Long-term experience with setup and implementation of an IHE-based image management and distribution system in intersectoral clinical routine

ECG is one of the most common examinations in hospitals, e.g. for diagnosing cardiovascular diseases - the most frequent cause of death worldwide. Goal of this paper was to identify and describe the typical digitized workflow, IT systems and data formats for ECG in hospitals: A survey on current ECG-data management practices was conducted with four German speaking hospitals. A generic model of ECG data management was drafted. Today, these hospitals do not use DICOM as exchange format nor do they implement IHE profiles such as REWF for the ECG. Reasons include missing IT infrastructure such as Master Patient Index or electronic archive. ECG data management could be improved at different levels, with the chance to reduce error sources and to improves in patient safety. Storage of ECG raw data promises better diagnoses based on big data and machine learning technologies.

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“…A good overview of this is provided in [11,12].  Full implementation of the SWF.b profile at process and semantic level.…”

Section: Discussionmentioning

confidence: 99%

Digitizing the ECG Workflow – A State-of-the-Art Analysis

Reichenpfader

Baker

Bürkle

2022

Studies in Health Technology and Informatics

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“…Reducing duplicate imaging improves the overall health care system efficiency and associated costs [ 2 - 5 , 8 , 9 ]. Technology-enabled models of electronic image sharing include institutional and multi-institutional regional picture archiving and communication systems (PACSs), onsite and offsite vendor neutral archives, cloud-based image transfer, and cross-enterprise document image sharing [ 10 - 13 ]. The technology environment of a health care organization or a clinical practice (ie, technology infrastructure, storage, and resources) influences the platform availability and channels of access for internal and external imaging studies [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…In order to alleviate the logistical and administrative burden of transferring imaging data across multiple systems, several jurisdictions have implemented centralized imaging repositories through health information exchanges [ 13 , 15 ]. For example, Scotland has adopted a unified nationwide approach with a single supplier PACS and a central data archive for long-term data storage and sharing [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Utility and Perceived Value of a Provincial Digital Diagnostic Imaging Repository: Multimethod Study

et al. 2020

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Background Timely and comprehensive diagnostic image sharing across institutional and regional boundaries can produce multiple benefits while supporting integrated models of care. In Ontario, Canada, the Diagnostic Imaging Common Service (DICS) was created as a centralized imaging repository to enable the sharing and viewing of diagnostic images and associated reports across hospital-based and community-based clinicians throughout the province. Objective The aims of this study were as follows: (1) to explore real-world utilization and perceived clinical value of the DICS following the provision of system-wide access and (2) to identify strategies to optimize the technology platform functionality and encourage adoption. Methods This multimethod study included semistructured interviews with physicians and administrative stakeholders and descriptive analysis of the current DICS usage data. Results In this study, 41 participants were interviewed, that is, 34 physicians and 7 administrative stakeholders. The following 4 key themes emerged: (1) utilization of the DICS depended on the awareness of the technology and the preferred channels for accessing images, which varied widely, (2) clinical responsibilities and available institutional resources were the drivers of utilization (or lack thereof), (3) centralized image repositories were perceived to offer value at the patient, clinician, and health care system levels, and (4) the enabling factors to realize value included aspects of technology infrastructure (ie, available functionality) alongside policy supports. High-volume DICS usage was not evenly distributed throughout the province. Conclusions Suboptimal adoption of the DICS was driven by poor awareness and variations in the clinical workflow. Alignment with physician workflow, policy supports, and investment in key technological features and infrastructure would improve functionality and data comprehensiveness, thereby optimizing health system performance, patient and provider experience, population health, and health care costs.

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“…First, due to a lack of a national electronic health record or electronic health information exchange (HIE) in the Netherlands, patient information and diagnostic imaging are not accessible during telephone consultation and impede the consultation and advice. 4 , 5 Second, patient information in portable document format (PDF) and imaging on CD-ROM provided through fax, mail or secured e-mail could lead to incomplete referrals and delayed consultation. 6 , 7 Timely referrals in cancer care need attention since a prolonged lead time could affect emotional distress, treatment outcome, and survival.…”

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confidence: 99%

A multidisciplinary neuro-oncological triage panel reduces the time to referral and treatment for patients with a brain tumor

Swart

Kouwenhoven

Hellingman

et al. 2021

Neuro-Oncology Practice

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Background Regional collaboration and appropriate referral management are crucial in neuro-oncological care. Lack of electronic access to medical records across healthcare organisations impedes interhospital consultation and may lead to incomplete and delayed referrals. To improve referral management, we have established a multidisciplinary Neuro-Oncological Triage Panel (NOTP) with digital image exchange and determined the effects on lead times, costs and time investment. Methods A prospective cohort study was conducted from February 2019 to March 2020. All newly diagnosed patients referred to Brain Tumor Center Amsterdam were analyzed according referral pathway: 1) standard referral, 2) NOTP. The primary outcome was lead time, defined as time-to-referral, time-to-treatment, and total time (median days [interquartile range]). Secondary outcomes were costs and time investment. Results In total, 225 patients were included, of whom 153 had standard referral and 72 NOTP referral. Patients discussed in the NOTP were referred more frequently for first neurosurgical consultation (44.7% versus 28.8%) or combined neurological and neurosurgical consultation (12.8% versus 2.5%, p=0.002). Time-to-referral was reduced for NOTP referral compared to standard referral (1[0.25-4] versus 6[1.5-10] days, p<0.001). Total time decreased from 27[14-48] days for the standard group to 15[12-38.25] days for the NOTP group (p=0.040). Costs and time investment were comparable for both groups. Conclusion Implementation of digital referral to a multidisciplinary NOTP is feasible and leads to more swift patient-tailored referrals at comparable costs and time investment as standard referral. This quality improvement initiative has the potential to improve collaboration and coordination of multidisciplinary care in the field of neuro-oncology.

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Long-term experience with setup and implementation of an IHE-based image management and distribution system in intersectoral clinical routine

Cited by 7 publications

References 16 publications

Digitizing the ECG Workflow – A State-of-the-Art Analysis

Digitizing the ECG Workflow – A State-of-the-Art Analysis

Utility and Perceived Value of a Provincial Digital Diagnostic Imaging Repository: Multimethod Study

A multidisciplinary neuro-oncological triage panel reduces the time to referral and treatment for patients with a brain tumor

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