Becker Murray, Goldszal Alberto, Detal Julie, Gronlund-Jacob Judith, Epstein Robert
Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; University Radiology, East Brunswick, New Jersey.
Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; University Radiology, East Brunswick, New Jersey.
J Am Coll Radiol. 2015 Jun;12(6):630-7. doi: 10.1016/j.jacr.2014.11.002. Epub 2014 Nov 4.
The aim of this study was to assess whether the complex radiology IT infrastructures needed for large, geographically diversified, radiology practices are inherently stable with respect to system downtimes, and to characterize the nature of the downtimes to better understand their impact on radiology department workflow.
All radiology IT unplanned downtimes over a 12-month period in a hybrid academic-private practice that performs all interpretations in-house (no commercial "nighthawk" services) for approximately 900,000 studies per year, originating at 6 hospitals, 10 outpatient imaging centers, and multiple low-volume off-hours sites, were logged and characterized using 5 downtime metrics: duration, etiology, failure type, extent, and severity.
In 12 consecutive months, 117 unplanned downtimes occurred with the following characteristics: duration: median time = 3.5 hours with 34% <1.5 hours and 30% >12 hours; etiology: 87% were due to software malfunctions, and 13% to hardware malfunctions; failure type: 88% were transient component failures, 12% were complete component failures; extent: all sites experienced downtimes, but downtimes were always localized to a subset of sites, and no system-wide downtimes occurred; severity (impact on radiologist workflow): 47% had minimal impact, 50% moderate impact, and 3% severe impact.
In the complex radiology IT system that was studied, downtimes were common; they were usually a result of transient software malfunctions; the geographic extent was always localized rather than system wide; and most often, the impacts on radiologist workflow were modest.
本研究的目的是评估大型、地域分散的放射科业务所需的复杂放射学信息技术基础设施在系统停机方面是否具有内在稳定性，并描述停机的性质，以便更好地了解其对放射科工作流程的影响。
在一家学术与私立混合性质的机构中，对12个月内所有放射学信息技术的非计划停机情况进行记录。该机构每年在内部进行约900,000例检查的解读（无商业“夜间鹰”服务），这些检查来自6家医院、10个门诊影像中心以及多个低流量非工作时间站点。使用5个停机指标对停机情况进行记录和描述：持续时间、病因、故障类型、范围和严重程度。
在连续12个月中，发生了117次非计划停机，其特点如下：持续时间：中位时间 = 3.5小时，34% <1.5小时，30% >12小时；病因：87% 是由于软件故障，13% 是由于硬件故障；故障类型：88% 是瞬时组件故障，12% 是完全组件故障；范围：所有站点都经历了停机，但停机总是局限于部分站点，未发生全系统停机；严重程度（对放射科医生工作流程的影响）：47% 影响极小，50% 影响中等，3% 影响严重。
在所研究的复杂放射学信息技术系统中，停机情况很常见；通常是由瞬时软件故障导致的；地理范围总是局部的而非全系统的；并且大多数情况下，对放射科医生工作流程的影响较小。
