus in designing the “catalog of
diagnostic tests” for each center (to be revised periodically)
• Administrative coordination of the workflow
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