First experience with the radiology PACS at the university of Innsbruck trauma care centre
S. Peer (1), R. Vogl (2), R. Peer (1), W. Jaschke (1)
(1) University of Innsbruck, Department of Radiology
(2) TILAK-GesmbH, Department of Information Managment
Introduction:
Radiology in the context of an outpatient trauma care centre demands high technical as well as logistical expertise. To quickly acquire high quality images and to provide all the necessary images and reports to the surgeon is the foremost aim. To meet these needs with the promising means of modern radiology, a fully digital X-ray division with consequent PACS-networking was instituted. We present our experience with the installation and meanwhile 1 year filmless routine.
Materials and methods:
The traumatological x-ray division of the university of Innsbruck department of radiology cares for about 82.000 patients a year and performs about 150.000 examinations (x-rays per region, CT, etc). The traumatology PACS in Innsbruck is based on a fast ATM-network in star topology. Included are 3 AGFA ADC70 storage phosphor radiography units, a GE helical CT-scanner, an ATL HDI 5000 ultrasound unit, a Phillips Integris angiography unit, a Lumisys x-ray film scanner and 28 workstations. As a general rule all images in the short term as well as long term archive are available to every single user on every workstation within the network at any time.
Results:
The introduction of a PACS is possible in an environment as sensitive as an outpatient traumatology department. Clear benefits could be shown within the first year: Costs of films and chemicals could be lowered to 75% (500.000,- ATS less than the year before). This could even be much lower, but at the time the surgical wards and the intensive care unit still have to be supplied with laser film printouts as they are not equipped with PACS-terminals till now while the whole outpatient section runs filmless. Repeat examinations have to be performed in only about 2% in the digital department (in conventionally equipped departments repeat rates between 5 and 12% are reported) - this spares radiation to the patient and saves time for different tasks.
Discussion:
It is less than easy to switch to digital in an environment as sensitive as an emergency department. Main problems lie in the introduction of the completely changed workflow, in the integration of the different information systems and in the acquisition of new methods for quality control and error analysis due to the high complexity of such a project. Individual adjustment of digital radiography and PACS to the local needs is necessary. Obvious advantages are the constantly high image quality even in difficult imaging conditions, quick access to all imaging data for the clinician witout the need for active interfernce by the radiology staff, as well as the inherent possibilities for image processing and viewing. The institutionalization of a competent and committed team of radiology technicians, radiologists and clinicians as well as technical support by the hospital staff as well as the industry is key for the functioning of an installation like this.
Corresponding author:
Dr.Siegfried Peer
Dept.of Radiology, University Hospital
Anichstr.35
A-6020 Innsbruck, Austria
Tel.: 0043/512/504/2761
E-Mail: Siegfried.Peer(at)uibk.ac.at
Oral presentation at EuroPACS'98, Barcelona, Spain