Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
University of California San Francisco, San Francisco, CA, USA.
J Digit Imaging. 2017 Oct;30(5):602-608. doi: 10.1007/s10278-017-9959-4.
Numerous initiatives are in place to support value based care in radiology including decision support using appropriateness criteria, quality metrics like radiation dose monitoring, and efforts to improve the quality of the radiology report for consumption by referring providers. These initiatives are largely data driven. Organizations can choose to purchase proprietary registry systems, pay for software as a service solution, or deploy/build their own registry systems. Traditionally, registries are created for a single purpose like radiation dosage or specific disease tracking like diabetes registry. This results in a fragmented view of the patient, and increases overhead to maintain such single purpose registry system by requiring an alternative data entry workflow and additional infrastructure to host and maintain multiple registries for different clinical needs. This complexity is magnified in the health care enterprise whereby radiology systems usually are run parallel to other clinical systems due to the different clinical workflow for radiologists. In the new era of value based care where data needs are increasing with demand for a shorter turnaround time to provide data that can be used for information and decision making, there is a critical gap to develop registries that are more adapt to the radiology workflow with minimal overhead on resources for maintenance and setup. We share our experience of developing and implementing an open source registry system for quality improvement and research in our academic institution that is driven by our radiology workflow.
有许多举措旨在支持放射科的基于价值的医疗服务，包括使用适宜性标准的决策支持、辐射剂量监测等质量指标，以及努力提高放射科报告的质量，以供参考医生使用。这些举措在很大程度上是由数据驱动的。组织可以选择购买专有注册系统、付费使用软件即服务解决方案，或部署/构建自己的注册系统。传统上，注册系统是为单一目的创建的，例如辐射剂量或特定疾病跟踪，如糖尿病注册。这导致了对患者的碎片化看法，并增加了维护这种单一用途的注册表系统的开销，因为需要替代的数据输入工作流程和额外的基础设施来托管和维护用于不同临床需求的多个注册表。这种复杂性在医疗保健企业中放大了，因为放射科系统通常与其他临床系统并行运行，因为放射科医生的临床工作流程不同。在基于价值的医疗新时代，数据需求随着对提供可用于信息和决策的数据的短周转时间的需求而增加，因此需要开发更适应放射科工作流程的注册表，而对资源的维护和设置开销最小。我们分享了我们在学术机构中开发和实施开源注册表系统的经验，该系统是由我们的放射科工作流程驱动的，用于质量改进和研究。
