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Seghers MC, Seghers VJ, Sher AC, Jadhav SP, States LJ, Trout AT, Alazraki AL, Sammer MBK. Working from home during the COVID-19 pandemic: surveys of the Society for Pediatric Radiology and the Society of Chiefs of Radiology at Children's Hospitals. Pediatr Radiol 2022; 52:1242-1254. [PMID: 35229184 PMCID: PMC8885321 DOI: 10.1007/s00247-022-05299-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/19/2021] [Accepted: 01/23/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Due to the COVID-19 pandemic, some pediatric radiologists have shifted to working from home; the long-term ramifications for pediatric radiologists and departments have not yet been defined. OBJECTIVE To characterize experiences of working from home associated with the COVID-19 pandemic and guide expectations after the pandemic is controlled, via separate surveys of Society for Pediatric Radiology (SPR) and Society of Chiefs of Radiology at Children's Hospitals (SCORCH) members. MATERIALS AND METHODS Two separate surveys were conducted. In the first, SPR members were surveyed Jan. 11 through Feb. 8, 2021. The response rate was 17.0% (255 of 1,501). Survey questions included demographics, information on the ability to work from home and subjective experiences ranked on a scale of 0 to 10. The survey enabled segregation and comparison of responses between those with and without home PACS. In the second survey, SCORCH members were surveyed Dec. 8, 2020, through Jan. 8, 2021. The response rate was 51.5% (51/99). Survey questions included the logistics of working from home, technical specifications and the expectations on clinical duties performed from home. The Wilcoxon rank test was used to determine statistical significance of compared variables between respondents with and without home PACS in SPR members, and expectations between SPR and SCORCH members. Descriptive statistics summarized demographic questions and free text responses. RESULTS The majority of member respondents (81.2%, 207/255) had a home PACS and most departments provided home PACS to faculty (94.1%, 48/51). Overall, radiologists who could work from home were satisfied with their ability to work from home (mean rating: 8.3/10) and were significantly more satisfied than predicted by those without home PACS (5.9/10, P<0.0001). Respondents overwhelmingly indicated they were less able to teach trainees (mean rating: 2.7/10) and had decreased emotional engagement (mean rating: 4.4/10), but had improved research productivity and cognitive ability for research when working from home (mean rating for both: 5.3/10). Regarding the expectations of the ability to work from home after no longer needing to address the pandemic, department chairs generally favored fewer rotations from home, with 97.9% (47/48) indicating working from home should be 60% or fewer assignments, compared with 84.1% (164/195) of individual radiologists (P=0.071). CONCLUSIONS Due to the COVID-19 pandemic, there has been a shift to working from home using PACS. Results of these SPR and SCORCH member surveys can help inform future decisions regarding pediatric radiologists working from home once the pandemic has been controlled.
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Affiliation(s)
- Matthew C. Seghers
- grid.89336.370000 0004 1936 9924Dell Medical School, The University of Texas at Austin, Austin, TX USA
| | - Victor J. Seghers
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Andrew C. Sher
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Siddharth P. Jadhav
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Lisa J. States
- grid.239552.a0000 0001 0680 8770Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Department of Radiology, University of Pennsylvania, Philadelphia, PA USA
| | - Andrew T. Trout
- grid.239573.90000 0000 9025 8099Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Adina L. Alazraki
- grid.428158.20000 0004 0371 6071Department of Radiology, Children’s Healthcare of Atlanta, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Radiology, Emory University, Atlanta, GA USA
| | - Marla B. K. Sammer
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
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Macri F, Niu BT, Erdelyi S, Mayo JR, Khosa F, Nicolaou S, Brubacher JR. Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency Department Workflow. Can Assoc Radiol J 2021; 73:249-258. [PMID: 34229465 DOI: 10.1177/08465371211023861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on Emergency Department (ED) patient flow in an urban, quaternary-care teaching hospital. METHODS Patient ED visit and imaging information were extracted from the hospital patient care information system for 2008 to 2018. An interrupted time-series approach with a comparison group was used to study the impact of 24/7/365 ETR on average monthly ED length of stay (ED-LOS) and Emergency Physician to disposition time (EP-DISP). Linear regression models were fit with abrupt and permanent interrupts for 24/7/365 ETR, a coefficient for comparison series and a SARIMA error term; subgroup analyses were performed by patient arrival time, imaging type and chief complaint. RESULTS During the study period, there were 949,029 ED visits and 739,796 diagnostic tests. Following implementation of 24/7/365 coverage, we found a significant decrease in EP-DISP time for patients requiring only radiographs (-29 min;95%CI:-52,-6) and a significant increase in EP-DISP time for major trauma patients (46 min;95%CI:13,79). No significant change in patient throughput was observed during evening hours for any patient subgroup. For overnight patients, there was a reduction in EP-DISP for patients with symptoms consistent with stroke (-78 min;95%CI:-131,-24) and for high acuity patients who required imaging (-33 min;95%CI:-57,-10). Changes in ED-LOS followed a similar pattern. CONCLUSIONS At our institution, 24/7/365 in-house ETR staff radiology coverage was associated with improved ED flow for patients requiring only radiographs and for overnight stroke and high acuity patients. Major trauma patients spent more time in the ED, perhaps reflecting the required multidisciplinary management.
