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PACS/Computers

Ernst R.; Mun S. J.; Le O.; Leonard M. H.; Chaljub G.; Oto A.; Riascos-Castaneda R. University of Texas Medical Branch, Galveston, TX

Address correspondence to R. Ernst (rdernst{at}utmb.edu)

Objective: Trace events and decisions occurring within the hospital and radiology department during the approach of a hurricane and following its landfall. Evaluate emergency procedures and describe the implementation of five improvements.

Materials and Methods: We review the timeline of events documented by the Emergency Operations Center of the institution and supplemented the history with our personal experiences. We noted equipment and report availability. The Trauma Data Center containing the Emergency Department Hospital Information System (HIS) is evaluated.

Results: While the trauma data center remained operational throughout the emergency, the main hospital data center, talk station server and PACS archive were shutdown as part of the university's disaster plan. The trauma center experienced a brief network outage. This delayed access to the separate emergency department PACS archive. To enhance disaster preparedness, 5 steps have been implemented by the department. First, an off-site location has been identified for continuation of the teleradiology enterprise. Second, two laptops have been prepared with voice recognition software for radiologists' dictation. Third, the main voice recognition server has been relocated to the Trauma Data Center. Fourth, the teleradiology gateway routing computer has been relocated. Fifth the network has been upgraded and reinforced.

Conclusion: While the department of radiology had prepared for emergencies, we discovered that improvements could be made to our computer systems. The storm caused relatively minor damage to our hospital, but lessons learned will help us be better prepared.

E436. Comparison Between Radiology Workload Indicators (ITALY–USA)

Cristofaro M.; Busi Rizzi E.; Schininà V.; Rovighi L.; Bibbolino C. INMI IRCCS L Spallanzani, Rome, Italy

Address correspondence to M. Cristofaro (mcristofar{at}sirm.org)

Objective: To carry out a comparative analysis between 4 models a) numerical calculation, b) model proposed by Sindacato Nazionale Radiologi–Società Italiana di Radiologia Medica (SNR-SIRM) based on number of patients, c) model based on the transfer prices that are used in the Emilia Romagna Region (RER), d) model based on work-RVU.

Materials and Methods: The period under consideration includes six years of activity (2000–2005) of the Imaging Diagnostic Operational Unit of the National Institute For Infectious Diseases L. Spallanzani in Rome, Italy. Data collection envisages the grouping of examinations into homogeneous groups (macroaggregates) The reference standards considered in order to obtain a homogenization of data were the following: number of examinations/hour per physician, score/hour according to the SNR-SIRM model, score/hour according to the RER model, number of work – RVU /working hour, the number of examinations/FTE, the number of work – RVU/FTE, the difficulty index.

Results: a) A total of 158,828 examinations was performed. The numerical calculation of examinations attributed to traditional radiology the highest percentage of activity (38.5%). b) The SNR-SIRM model indicates that echography is the most relevant macroaggregate (43%). c) The RER model shows that TC is prevailing (40.4%). d) According to the RVU model, the prevailing method is echography (37.8%). Other calculations included: number of exams/FTE = 6.141, number of work – RVU/FTE = 4.134; the difficulty index given by the work – RVU/number examinations ratio, with an overall average = 0.72; number of work – RVU per working hour = 2.92.

Conclusion: Numerical calculation does not highlight the weight of technologically committed examinations. The SNR-SIRM model, suitably considers the combination number of patients – patient weight among the macroaggregates that are taken into consideration. The RER model particularly highlights the use of expensive technologies since it evaluates the total weight of the performance and not only the weight of radiologist's activity. The RVU model introduces the difficulty index. This index can support the evaluation of the real technological and scientific commitment of Unit's activities.

E437. Assessment of Risk in Radiology Using Malpractice RVU

Cristofaro M.; Busi Rizzi E.; Schininà V.; Rovighi L.; Bibbolino C. INMI IRCCS L Spallanzani, Rome, Italy

Address correspondence to M. Cristofaro (mcristofar{at}sirm.org)

Objective: Analysis on the causes and remedies needed to reduce the incidence of malpractice has been under continual studies, although limited data is available regarding quantitative evaluation of the risk. OBJECTIVES: To determine radiological risk in a preventive and quantitative manner and verify if the malpractice relative value units (mp-rvu) are a good indicator of associated risk factors.

Materials and Methods: Radiological examinations executed by our Radiology Department in 2000–2004 have been codified according to nomenclature HCPCS (Healthcare Common Procedure Coding System) used by U.S. Centers for Medicare and Medicaid Services (CMS). The annual weight of malpractice was calculated for every examination. The data has been grouped in macroaggregates by methodology. The ratio mp-rvu/n.examinations has been considered as an index of insurance risk (mp index)

Results: A total of 133,005 examinations was performed, which produced 25,252 mp-rvu points, the total mp index was 0.193 Traditional radiology represents 38% of the examinations, accounting for 8% of mp-rvu with a mp index = 0.039. Ultrasound represents 35% of the examinations, accounting for 23% of mp-rvu with a mp index = 0.125. CT represents 13% of the examinations, accounting for 28% of mp-rvu with a mp index = 0.434 MR represents 11% of the examinations, accounting for 39% of mp-rvu with a mp index = 0.667

Conclusion: Malpractice relative value units (mp-rvu) are indicative of the risk considered globally and when subgrouped. MP index correlates this risk with number of exams carried out divided by methodology. This model provided quantitative data for projects concerning risk management and allowed the correlation between data obtained in different departments.

E438. www.PubmedReader.com - A Custom-defined Tool for Instant Literature Updates

Talanow R. The Cleveland Clinic Foundation, Cleveland, OH

Address correspondence to R. Talanow (arrs.org{at}talanow.info)

Objective: To provide a program which provides an immediate and easy access from PubMed to specific medical topics, independent from location, and without the need to redefine search criteria repeatedly to accelerate the physician's workflow in research and daily work.

Materials and Methods: The program runs on a 700 MHz Pentium II quad processor with Microsoft Server 2003 as operating system. Script languages include PERL, JAVASCRIPT, DHTML. All information is stored in a MySQL database.

Results: The user may create multiple search criteria and save them in a personal profile. The information is obtained via RSS feed from the PubMed database and provided to the user as HTML code in the form of a custom defined Website. The program may be used in different modes for a broad overlook about all defined search criteria with access to the PubMed information and another mode for on-the-fly access to the information directly from the user's computer. By using the latter mode, the user receives an instant access to custom defined search criteria with literally a click of the mouse.

Conclusion: This web-based program provides PubMed information to specific medical topics on-the-fly without need for reentering frequent search criteria. It offers individualized user accounts, is free of charge and easy to use. The user stays always up-to-date and by individualization of the search criteria, access and layout of the information presentation, the user is provided with a flexible and practical tool to facilitate the physician's workflow in research and daily work.

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This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content Social Bookmarking                      What's this?