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基于远程医疗的放射学质量管理与同行评审系统。

Telemedicine-based system for quality management and peer review in radiology.

作者信息

Morozov Sergey, Guseva Ekaterina, Ledikhova Natalya, Vladzymyrskyy Anton, Safronov Dmitry

机构信息

Research and Practical Center of Medical Radiology, Department of Health Care of Moscow, 28-1, ul. Srednyaya Kalitnikovskaya, Moscow, 109029, Russia.

出版信息

Insights Imaging. 2018 Jun;9(3):337-341. doi: 10.1007/s13244-018-0629-y. Epub 2018 May 18.

Abstract

OBJECTIVES

Quality assurance is the key component of modern radiology. A telemedicine-based quality assurance system helps to overcome the "scoring" approach and makes the quality control more accessible and objective.

METHODS

A concept for quality assurance in radiology is developed. Its realization is a set of strategies, actions, and tools. The latter is based on telemedicine-based peer review of 23,199 computed tomography (CT) and magnetic resonance imaging (MRI) images.

RESULTS

The conception of the system for quality management in radiology represents a chain of actions: "discrepancies evaluation - routine support - quality improvement activity - discrepancies evaluation". It is realized by an audit methodology, telemedicine, elearning, and other technologies. After a year of systemic telemedicine-based peer reviews, the authors have estimated that clinically significant discrepancies were detected in 6% of all cases, while clinically insignificant ones were found in 19% of cases. Most often, problems appear in musculoskeletal records; 80% of the examinations have diagnostic or technical imperfections. The presence of routine telemedicine support and personalized elearning allowed improving the diagnostics quality. The level of discrepancies has decreased significantly (p < 0.05).

CONCLUSION

The telemedicine-based peer review system allows improving radiology departments' network effectiveness.

MAIN MESSAGES

• "Scoring" approach to radiologists' performance assessment must be changed. • Telemedicine peer review and personalized elearning significantly decrease the number of discrepancies. • Teleradiology allows linking all primary-level hospitals to a common peer review network.

摘要

目的

质量保证是现代放射学的关键组成部分。基于远程医疗的质量保证系统有助于克服“评分”方法,使质量控制更易于实施且更客观。

方法

制定了放射学质量保证的概念。其实现包括一系列策略、行动和工具。后者基于对23199份计算机断层扫描(CT)和磁共振成像(MRI)图像进行的基于远程医疗的同行评审。

结果

放射学质量管理系统的概念代表了一系列行动:“差异评估 - 常规支持 - 质量改进活动 - 差异评估”。它通过审核方法、远程医疗、电子学习和其他技术来实现。经过一年基于远程医疗的系统性同行评审,作者估计在所有病例中,6%检测到具有临床意义的差异,而19%的病例中发现无临床意义的差异。问题最常出现在肌肉骨骼记录中;80%的检查存在诊断或技术缺陷。常规远程医疗支持和个性化电子学习的存在有助于提高诊断质量。差异水平显著降低(p < 0.05)。

结论

基于远程医疗的同行评审系统有助于提高放射科的网络效能。

主要信息

• 必须改变对放射科医生绩效评估的“评分”方法。• 远程医疗同行评审和个性化电子学习显著减少差异数量。• 远程放射学可将所有基层医院连接到一个共同的同行评审网络。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5db6/5991002/94748c696c6e/13244_2018_629_Fig1_HTML.jpg

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