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Affiliation(s)
- Francesco Macri
- Department of Emergency and Trauma Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.,Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bonnie T Niu
- Department of Emergency and Trauma Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.,Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon Erdelyi
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - John R Mayo
- Department of Emergency and Trauma Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.,Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Faisal Khosa
- Department of Emergency and Trauma Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.,Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Savvas Nicolaou
- Department of Emergency and Trauma Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.,Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey R Brubacher
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Rosenkrantz AB, Hanna TN, Steenburg SD, Tarrant MJ, Pyatt RS, Friedberg EB. The Current State of Teleradiology Across the United States: A National Survey of Radiologists' Habits, Attitudes, and Perceptions on Teleradiology Practice. J Am Coll Radiol 2019; 16:1677-1687. [PMID: 31271736 DOI: 10.1016/j.jacr.2019.05.053] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To explore the current state of teleradiology practice, defined as the interpretation of imaging examinations at a different facility from where the examination was performed. METHODS A national survey addressing radiologists' habits, attitudes, and perceptions regarding teleradiology was distributed by e-mail to a random sample of ACR members in early 2019. RESULTS Among 731 of 936 respondents who indicated a non-teleradiologist primary work setting, 85.6% reported performing teleradiology within the past 10 years and 25.4% reported that teleradiology represents a majority of their annual imaging volumes; 84.4% performed teleradiology for internal examinations and 45.7% for external examinations; 46.2% performed teleradiology for rural areas and 37.2% for critical access hospitals; 91.3% performed teleradiology during weekday normal business hours and 44.5% to 79.6% over evening, overnight, and weekend hours. In all, 76.9% to 86.2% perceived value from teleradiology for geographic, after-hours, and multispecialty coverage, as well as reduced interpretation turnaround times. The most common challenges for teleradiology were electronic health record access (62.8%), quality assurance (53.8%), and technologist proximity (48.4%). The strategy most commonly considered useful for improving teleradiology was technical interpretation standards (33.3%). Radiologists in smaller practices were less likely to perform teleradiology or performed teleradiology for lower fractions of work, were less likely to experience coverage advantages of teleradiology, and reported larger implementation challenges, particularly relating to electronic health records and prior examination access. CONCLUSION Despite historic concerns, teleradiology is widespread throughout modern radiology practice, helping practices achieve geographic, after-hours, and multispecialty coverage; reducing turnaround times; and expanding underserved access. Nonetheless, quality assurance of offsite examinations remains necessary. IT integration solutions could help smaller practices achieve teleradiology's benefits.
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Affiliation(s)
| | - Tarek N Hanna
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Scott D Steenburg
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Robert S Pyatt
- Chambersburg Imaging Associates, Chambersburg, Pennsylvania
| | - Eric B Friedberg
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
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Hryhorczuk AL, Hanneman K, Eisenberg RL, Meyer EC, Brown SD. Radiologic Professionalism in Modern Health Care. Radiographics 2016; 35:1779-88. [PMID: 26466185 DOI: 10.1148/rg.2015150041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Modern radiology is at the forefront of technological progress in medicine, a position that often places unique challenges on its professional character. This article uses "Medical Professionalism in the New Millennium: A Physician Charter," a document published in 2002 and endorsed by several major radiology organizations, as a lens for exploring professional challenges in modern radiology. The three main tenets of the Charter emphasize patient welfare, patient autonomy, and the reduction of disparities in health care distribution. This article reviews the ways in which modern technology and financial structures potentially create stressors on professionalism in radiology, while highlighting the opportunities they provide for radiologists seeking to fulfill the professional goals articulated in the Charter. Picture archiving and communication systems (PACS) and voice recognition systems have transformed the speed of radiology and enhanced the ability of radiologists to improve patient care but also have brought new tensions to the workplace. Although teleradiology may improve global access to radiologists, it may also promote the commoditization of radiology, which diminishes the professional stature of radiologists. Social media and patient portals provide radiologists with new forums for interacting with the public and patients, potentially promoting patient welfare. However, patient privacy and autonomy are important considerations. Finally, modern financial structures provide radiologists with both entrepreneurial opportunities as well as the temptation for unprofessional conduct. Each of these advances carries the potential for professional growth while testing the professional stature of radiology. By considering the risks and benefits of emerging technologies in the modern radiology world, radiologists can chart an ethical and professional future path.
