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Health IT & Picture Archiving and Communication Systems
The document is a seminar presentation by Dr. Rogier van de Wetering discussing health IT and Picture Archiving and Communication Systems (PACS), focusing on key developments in healthcare, the historical evolution of medical imaging, and PACS maturity models. It highlights the increasing engagement of individuals in healthcare decisions, technological advancements, rising healthcare costs, and the need for effective implementation of health information technology. The presentation emphasizes the importance of integrating PACS into hospital workflows for improved operational efficiency and quality of care.
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Health IT & Picture Archiving and Communication Systems
- 1. Health IT &Picture Archiving and Communication Systems Utrecht, May 16, 2013 dr. Rogier van de Wetering Seminar Medical Informatics
- 2. © 2012 DeloitteThe Netherlands Content 1 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems Introduction Key health developments Types of Health IS A brief history of medical imaging and PACS Exercise Introduction to PACS Maturity concepts Optional: Trends in medical imaging Preview on lecture (31-05)
- 3. Introduction 2 dr R.van de Wetering: Health IT & Picture Archiving and Communication Systems dr. Rogier van de Wetering Background in Information Sciences Currently Manager at Deloitte Consulting Former positions: Senior managing consultant (Deloitte Consulting) Lecturer Information Sciences and Medical Informatics Phd-student – A Strategic PACS maturity approach (2007-2011) Management consultant (Deloitte Consulting) Business Analist (Deloitte Consulting) Short introduction
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- 5. A perspective onkey developments in healthcare using an international lens 4 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems Individuals more engaged in decisions and purchases Providers develop new services to clients (product and quality information) Innovations to improve efficiency & transparency Growing costs of healthcare Ageing population E-prevention programs will reduce future healthcare spending Providers develop management information on performance
- 6. International Comparison ofSpending on Health, 1980–2007 5 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems Source: Davis et al., How the performance of the U.S. health care system compares internationally. The common wealth fund (2010). See also OECD.org
- 7. What is drivinghealth care costs? Spending on healthcare in all OECD countries are rising faster than economic growth, especially within the U.S. Advances in medical technologies improve diagnosis and patient treatment. However, they also increase health spending This can be clearly seen from the rapid growth and use of computed tomography (CT) scanners and magnetic resonance imaging (MRI) units used for diagnostic purposes Factors include: 6 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems Advances in medical technology Population expectations Population ageing
- 8. The U.S. andGreece show a big difference in their use per capita as opposed to the Netherlands 7 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems 98,1 91,2 72,3 62,8 53,7 48,5 47,7 38,8 37,8 31,2 27,8 24,2 21,4 12,7 0 20 40 60 80 100 Greece UnitedStates Iceland Luxembourg Belgium France OECD Netherlands Denmark Canada CzechRepublic SlovakRepublic Australia1 Korea MRI exams per 1 000 population Data include only exams for out-patients and private in- patients (excluding exams in public hospitals). Number of MRI exams per 1 000 population, 2008 (or latest year available)
- 9. Developments in healthcarefrom a hospital CXO perspective 8 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems Hospital CXO ICD10/DOT Governance, risk & compliance Horizontal /vertical integration Reimburse ments M&A Alliances Order mngt Lean operations Tele-medicine / eHealth Patient influence Cloud solutions / SaaS Mobile apps Information Management Patient engagement / empower- ment Shared Services Integrated supporting processes Information Security Medical Imaging Technology Minimal Invasive surgery RFID / Track & Trace Regulations Virtualization Big Data/ Analytics Mobility outpatient clinic Business Intelligence Customized care EHR/EPR Business IT Healthcare Lean Chain care
- 10. Hype Cycle forHealthcare Provider Applications and Systems 2012 9 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
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- 12. Overview of varioustypes of IS/IT • Electronic health records (ePR/eMR) • Computerized provider order entry (CPOE) • Decision and diagnostic support (e.g. CAD/CAR) • Advanced visualization tools • Surgical simulation and modeling • Knowledge discovery/mining and retrieval systems • Enterprise-wide image management systems (i.e. PACS) • Data exchange networks (e.g. XDS-i, IHE) • Prescribing systems • E-Health / consumer informatics / educational • Tele-medicine • Mobile (apps) computing • Administration (Cf. Haux, 2010; Chaundry, 2006; Huang, 2010; Van de Wetering, 2011) 11 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems Source: M. J. Schuemie et al., Mapping the Domain of Medical Informatics. Methods Inf Med 2009; 48: 76–83 Extracted medical informatics clusters/classifications appearing between 2005 and 2008 Organization, application, and evaluation of health IS Medical knowledge representation Signal and data analysis
- 13. There are manypossible benefits and costs of implementing health information technology Effects of health IS/IT (Cf. Chaundry, 2006): • Quality • Efficiency • Costs Challenges for the future: • Interoperability of medical data • Adoption rates of IS/IT • Misalignment of incentives for its use Key question remains: How to apply IT effectively? 12 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
- 14. A brief historyof medical imaging and PACS
