Medical Informatics to Improve Quality of Radiology - Research Paper Example

? Medical Informatics to Improve Quality of Radiology Nidhi Panchal Bellingham Technical College Medical imaging informatics makes changes in the efficiency and quality of radiology process in medicine field. Informatics improves the efficiency of radiology functionality and gives a significant impact on the area of imaging techniques. Picture Archiving and Communication Systems is one of the software that helps in enhancing the way in which radiologist works and work flow analysis in radiology department. Data managing is a challenge in radiology department and informatics provides as a best way to collect and analyze data related to radiology department. PACS allows the distribution of images on an International platform and radiologist can access and interpret images from any place. Imaging informatics is the field of radiology that helps in enhancing the accuracy, efficacy and reliability of the radiology functionalities in medical environment. The idea involves a modification of the concepts of radiologic systems and will have the consequences for organization within and outside the department of radiology and for the information system of hospital as a whole. Keywords: PACS, EMR, RISs, HISs, MII, Data transfer, workstation, CAD. Using Informatics to Improve Quality of Radiology Radiology is a crucial department in field of medicine and efficiency in it matters significantly for the welfare of the patients. The radiology field is constantly indulged in improving its quality of operations and performance for the better service of its patients. So in order to make better medical decisions and attain quality performance, the use of medical imaging informatics has been in increasing lately.“Medical imaging informatics is the rapidly evolving field that combines biomedical informatics and imaging, developing and adapting core methods in informatics to improve the usage and application of imaging in health care.”(Bui & Taira, 2011, pg. 3)Imaging plays a major role in the objectifying of clinical presentations and is an optimal diagnostic in many cases to relate symptoms to etiology.(Geis, 2007,pg.99-104.) When properly recorded, imaging serves as the basis for shared communication between health providers, detailing evidence of current and past medical findings.At present MRI and CT scanners have become widespread tools in clinical diagnosis. Recently, medical imaging informatics has been interested in ways to handle images and its content management. As a result, new imaging based models of normal anatomy and disease processes are now being formed. Clearly implicit knowledge is advanced through current informatics endeavors, as employed by the scientist and clinician. The overload of image and information problem has been the main focus of medical imaging informatics In the context of radiology; medical imaging informatics provides the transformative outlook into its operation.(Bui & Taira, 2011, pg. 11) The Concept of Medical Imaging Informatics Medical imaging is an invaluable tool in the medical field and often is the only means of studying diseases and human conditions. Medical Imaging informatics performs interpretation process in radiological field effectively through efficient use of communication and information technolgy.Large scale medical image database study is the core activity of medical imaging informatics. The application of medical imaging informatics infrastructure is developed in order to work in collaboration with PACS images and resources related to it. The usage of data of PACS is for customer utilization and it is the main objective of medical imaging informatics. The communication network of medical imaging informatics can be independent or can be shared with PACS .According to “ One of the role of an informatics architect is to provide an infrastructure that enables radiologists to read images immediately wherever they are”.(Nagy, 2008,pg.9) Medical imaging informatics has enabled the utilization of imaging techniques otherwise was inefficient due to poor data and connectivity problems. Notably, medical imaging informatics addresses not only images themselves, but also encompasses the associated data to understand the context of the imaging study. With the help of imaging informatics the observation of document has become easier and their correlation to reach better conclusions about various disease is effectively done. Medical imaging informatics helps in understanding a problem in a patient and the seriousness of it and what to do about it.(Bui & Taira, 2011, pg. 4) The Role of Informatics in Radiology Imaging informatics provides all the necessary tools for rapid collection, analysis, and monitoring of all quality control data. When a primary care physician decides to obtain an imaging study to diagnosis or otherwise assess a problem, the selection of an appropriate imaging protocol to analyze the problem of a patient depends on the imaging quality he or shereceives through radiology techniques. Informatics imaging assist interpreting consultants in analyzing vast amount of imagery data and interpreting important findings in images, whether histological, radiological or dermatological. An understanding of medical imaging informatics begins with the knowledge of medical imaging and its application towards diagnostic and therapeutic clinical assessment.