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Affiliation(s)
- Anastasia L Hryhorczuk
- From the Department of Radiology, Tufts Medical Center, 800 Washington St, Boston, MA 02111 (A.L.H.); Department of Radiology, Stanford University Medical Center, Palo Alto, Calif (K.H.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (R.L.E.); Institute for Professionalism and Ethical Practice (E.C.M., S.D.B.) and Department of Radiology (S.D.B.), Boston Children's Hospital, Boston, Mass
| | - Kate Hanneman
- From the Department of Radiology, Tufts Medical Center, 800 Washington St, Boston, MA 02111 (A.L.H.); Department of Radiology, Stanford University Medical Center, Palo Alto, Calif (K.H.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (R.L.E.); Institute for Professionalism and Ethical Practice (E.C.M., S.D.B.) and Department of Radiology (S.D.B.), Boston Children's Hospital, Boston, Mass
| | - Ronald L Eisenberg
- From the Department of Radiology, Tufts Medical Center, 800 Washington St, Boston, MA 02111 (A.L.H.); Department of Radiology, Stanford University Medical Center, Palo Alto, Calif (K.H.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (R.L.E.); Institute for Professionalism and Ethical Practice (E.C.M., S.D.B.) and Department of Radiology (S.D.B.), Boston Children's Hospital, Boston, Mass
| | - Elaine C Meyer
- From the Department of Radiology, Tufts Medical Center, 800 Washington St, Boston, MA 02111 (A.L.H.); Department of Radiology, Stanford University Medical Center, Palo Alto, Calif (K.H.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (R.L.E.); Institute for Professionalism and Ethical Practice (E.C.M., S.D.B.) and Department of Radiology (S.D.B.), Boston Children's Hospital, Boston, Mass
| | - Stephen D Brown
- From the Department of Radiology, Tufts Medical Center, 800 Washington St, Boston, MA 02111 (A.L.H.); Department of Radiology, Stanford University Medical Center, Palo Alto, Calif (K.H.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (R.L.E.); Institute for Professionalism and Ethical Practice (E.C.M., S.D.B.) and Department of Radiology (S.D.B.), Boston Children's Hospital, Boston, Mass
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Rosenberg C, Kroos K, Rosenberg B, Hosten N, Flessa S. Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital. Eur Radiol 2013; 23:2197-205. [PMID: 23604799 DOI: 10.1007/s00330-013-2810-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 01/18/2013] [Accepted: 01/23/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. METHODS Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. RESULTS Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. CONCLUSIONS Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. KEY POINTS • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.
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Affiliation(s)
- Christian Rosenberg
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ernst Moritz Arndt University, Ferdinand-Sauerbruch-Str. 1, 17475, Greifswald, Germany.
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Maskell G. Commentary on: Does every patient need to be discussed at a multidisciplinary team meeting? Clin Radiol 2013; 68:760-1. [PMID: 23601985 DOI: 10.1016/j.crad.2013.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 03/06/2013] [Indexed: 12/24/2022]
Affiliation(s)
- G Maskell
- Royal Cornwall Hospital, Truro, Cornwall TR1 3LJ, UK.
