Carrino J A, Unkel P J, Miller I D, Bowser C L, Freckleton M W, Johnson T G
Wilford Hall Medical Center, Lackland Air Force Base, TX 78236-5300, USA.
J Digit Imaging. 1998 Aug;11(3 Suppl 1):3-7. doi: 10.1007/BF03168246.
The transition to filmless radiology is a much more formidable task than making the request for proposal to purchase a (Picture Archiving and Communications System) PACS. The Department of Defense and the Veterans Administration have been pioneers in the transformation of medical diagnostic imaging to the electronic environment. Many civilian sites are expected to implement large-scale PACS in the next five to ten years. This presentation will related the empirical insights gleaned at our institution from a large-scale PACS implementation. Our PACS integration was introduced into a fully operational department (not a new hospital) in which work flow had to continue with minimal impact. Impediments to user acceptance will be addressed. The critical components of this enormous task will be discussed. The topics covered during this session will include issues such as phased implementation, DICOM (digital imaging and communications in medicine) standard-based interaction of devices, hospital information system (HIS)/radiology information system (RIS) interface, user approval, networking, workstation deployment and backup procedures. The presentation will make specific suggestions regarding the implementation team, operating instructions, quality control (QC), training and education. The concept of identifying key functional areas is relevant to transitioning the facility to be entirely on line. Special attention must be paid to specific functional areas such as the operating rooms and trauma rooms where the clinical requirements may not match the PACS capabilities. The printing of films may be necessary for certain circumstances. The integration of teleradiology and remote clinics into a PACS is a salient topic with respect to the overall role of the radiologists providing rapid consultation. A Web-based server allows a clinician to review images and reports on a desk-top (personal) computer and thus reduce the number of dedicated PACS review workstations. This session will focus on effective strategies for a seamless transition. Critical issues involve maintaining a good working relationship with the vendor, cultivating personnel readiness and instituting well-defined support systems. Success depends on the ability to integrate the institutional directives, user expectations and available technologies. A team approach is mandatory for success.
向无胶片放射学的转变是一项比提出购买（图像存档与通信系统）PACS的提案艰巨得多的任务。国防部和退伍军人管理局一直是将医学诊断成像转变为电子环境的先驱。预计许多民用机构将在未来五到十年内实施大规模的PACS。本报告将介绍我们机构在大规模实施PACS过程中获得的经验见解。我们的PACS集成被引入到一个全面运作的科室（而非新建医院），在此科室中工作流程必须在影响最小的情况下继续进行。将探讨用户接受度方面的障碍。将讨论这项艰巨任务的关键组成部分。本次会议涵盖的主题将包括分阶段实施、基于医学数字成像和通信（DICOM）标准的设备交互、医院信息系统（HIS）/放射学信息系统（RIS）接口、用户审批、网络、工作站部署和备份程序等问题。报告将针对实施团队、操作说明、质量控制（QC）、培训和教育提出具体建议。识别关键功能区域的概念与使医疗机构完全上线的转变相关。必须特别关注手术室和创伤室等特定功能区域，因为这些区域的临床需求可能与PACS功能不匹配。在某些情况下可能需要打印胶片。就放射科医生提供快速会诊的整体作用而言，将远程放射学和远程诊所集成到PACS是一个重要主题。基于网络的服务器允许临床医生在台式（个人）计算机上查看图像和报告，从而减少专用PACS查看工作站的数量。本次会议将聚焦于实现无缝转变的有效策略。关键问题包括与供应商保持良好的合作关系、培养人员的准备状态以及建立明确的支持系统。成功取决于整合机构指令、用户期望和可用技术的能力。成功必须采用团队协作方式。
