Helse Sør-Øst Health Services Research Centre Akershus University Hospital, NO-1478 Lørenskog, Norway.
BMC Health Serv Res. 2010 Sep 6;10:262. doi: 10.1186/1472-6963-10-262.
One year after the introduction of Information and Communication Technology (ICT) to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT) reports in the Electronic Medical Record (EMR) was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS).
Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups.
There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence.
Our results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction.
在我们医院引入信息和通信技术（ICT）以支持诊断成像一年后，临床医生能够更快、更好地访问放射学报告和图像；直接在电子病历（EMR）中访问计算机断层扫描（CT）报告尤其受欢迎。本研究的目的是确定在引入 ICT 一年后，放射学报告和临床获取诊断成像信息的改进是否与患者住院时间（LOS）的缩短有关。
从 EMR 中回顾性收集描述住院时间和诊断成像的数据，在引入 ICT 前后相等的时间段内进行。选择后 ICT 时期是因为在此期间记录到临床访问放射学结果的改善。数据集被随机分为探索部分和验证部分。使用数据来比较 ICT 引入前后的状态，也比较组间的差异。
在引入 ICT 一年后，LOS 并没有普遍降低。然而，对于接受 CT 扫描的一组患者，LOS 降低了 25%。该组具有异质性，涵盖了 445 种不同的主要出院诊断。对亚组进行了分析，以减少这种差异的影响。
我们的结果表明，改善对放射学结果的访问并没有减少患者的 LOS。然而，接受 CT 扫描的患者的 LOS 确实显著降低。鉴于临床医生对 CT 报告的兴趣以及亚组分析的结果，很可能是对 CT 报告的更好访问促成了这种降低。
