Systems Integration Evolution: PACS, Diagnostic by image, patients, voice recognition and costs evaluation at the San Juan University Hospital.
J. A. Gómez (*), N. Reyes (*), I. Gonzalez, C. Crespo, J. Galant
(*) Data processing unit, Radiology
Department
San Juan University Hospital, Alicante (Spain)
1. Introduction.
In May 1994, the installation of a new data information system was started in the Radiology Department at the San Juan University Hospital. The aims of the installation were to obtain basic information of the department, like patient, citations, activity capture, reporting, statistics, costs control and clinical histories archive; being this system 100% integrated with the system for patients (IRIS).
Four years later, with the expertise obtained, we have gone a step forward to the integration of PACS and voice recognition in our current system GERMEN (Management of Radiology Department and Nuclear Medicine).
2. Hardware/Software.
The system operates within the LAN of the Hospital, an Ethernet 802.3, of twisted pair wiring and fibre optic. The LAN, with around 200 connecting points, sustains 6 UNIX and one NT servers, together with 130 PC workstations and 70 serial terminals (fig. 1).
GERMEN is supported by a hardware composed by two servers. One of them contains the database of the Hospital. That is patients information, accomplished activity, scheduling examination reports and an analysis of their consumptions. The other one, contains the PACS obtained from ultrasound and CTs with digital exit and some manually introduced to have records of some interesting cases. Workers within the Radiology and Nuclear Medicine Department are distributed in 3 main areas. Management composed by 9 working teams, medical reporting and exams review composed by 5 working teams and PACS management composed by 3 working teams.
The system was developed by the data processing unit of San Juan Hospital in Windows Multibase against a database management system INFORMIX on-line v. 7. It integrates the PACS associated to each exam, its medical report and its administrative data (patients data, examinations, plates, materials). The software for PACS management is a standard application, developed beside the Radiology Department of the Dr. Peset Hospital of Valencia. It allows visualisation and further study of images by means of Sequences Analysis and Multi-spectral medical images. MS-Word is the software used for reporting. It also integrates menus from the IBM's voice recognition system "Via Voice".
3. Project.
The project has been carried out in different stages. Starting with an old citation software, it was enlarged for specific activity capturing in 1994, and afterwards to cover the medical report area.
Initially, those were carried out by hand from the radiologists records. At present, this method is combined with the IBM's "Via Voice" which transcripts voice into words. The latest improvement in the voice recognition applications has been decisive in the elimination of the Dictaphone and also has increased the efficiency in the area.
Currently our database has some 325,000 examinations and about 80,000 medical reports. Currently it is being enhanced to include PACS and a cost analysis per process, which will reassign the staff to cover those places where greater deviations are originated. The cost analysis obtained that way is more accurate, improving then further evaluation methods.
The project of clinical histories systems enlarges with the radiological image storage, making possible the access so from others department of the Hospital as from any hospital of the "Valencia Community", which are linked through ARTERIAS WAN.
The system allows clinical examinations to be appointed directly from the nursery control reducing the stance.
Oral presentation at EuroPACS'98, Barcelona, Spain