A Filmless Radiology Department in a Full Digital Regional Hospital: Quantitative Evaluation of the Increased Quality and Efficiency

Abstract

Reggio Emilia hospital installed Picture Archiving and Communications Systems (PACS) as the final step towards a completely digital clinical environment completing the HIS/EMR and 1,400 web/terminals for patient information access. Financial benefits throughout the hospital were assessed upfront and measured periodically. Key indicators (radiology exam turnaround time, number of radiology procedures performed, inpatients length of stay before and after the PACS implementation, etc.) were analyzed and values were statistically tested to assess workflow and productivity improvements. The hospital went “filmless” in 28 weeks. Between the half of 2004 and the respective period in 2003, overall Radiology Department productivity increased by 12%, TAT improved by more than 60%. Timelier patient care resulted in decreased lengths of stay. Neurology alone experienced a 12% improvement in average patient stay. To quantify the impact of PACS on the average hospital stays and the expected productivity benefits to inpatient productivity were used a “high level” and a “detailed” business model. Annual financial upsides have exceeded $1.9 millions/year. A well-planned PACS deployment simplifies imaging workflow and improves patient care throughout the hospital while delivering substantial financial benefits. Staff buy-in was the key in this process and on-going training and process monitoring are a must.

The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence

“…115 The key indicators were turnaround time, number of procedures, and hospital length of stay (LOS), as well as workflow and productivity. After 1 year of becoming fully digital, the following improvements were observed: productivity increased by 12%; turnaround time reduced by 60%; and number of imaging procedures increased by 7%, whereas LOS for neurology patients decreased by 12%.…”

The Effectiveness of Service Delivery Initiatives at Improving Patients’ Waiting Times in Clinical Radiology Departments: A Systematic Review

“…Most of the studies combined multiple PETs [141][142][143][144][145][146][147][148][149][150]. The remainder combined quality management methodologies (QMMs) with PETs [151][152][153][154].…”

“…The studies used varied research designs including the post-intervention only design [147,148] and the uncontrolled pre-and post-intervention design. In terms of outcome measure, most of the studies reported RTAT [141,142,[146][147][148][151][152][153][154], two studies measured TRWT [143][144][145] and one study reported the PEWT [149].…”

Contrast Detail Phantom Comparison on a Commercially Available Unit. Digital Breast Tomosynthesis (DBT) versus Full-Field Digital Mammography (FFDM)

“…1 The reason of this "digital revolution" can be found mostly in the intrinsic digital data nature of the images that allows image processing (e.g., contrast enhancement), computed-aided diagnosis, and fast availability of images on the hospital PACS: the processes of image acquisition, storage, retrieval, display, and evaluation are distinct allowing each one to be independently optimized. 2,3 Furthermore, from a physical point of view, FFDM has a higher detective quantum efficiency and a greater dynamic range with respect to SFS. [4][5][6][7][8] In FFDM and SFS, benign lesions and background tissue are implicated for undetected breast lesions.…”