PACS Quality Dimensions

PACS Quality Dimensions

Carrison K.S. Tong (Pamela Youde Nethersole Eastern Hospital, HK) and Eric T.T. Wong (Hong Kong Polytechnic Institute, Hong Kong)
DOI: 10.4018/978-1-59904-672-3.ch009
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Abstract

A large number of studies have attempted to identify the factors that contribute to good PACS quality, such as that shown by Reiner et al (2003). Results from these studies (Bauman, 2000; Ralston, 2000) reveal that the success of PACS requires healthcare organizations and managers to adequately address various types of challenges: technological (e.g., integration with other information systems), managerial (e.g., project management), organizational (e.g., availability of resources), behavioural (e.g., change management), and political (e.g., alignment among key participants). Most investigations have considered a single, or at best, a small number of factors contributing to a fragmented view of PACS success. Broadly, these studies may be classified into those that consider the impact of PACS on radiologists’ workload and productivity (Gale, 1999), those that consider its clinical implications (Hertzberg, 2000) and those associated with performance of the radiology department (Hayt, 2001). Rather than measuring the quality of the PACS performance, other researchers have preferred to focus on the quality of the information, that the system produces, primarily in the form of images and reports. For instance, Lou et al. (1997) considered the data integrity and completeness of acquired images. Quality of images in terms of timeliness, accuracy, completeness, and so forth, was also considered to be a key success factor in several evaluative studies (Cox, 2002; Pavlicek, 1999; Pilling, 2003; Blado, 2002). Indeed, Cox’s work was part of a wider evaluation exercise undertaken to assess the impact of the introduction of a PACS on the adult intensive care unit (AICU) at the Royal Brompton NHS Trust in London. The objectives of the research were to evaluate the perceptions of PACS of the medical and ancillary staff working within AICU as well as to undertake a preliminary assessment of its impact on the workload of radiographers. Questionnaires, interviews and a process analysis were undertaken. The research findings indicate that the overall perception of staff towards the introduction of the PACS was positive. The impact of the system on the workload of radiographers was significant, reducing the time taken to obtain an image from 90 to 60 minutes. However, lessons to be learned for future PACS implementations include the need to ensure compatibility with existing IT systems and adequate IT support. In short, once this expanded, but rather fragmented view of PACS success is recognized, it is not surprising to find that there are so many different measures of PACS quality in the literature depending upon which aspect of PACS the researcher focused his or her attention.
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Pacs Operating Problems

In spite of the adherence to various PACS-QA programs and the presence of various theoretical quality frameworks for the hospital administration, operating problems are still encountered in most PACS. For instance, in the image-guided surgery environment, the problems can generally be grouped under the four categories: hardware, software, hardware/software integration and human factors.

The goal of image guided surgery is the seamless creation, visualization, manipulation and application of images in the surgical environment with fast availability, reliability, accuracy and minimal additional cost. A computer network devoted to image-guided surgery ensures fast and efficient transfer of images from the scanner to the surgical navigation workstation in the operating room. The network server also serves images to desktop PCs where pre-surgical planning can be done. The network for image-guided therapies at Hong Kong hospitals generally includes connections to all CT and magnetic resonance imaging scanners, as well as connections via a dedicated server to home and office PCs and surgical navigation workstations. This smooth workflow and the presence of a multidisciplinary team that includes surgeons, radiologists, radiation oncologists, physicists and engineers with a competent technical support staff should offer the key to good PACS quality. However, following problems were observed in two Hong Kong hospitals:

