De Simone D N, Kundel H L, Arenson R L, Seshadri S B, Brikman I S, Khalsa S S, Davey M J, Brisbon N E
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Radiology. 1988 Oct;169(1):41-4. doi: 10.1148/radiology.169.1.3420281.
This study examined the effect of a medical image management network on the behavior of physicians working in a medial intensive care unit (MICU). For 1 year, 8-week periods during which chest radiographs were digitized and made available to MICU physicians on a digital display console were alternated with 8-week periods during which only film images were available. Clinical efficacy during the periods was compared by measuring the time between completion of imaging examinations and initiation of specific clinical actions such as placement and positioning of tubes. Results indicate that the time required to take some clinical actions decreased with the immediate availability of images on the digital display console. Established procedures for obtaining radiologic information were altered by the digital imaging network. The time at which physicians viewed images changed, and consultations between MICU staff and radiologists decreased. These results indicate that behavior patterns are altered when a new technology replaces an existing one. Optimal use of this technology may require changes in the logistics of clinical practice.
本研究考察了医学图像管理网络对在医学重症监护病房(MICU)工作的医生行为的影响。在为期1年的时间里,8周的时间段内胸部X光片被数字化并在数字显示控制台提供给MICU医生,与另外8周仅提供胶片图像的时间段交替进行。通过测量成像检查完成到开始特定临床行动(如放置和定位导管)之间的时间,比较各时间段的临床疗效。结果表明,在数字显示控制台即时获取图像时,采取某些临床行动所需的时间减少了。获取放射学信息的既定程序因数字成像网络而改变。医生查看图像的时间发生了变化,MICU工作人员与放射科医生之间的会诊减少了。这些结果表明,当新技术取代现有技术时,行为模式会发生改变。对该技术的最佳使用可能需要改变临床实践的后勤保障。