(Bui & Taira, 2011, pg. 4-14) Like in radiology, appropriate use of informatics is crucial for communication, management and monitor of data flow. The radiologist will benefit from the computational and analytical skills with the help of medical imaging informatics and deliver a better quality health service to patients. The radiologists and the radiology department both will be faster, better and cheaper. With the help of Medical imaging technology, the functions of the human body and the internal organ’s structure can be analyzed extensively.“In practical terms, MII already occurs at a basic level throughout radiology practice, from the moment a clinician considers ordering an imaging study, until images and interpretation are used to plan the patient’s treatment”. (Geis, 2007,PG 99) Radiologist value MII because it is directly focusing on images.(Deven, Hibbert&Chhem, 2009, 196) PACS and Radiology Medical imaging informatics has evolved from developments in medical imaging, PACS and medical informatics. Medical imaging is the study of human anatomy, physiology and pathology based on imaging techniques.PACS image management functions must be integrated with RISs and HISs. Because an RIS keeps track of examination records and associates them with patients and a PACS keeps tracks of images and associates them with examination. The main function of PACS is image management and it also decides the placement of image throughout the system to ensure it is stored accurately, once obtained from the imaging device. The ubiquitous image presence in PACS allows an improved quality in clinical care and enhances the service quality of health sector.“Picture archiving and communication systems (PACS) and Radiology Information Systems (RIS) are the most visible parts, but MII is more than that”. (Geis, 2007,pg.99-104.) One of the objectives of PACS is to ease the work flow of film based image technology of radiology department. PACS is used in integration with RIS in radiology department for image processing, storage and retrieval. A PACS which is centralized work with the help of a central archive which is connected to all work stations and modalities. The reports can be reviewed and the images accessed if available. These files can be sent in different formats and image sizes, and gray scales can be modified. Images can also be selected by radiologists for storage as teaching file cases. Todayradiologists are benefiting significantly from MII and it helps them in managing imaging data and their storage.MII helps the radiologist in improving the quality and efficiency delivered to the patients’ care and reducesworkload and the medical errors caused.(Shortliffe & Cimino, 2006, 653) Initially hospitals purchased film digitizers soroutine x – ray films could be converted to digital forms. Now PACS receives images directly from the imaging devices. Upon analysis and study the images get transferred from modalities to the nearest archive and the webserver.The web server does not store the image itself, but stores the image storage parameters and its demogrpahicsThe images can be viewed from any work station without any problem. Images can be manually or automatically routed to specific primary diagnostic stations based on work flow parameters stored in a database server.PACS is efficient due to the availability of high speed processing computer system and high resolution monitors to view images. Most monitors are still gray scale as they have better resolution compared to color. It is estimated that 30% of hospitals now have PACS.The combination of computerized modalities a PACS and RISprovides the equivalent of the Electronic Medical Records (EMRS) a corner stone of Medical Informatics and a base for applying many of the methods of Informatics to radiology. (Hoyt, Sutton & Yoshihashi, 2007, 208) PACS Key Components Digital acquisition devices: the devices that are the source of the images. Digital angiography, fluoroscopy and mammography are the newcomers to PACS. TheNetwork:tiesthe PACS components together. DatabaseServer:high speed and robust central computer to process information Archival Server: responsible for storing images and enables short term and long-term storage. Radiology Information System (RIS): system that maintains patient demographics, scheduling, billing informations and interpretations. Work stations or soft copy display: containsthe software and hardware to access the PACS. Converting to PACS has shown high efficiency and increased the inpatient radiology utilization highly. PACS is held now in high regard by radiologist and health care organizations.