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Table of Contents
Chapter 1
Introduction  (pages 1-27)
Carrison K.S. Tong, Eric T.T. Wong
Picture archiving and communications system (PACS) is a filmless and computerized method of communicating and storing medical image data such as... Sample PDF
Introduction
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Chapter 2
Carrison K.S. Tong, Eric T.T. Wong
The protection of information for a healthcare organization, in any form, while in storage, processing, or transport, from being available to any... Sample PDF
ISO 27000 Information Security Management System
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Chapter 3
Carrison K.S. Tong, Eric T.T. Wong
PACS disasters can, and do, appear in a variety of forms including storage hard disk failure, file corruption, network breakdown, and server... Sample PDF
High Availability Technologies for PACS
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Chapter 4
Carrison K.S. Tong, Eric T.T. Wong
Fundamental to ISO 27000 (ISO/IEC 27001:2005, 2005) is the concept of an information security management system (ISMS). The information security... Sample PDF
Implementation of Information Security Management System (ISMS)
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Chapter 5
Carrison K.S. Tong, Eric T.T. Wong
Filmless hospital is transforming at an unprecedented rate. Physicians, nurses, clinicians, pharmacists, radiologists, emergency departments, local... Sample PDF
Planning for a Filmless Hospital
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Chapter 6
Carrison K.S. Tong, Eric T.T. Wong
More rapidly than any technological advance in medical history, filmless hospital is changing the clinical and business aspects of radiology... Sample PDF
Design of a Filmless Hospital
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Chapter 7
Carrison K.S. Tong, Eric T.T. Wong
A PACS has tremendous benefits (Bryan, Weatherburn, Watkins, Buxton, 1999) and values outside of radiology as well as internally. The biggest... Sample PDF
Implementation of Filmless Hospital
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Chapter 8
Carrison K.S. Tong, Eric T.T. Wong
As PACS gains widespread use, the importance of Quality Control (QC), Quality Assurance (QA), and Business Continuity Plan (BCP) in PACS is rising.... Sample PDF
Quality Control, Quality Assurance, and Business Continuity Plan in PACS
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Chapter 9
PACS Quality Dimensions  (pages 140-153)
Carrison K.S. Tong, Eric T.T. Wong
A large number of studies have attempted to identify the factors that contribute to good PACS quality, such as that shown by Reiner et al (2003).... Sample PDF
PACS Quality Dimensions
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Chapter 10
Customer Oriented PACS  (pages 154-169)
Carrison K.S. Tong, Eric T.T. Wong
During the early development phase of PACS, its implementation was mainly a matter of the radiology department. This is changing rapidly, and PACS... Sample PDF
Customer Oriented PACS
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Chapter 11
Carrison K.S. Tong, Eric T.T. Wong
Nowadays it is hard to think of any applications in modern society in which electronic systems do not play a significant role. In aerospace and... Sample PDF
Design for PACS Reliability
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Chapter 12
Carrison K.S. Tong, Eric T.T. Wong
There are some medical errors for which preventability is rarely questioned. These include medical errors such as wrong site surgery, wrong... Sample PDF
PACS Failure Mode and Effects
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Chapter 13
Carrison K.S. Tong, Eric T.T. Wong
Economically speaking, it is interesting to see that over the years, the question as to whether PACS is cost-justifiable has not been easier to... Sample PDF
PACS Network Traffic Control
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Chapter 14
Human Factors and Culture  (pages 225-243)
Carrison K.S. Tong, Eric T.T. Wong
Human factors engineering (HFE) is the science of designing systems to fit human capabilities and limitations. These include limitations in... Sample PDF
Human Factors and Culture
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Chapter 15
PACS Monitoring  (pages 244-263)
Carrison K.S. Tong, Eric T.T. Wong
The present study advocates the application of statistical process control (SPC) as a performance monitoring tool for a PACS. The objective of... Sample PDF
PACS Monitoring
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Chapter 16
Carrison K.S. Tong, Eric T.T. Wong
To illustrate the benefits of implementing QM in PACS, a successful case based on the Six Sigma approach is given below. It involves a project... Sample PDF
Quality Management Benefits
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Chapter 17
Epilogue  (pages 288-297)
Carrison K.S. Tong, Eric T.T. Wong
Today’s filmless radiology through PACS provides greater speed and superior image quality. However, when workflow is encumbered by inefficiencies... Sample PDF
Epilogue
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Appendix A
Appendix B
Appendix C
About the Authors