- 15. A brief historyof medical imaging – the Classical time 14 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems Careful anatomical lessons in 17th century The Anatomy Lesson of Dr. Nicolaes Tulp (1632) by Rembrandt Src: retrieved from Wiki 2012
- 16. Revolution came withRöntgen's discovery of the X-ray 15 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems • Wilhelm Conrad Röntgen (1845 - 1923) • German physicist • Discovered penetrating “X-ray” (invisible beam) on November 8, 1895 • A brief article was published on January 5, 1896 • He earned the first Noble Prize in 1901 in Physics Src: retrieved from Auntminnie.com
- 17. PACS – backgroundand definition • Due to the changing health care environment, hospitals are obliged to utilize the full potential of Information Systems and Information Technology and (IS/IT) • Hospitals have taken on this challenge by moving towards filmless operations and investing in Picture Archiving and Communication System (PACS) • The concept of PACS was introduced as early as 1982 16 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems Acquire images Store into central repositories Distribute upon request Display images “Workflow-integrated imaging systems” “Designed to streamline operations” “Many interrelated system components ”
- 18. PACS consists ofmany interrelated system components and is most efficient when integrated with the Hospital- and Radiology information system 17 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems PACS components Source: Canadian Association of Radiologist Hospital IT-architecture Source: Muller et al., 2004
- 19. X–Ray Exam withoutPACS: an inefficient process Un–Hang Films & Attach Report Patient Registered Exam Performed Patient Data Re–Entered at Acq Device Previous Exams hung in Reading Room GEYMS CT Return Films to File Room Re–assemble Film Jacket Send Films & Report to Referring Physician Retrieve Films & Report to Referring Physician Radiologist Read Dictate & Approve Develop Film Quality Assurance Hang Films 18 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
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- 21. 1. Develop aX–Ray Exam with PACS: an efficient process 2. Identify possible uses for mobile apps Un–Hang Films & Attach Report Patient Registered Exam Performed Patient Data Re–Entered at Acq Device Previous Exams hung in Reading Room GEYMS CT Return Films to File Room Re–assemble Film Jacket Send Films & Report to Referring Physician Retrieve Films & Report to Referring Physician Radiologist Read Dictate & Approve Develop Film Quality Assurance Hang Films 20 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
- 22. X–Ray Exam withPACS: an efficient process Patient Registered Exam Performed GEYMS CT Radiologist Read Dictate & Approve Referring Physician Accesses Report and Films 21 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
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- 24. PACS are thusworkflow-integrated imaging systems designed to streamline operations throughout the entire patient-care delivery process (Huang) To: Digital Workflow From: Film Based Workflow ‘How can hospitals mature their PACS?’ 23 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
- 25. The PMM describesfive levels of PACS maturity and towards higher levels of maturity, operational efficiencies, IT-integration and effective care expand 24 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems References: Van de Wetering, R. and R. Batenburg (2009). "A PACS maturity model: a systematic meta-analytic review on maturation and evolvability of PACS in the hospital enterprise." Int J Med Inform 78(2): 127-40. & Van de Wetering, R., R. Batenburg and R. Lederman (2010). "Evolutionistic or revolutionary paths? A PACS maturity model for strategic situational planning." Int J CARS (in press).
- 26. Does this soundfamiliar to you? 25 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems “… we see the computer age everywhere but in the productivity statistics.” Robert Solow, New York Review of Books, 12 juli 1987 Business/IT alignment
- 27. A conceptual modelwas developed combining (1) PACS maturity, (2) PACS alignment and (3) PACS performance 26 Reference: Van de Wetering, R., Batenburg, R., Oudkerk, M., Van Ooijen, P.M.A., Brinkkemper, S., and Scheper, W., A situational alignment framework for PACS. Published online 5 March 2011 in the Journal of Digital Imaging a: PACS is compatible with current international standards and classifications b: PACS exchanges information with the RIS and HIS without any complications a: End-users affect the decision making process in selecting a specific PACS vendor b: End-users affect digital PACS-workflow and functionality improvements a: Impact and opportunities for chain partners with respect to PACS b: External environment is consciously inquired for new developments to optimize PACS functionality dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
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- 30. In search formetrics that allow standardized measurement of productivity, for comparative evaluation and ongoing efforts to improve efficiency Source: Hu et al. (2011) Informatics in Radiology. Efficiency Metrics for Imaging Device Productivity 29 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
- 31. An illustrative examplefor automating real-time reporting on Imaging procedures and productivity monitoring Source: Hu et al. (2011) Informatics in Radiology. Efficiency Metrics for Imaging Device Productivity 30 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems
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- 33. Contact me 32 drR. van de Wetering: Health IT & Picture Archiving and Communication Systems dr. Rogier van de Wetering Email: rvandewetering@deloitte.nl Tel: +31620789870
- 34. Preview lecture byErik van der Zijden BSc MBA 33 dr R. van de Wetering: Health IT & Picture Archiving and Communication Systems • Erik is CEO & Co-founder of Synappz • Lecture on Medical Apps (31 May) • Development process • What would you like to know?