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Duszak R, Muroff LR. Measuring and Managing Radiologist Productivity, Part 2: Beyond the Clinical Numbers. J Am Coll Radiol 2010; 7:482-9. [DOI: 10.1016/j.jacr.2010.01.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 01/29/2010] [Indexed: 11/26/2022]
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You JJ, Laupacis A, Newman A, Bell CM. Non-adherence to recommendations for further testing after outpatient CT and MRI. Am J Med 2010; 123:557.e1-8. [PMID: 20569765 DOI: 10.1016/j.amjmed.2009.11.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 11/15/2009] [Accepted: 11/16/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nearly 1 in every 5 outpatient visits ends with a request for a diagnostic imaging test, and imaging reports often contain recommendations for further testing. Little is known about adherence to recommendations for further testing after outpatient computed tomography (CT) and magnetic resonance imaging (MRI). METHODS We performed a retrospective cohort study linking provincial administrative data to a cross-sectional audit of 23,691 outpatient CT and MRI scans performed in 2005 in Ontario, Canada. After excluding patients who died (n=1031), were hospitalized (n=3030), or visited an emergency department (n=3660) within 180 days of the index CT/MRI scan, 15,970 CT/MRI scans were included. The primary outcome was adherence to recommendations for further testing within 180 days of an index CT/MRI scan. RESULTS Further testing was recommended in 2027 of 15,970 (12.7%) index CT/MRI scan reports and was recommended most frequently after CT chest scans (593 of 2276 [26.1%]). From the 2027 scans in which further testing was recommended, we identified 2102 individual recommendations for a specific type of follow-up test and found that just over one third (37.6%) of these recommendations were followed at 180 days. Adherence was lower (32.3%) when patients had a visit to the referring physician within 180 days of the index CT/MRI scan, compared with when they had no such visit (50.5%; P <.001). CONCLUSIONS Radiologists commonly recommend further testing after outpatient CT and MRI scanning. However, nearly two thirds of these recommendations are not followed. This suggests that substantial opportunities exist to improve the exchange of information between clinicians and radiologists and to advance the quality of outpatient care.
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Affiliation(s)
- John J You
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Steele JR, Hovsepian DM, Schomer DF. The Joint Commission Practice Performance Evaluation: A Primer for Radiologists. J Am Coll Radiol 2010; 7:425-30. [DOI: 10.1016/j.jacr.2010.01.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 01/29/2010] [Indexed: 10/19/2022]
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Latifi R, Merrell RC, Doarn CR, Hadeed GJ, Bekteshi F, Lecaj I, Boucha K, Hajdari F, Hoxha A, Koshi D, de Leonni Stanonik M, Berisha B, Novoberdaliu K, Imeri A, Weinstein RS. "Initiate-build-operate-transfer"--a strategy for establishing sustainable telemedicine programs in developing countries: initial lessons from the balkans. Telemed J E Health 2010; 15:956-69. [PMID: 19832055 DOI: 10.1089/tmj.2009.0084] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in Kosova has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in the Balkans. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy, "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services in developing countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs, was discussed. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the healthcare infrastructure. The endpoint is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program will be transitioned to the national Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Albania, Macedonia, and other countries around the world. The IBOT model has been effective in creating sustainable telemedicine and e-health integrated programs in the Balkans and may be a good model for establishing such programs in developing countries.
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Affiliation(s)
- Rifat Latifi
- Department of Surgery, Division of Trauma, Critical Care & Emergency Surgery, University of Arizona , Arizona Health Sciences Center, Tucson, Arizona.
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Benjamin M, Aradi Y, Shreiber R. From shared data to sharing workflow: merging PACS and teleradiology. Eur J Radiol 2009; 73:3-9. [PMID: 19914789 DOI: 10.1016/j.ejrad.2009.10.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Accepted: 09/07/2009] [Indexed: 11/16/2022]
Abstract
Due to a host of technological, interface, operational and workflow limitations, teleradiology and PACS/RIS were historically developed as separate systems serving different purposes. PACS/RIS handled local radiology storage and workflow management while teleradiology addressed remote access to images. Today advanced PACS/RIS support complete site radiology workflow for attending physicians, whether on-site or remote. In parallel, teleradiology has emerged into a service of providing remote, off-hours, coverage for emergency radiology and to a lesser extent subspecialty reading to subscribing sites and radiology groups. When attending radiologists use teleradiology for remote access to a site, they may share all relevant patient data and participate in the site's workflow like their on-site peers. The operation gets cumbersome and time consuming when these radiologists serve multi-sites, each requiring a different remote access, or when the sites do not employ the same PACS/RIS/Reporting Systems and do not share the same ownership. The least efficient operation is of teleradiology companies engaged in reading for multiple facilities. As these services typically employ non-local radiologists, they are allowed to share some of the available patient data necessary to provide an emergency report but, by enlarge, they do not share the workflow of the sites they serve. Radiology stakeholders usually prefer to have their own radiologists perform all radiology tasks including interpretation of off-hour examinations. It is possible with current technology to create a system that combines the benefits of local radiology services to multiple sites with the advantages offered by adding subspecialty and off-hours emergency services through teleradiology. Such a system increases efficiency for the radiology groups by enabling all users, regardless of location, to work "local" and fully participate in the workflow of every site. We refer to such a system as SuperPACS.
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Commentary on the impact of teleradiology in the United States over the last decade: driving consolidation and commoditisation of radiologists and radiology services. Clin Radiol 2009. [DOI: 10.1016/j.crad.2008.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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