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Lastrucci A, Wandael Y, Barra A, Miele V, Ricci R, Livi L, Lepri G, Gulino RA, Maccioni G, Giansanti D. Precision Metrics: A Narrative Review on Unlocking the Power of KPIs in Radiology for Enhanced Precision Medicine. J Pers Med 2024; 14:963. [PMID: 39338217 PMCID: PMC11433247 DOI: 10.3390/jpm14090963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/21/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024] Open
Abstract
(Background) Over the years, there has been increasing interest in adopting a quality approach in radiology, leading to the strategic pursuit of specific and key performance indicators (KPIs). These indicators in radiology can have significant impacts ranging from radiation protection to integration into digital healthcare. (Purpose) This study aimed to conduct a narrative review on the integration of key performance indicators (KPIs) in radiology with specific key questions. (Methods) This review utilized a standardized checklist for narrative reviews, including the ANDJ Narrative Checklist, to ensure thoroughness and consistency. Searches were performed on PubMed, Scopus, and Google Scholar using a combination of keywords related to radiology and KPIs, with Boolean logic to refine results. From an initial yield of 211 studies, 127 were excluded due to a lack of focus on KPIs. The remaining 84 studies were assessed for clarity, design, and methodology, with 26 ultimately selected for detailed review. The evaluation process involved multiple assessors to minimize bias and ensure a rigorous analysis. (Results and Discussion) This overview highlights the following: KPIs are crucial for advancing radiology by supporting the evolution of imaging technologies (e.g., CT, MRI) and integrating emerging technologies like AI and AR/VR. They ensure high standards in diagnostic accuracy, image quality, and operational efficiency, enhancing diagnostic capabilities and streamlining workflows. KPIs are vital for radiological safety, measuring adherence to protocols that minimize radiation exposure and protect patients. The effective integration of KPIs into healthcare systems requires systematic development, validation, and standardization, supported by national and international initiatives. Addressing challenges like CAD-CAM technology and home-based radiology is essential. Developing specialized KPIs for new technologies will be key to continuous improvement in patient care and radiological practices. (Conclusions) In conclusion, KPIs are essential for advancing radiology, while future research should focus on improving data access and developing specialized KPIs to address emerging challenges. Future research should focus on expanding documentation sources, improving web search methods, and establishing direct connections with scientific associations.
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Affiliation(s)
- Andrea Lastrucci
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Yannick Wandael
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Angelo Barra
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Renzo Ricci
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Lorenzo Livi
- Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, 50134 Florence, Italy
| | - Graziano Lepri
- Azienda Unità Sanitaria Locale Umbria 1, Via Guerriero Guerra 21, 06127 Perugia, Italy
| | - Rosario Alfio Gulino
- Facoltà di Ingegneria, Università di Tor Vergata, Via del Politecnico, 1, 00133 Rome, Italy
| | - Giovanni Maccioni
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Daniele Giansanti
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Keogh RJ, Harvey H, Brady C, Hassett E, Costelloe SJ, O'Sullivan MJ, Twomey M, O'Leary MJ, Cahill MR, O'Riordan A, Joyce CM, Moloney G, Flavin A, M Bambury R, Murray D, Bennett K, Mullooly M, O'Reilly S. Dealing with digital paralysis: Surviving a cyberattack in a National Cancer center. J Cancer Policy 2024; 39:100466. [PMID: 38176467 DOI: 10.1016/j.jcpo.2023.100466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/26/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION Cyberattacks represent a growing threat for healthcare delivery globally. We assess the impact and implications of a cyberattack on a cancer center in Ireland. METHODS On May 14th 2021 (day 0) Cork University Hospital (CUH) Cancer Center was involved in the first national healthcare ransomware attack in Ireland. Contingency plans were only present in laboratory services who had previously experienced information technology (IT) failures. No hospital cyberattack emergency plan was in place. Departmental logs of activity for 120 days after the attack were reviewed and compared with historical activity records. Daily sample deficits (routine daily number of samples analyzed - number of samples analyzed during cyberattack) were calculated. Categorical variables are reported as median and range. Qualitative data were collected via reflective essays and interviews with key stakeholders from affected departments in CUH. RESULTS On day 0, all IT systems were shut down. Radiotherapy (RT) treatment and cancer surgeries stopped, outpatient activity fell by 50%. hematology, biochemistry and radiology capacity fell by 90% (daily sample deficit (DSD) 2700 samples), 75% (DSD 2250 samples), and 90% (100% mammography/PET scan) respectively. Histopathology reporting times doubled (7 to 15 days). Radiotherapy (RT) was interrupted for 113 patients in CUH. The median treatment gap duration was six days for category 1 patients and 10 for the remaining patients. Partner organizations paused all IT links with CUH. Outsourcing of radiology and radiotherapy commenced, alternative communication networks and national conference calls in RT and Clinical Trials were established. By day 28 Email communication was restored. By day 210 reporting and data storage backlogs were cleared and over 2000 computers were checked/replaced. CONCLUSION Cyberattacks have rapid, profound and protracted impacts. While laboratory and diagnostic deficits were readily quantified, the impact of disrupted/delayed care on patient outcomes is less readily quantifiable. Cyberawareness and cyberattack plans need to be embedded in healthcare. POLICY SUMMARY Cyberattacks pose significant challenges for healthcare systems, impacting patient care, clinical outcomes, and staff wellbeing. This study provides a comprehensive review of the impact of the Conti ransomware attack on cancer services in Cork University Hospital (CUH), the first cyberattack on a national health service. Our study highlights the widespread disruption caused by a cyberattack including shutdown of information technology (IT) services, marked reduction in outpatient activity, temporary cessation of essential services such as radiation therapy. We provide a framework for other institutions for mitigating the impact of a cyberattack, underscoring the need for a cyberpreparedness plan similar to those made for natural disasters and the profound legacy of a cyberattack on patient care.
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Affiliation(s)
- Rachel J Keogh
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland.
| | - Harry Harvey
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Claire Brady
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland
| | - Edel Hassett
- Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland
| | - Seán J Costelloe
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork, Ireland
| | - Martin J O'Sullivan
- Department of Breast Surgery, Cork University Hospital, Ireland; University College Cork, College Road, University College Cork, Ireland
| | - Maria Twomey
- Department of Radiology, Cork University Hospital, Ireland
| | - Mary Jane O'Leary
- Palliative Medicine, Marymount University Hospital and Hospice, Cork, Ireland; Palliative Medicine, Cork University Hospital, Ireland
| | - Mary R Cahill
- Department of Haematology, Cork University Hospital, Ireland
| | | | - Caroline M Joyce
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork, Ireland; INFANT Centre, University College Cork, Ireland; Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, University College Cork, Ireland
| | - Ger Moloney
- Information and Communication Technology (ICT) Department, Cork University Hospital, Ireland
| | - Aileen Flavin
- Bon Secours Radiotherapy Cork in Partnership with UPMC Hillman Cancer Centre, Cork, Ireland
| | - Richard M Bambury
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland; Cancer Research @UCC, University College Cork, Cork, Ireland
| | | | - Kathleen Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences Dublin, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences Dublin, Ireland
| | - Seamus O'Reilly
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland; Cancer Research @UCC, University College Cork, Cork, Ireland
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