(Hoyt, Sutton & Yoshihashi, 2007, 208) PACS Advantages Replaces standard x- ray films archives, which mean a much smaller storage space. Space can be converted into revenue generating services and it reduces the need for file clerks. Allows for remote viewing and reporting; to also include Teleradiology Can expedite the incorporation of medical images into electronic health record systems. Images can be archived and transported to a CD- ROM Unlike conventional x-rays, digital films have a zoom feature. Improves productivity by allowing multiple clinicians to view the same images from different locations. Rapid retrieval of digital images for interpretation and comparison with previous studies. Quick reporting back to the requesting clinician. Digital imaging allows for computer aided detection- using artificial intelligence, CAD identifies mammogram abnormalities. CAD appears to be about as accurate as the interpretation bya radiologist.(Hoyt, Sutton & Yoshihashi, 2008, 254) Medical Image Informatics Contribution to Radiology .. A properly designed MII can take full advantage of the enormous volume of data from PACS and other related medical databases to achieve new levels of clinical, research and educational application that could not be performed because of insufficient data. Radiologists, who are fully familiar with all the sophistications and complexities of the system, are the users who exploit the PACS to full capacity. Because PACS increases efficiency in their daily work, they have become adept users of advanced features, such as using keyboard command keys.(Siegel & Kolodner, 2001,397,409) A radiologist can report and read on the findings in the comfort of home, or from another location of hospital or form any place in the globe, with PACS which is web based. The software and mode of working with PACS has enabled soft copy reporting to be as fast as, and often faster than, conventional hard copy film reporting. (Siegel & Kolodner, 2001,397) PACS also enables the production of CDs of the image and emailing of it is possible through links which are encrypted to the online images to enhance the image sharing process. Databases of medical images available for clinical and research purposes, will be indexed for retrieval by image, by case, by diagnosis or by feature. (Shortliffe & Cimino, 2006, 657) Conclusion Within the coming years a new PACS concept – the hospital integrated PACS will develop in the clinical environment. Digital image management is a specialized part of the future global hospital information world, integrated with the acquisition modalities themselves and the hospital information systems. This idea involves a modification of the concepts of radiological systems and will have consequences for the organization within and outside the department of radiology and for the information system of the hospital as a whole. To see the PACS technology as an ‘add on’ or just a ‘graft ‘upon existing system produced failures in the past and will fail in the future, to produce acceptable clinical results. As per (Vaccari, 2006,pg 87-101)“The transition from film-based to filmless imaging is now a foregone conclusion. ThePractice of diagnostic radiology should not only convert to filmless and digital work flow,but radiologists must also become active participants in this conversion”. In such a perspective more research and development remains to be done before a global PACS concept is reached: the filmless hospital. It should be mentioned; however that in the meantime there are effective partial solutions for a hybrid environment. The global potentialities and the perspectives of the PACS technology can no longer be questioned. In order to define a second generation PACS, the research efforts should be done in all fields along with HIS and RIS. References Bui, A. A. T., & Taira, R. K. (2011).Medical imaging informatics. Springer Verlag. Deven, T. V., Hibbert, K. M., &Chhem, R. K. (2009). The practice of radiology education, challenges and trends. Springer Verlag. Geis, R. (2007, June 16). Medical Imaging Informatics: How It Improves Radiology Practice Today. Journal of Digital Imaging, 20(2), 99-104.(n.d.). Retrieved from http://web.ebscohost.com.ezproxy.btc.ctc.edu:2048/ehost/pdfviewer/pdfviewer?sid=cbee43cf-fd19-432e-8b0d-dea3f8796cbb@sessionmgr14&vid=7&hid=7 Hoyt, O., Sutton, M., & Yoshihashi, A. (2007). Medical informatics, practical guide for the healthcare professional 2007. 207-211. Hoyt, R. E., Sutton, M., & Yoshihashi, A. (2008). Medical informatics: Practical guide for the healthcare professional 2008. Lulu.com. Nagy, P. G. (2008, December). Using informatics to improve the quality of radiology. Supplement to Applied Radiology, 5, 759-765.(n.d.). Retrieved from http://www.appliedradiology.com/uploadedfiles/Issues/2008/12/Supplements/AR_12-08_info_Nagy.pdf Shortliffe, E. H., & Cimino, J. J. (2006). Biomedical informatics, computer applications in health care and biomedicine. New York: Springer Verlag. Siegel, E. L., & Kolodner, R. M. (2001). Filmless radiology. Springer Verlag. Vaccari, G. (2006). Radiology Informatics and Work Flow Redesign. PsychNology Journal, 4(1), 87-101(n.d.). Retrieved from http://www.psychnology.org/File/PNJ4(1)/PSYCHNOLOGY_JOURNAL_4_1_VACCARI.pdf Read More