The organizational implications of medical imaging in the context of Malaysian hospitals

This research investigated the implementation and use of medical imaging in the context of Malaysian hospitals. In this report medical imaging refers to PACS, RIS/HIS and imaging modalities which are linked through a computer network. The study examined how the internal context of a hospital and its external context together influenced the implementation of medical imaging, and how this in turn shaped organizational roles and relationships within the hospital itself. It further investigated how the implementation of the technology in one hospital affected its implementation in another hospital. The research used systems theory as the theoretical framework for the study. Methodologically, the study used a case-based approach and multiple methods to obtain data. The case studies included two hospital-based radiology departments in Malaysia. The outcomes of the research suggest that the implementation of medical imaging in community hospitals is shaped by the external context particularly the role played by the Ministry of Health. Furthermore, influences from both the internal and external contexts have a substantial impact on the process of implementing medical imaging and the extent of the benefits that the organization can gain. In the context of roles and social relationships, the findings revealed that the routine use of medical imaging has substantially affected radiographers’ roles, and the social relationships between non clinical personnel and clinicians. This study found no change in the relationship between radiographers and radiologists. Finally, the approaches to implementation taken in the hospitals studied were found to influence those taken by other hospitals. Overall, this study makes three important contributions. Firstly, it extends Barley’s (1986, 1990) research by explicitly demonstrating that the organization’s internal and external contexts together shape the implementation and use of technology, that the processes of implementing and using technology impact upon roles, relationships and networks and that a role-based approach alone is inadequate to examine the outcomes of deploying an advanced technology. Secondly, this study contends that scalability of technology in the context of developing countries is not necessarily linear. Finally, this study offers practical contributions that can benefit healthcare organizations in Malaysia

Content Based Image Retrieval (CBIR) in Remote Clinical Diagnosis and Healthcare

Content-Based Image Retrieval (CBIR) locates, retrieves and displays images alike to one given as a query, using a set of features. It demands accessible data in medical archives and from medical equipment, to infer meaning after some processing. A problem similar in some sense to the target image can aid clinicians. CBIR complements text-based retrieval and improves evidence-based diagnosis, administration, teaching, and research in healthcare. It facilitates visual/automatic diagnosis and decision-making in real-time remote consultation/screening, store-and-forward tests, home care assistance and overall patient surveillance. Metrics help comparing visual data and improve diagnostic. Specially designed architectures can benefit from the application scenario. CBIR use calls for file storage standardization, querying procedures, efficient image transmission, realistic databases, global availability, access simplicity, and Internet-based structures. This chapter recommends important and complex aspects required to handle visual content in healthcare.Comment: 28 pages, 6 figures, Book Chapter from "Encyclopedia of E-Health and Telemedicine

Kontextsensitivität für den Operationssaal der Zukunft

The operating room of the future is a topic of high interest. In this thesis, which is among the first in the recently defined field of Surgical Data Science, three major topics for automated context awareness in the OR of the future will be examined: improved surgical workflow analysis, the newly developed event impact factors, and as application combining these and other concepts the unified surgical display.Der Operationssaal der Zukunft ist ein Forschungsfeld von großer Bedeutung. In dieser Dissertation, die eine der ersten im kürzlich definierten Bereich „Surgical Data Science“ ist, werden drei Themen für die automatisierte Kontextsensitivität im OP der Zukunft untersucht: verbesserte chirurgische Worflowanalyse, die neuentwickelten „Event Impact Factors“ und als Anwendungsfall, der diese Konzepte mit anderen kombiniert, das vereinheitlichte chirurgische Display

Future developments and trends in use of picture archiving and communication systems

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University London.Objectives: This study identifies modern information technologies that can improve the clinical practice of Picture Archiving and Communication Systems (PACS) and determines the approaches that are needed to improve the functionality of current PACS to provide better next generation PACS and to improve the future of radiology practices and workflow with future PACS generations. Method: A parallel mixed method approach was adopted including qualitative method (semi-structured interviews), quantitative method (questionnaire survey) and observation of online discussion groups on PACS. Five databases were searched to find salient literature, including Science Direct, Springer Link, Scopus, CINAHL Plus and Google Scholar. Six radiologists were interviewed and questionnaires were collected from 120 radiologists. Four online discussion groups related to PACS were monitored via LinkedIn. The data were analysed thematically using the thematic analysis method. Finally, a focus group was held with a separate group of radiologists to validate the findings. Results: Eight themes emerged from the thematic analysis of the data: (1) limitations of traditional PACS; (2) user needs and requirements that can increase PACS functionality; (3) Web based solutions of PACS; (4) PACS on mobile phones; (5) Vendor Neutral Archive (VNA); (6) full integration of voice recognition in PACS; (7) backup solutions for the system and (8) continuous training for PACS users. Discussion: With the development of healthcare information and communication technology (ICT) and with the increased demands of the radiologists to expand PACS usability, traditional PACS must be updated to follow the changes. Modern technologies can provide better solutions to enhance the functionality of current PACS. The next generation of PACS can fulfil the future requirements of users. This study considers the issues between the needs and requirements of the users of a PACS system in the future and the developing solutions in ICT and the PACS industry. Moreover, highly developed PACS systems with advanced features will have a direct impact in changing and improving radiology workflow. Accordingly, a model has been developed that proposes new features for the next generation PACS system, which may be applied to the next generation radiology practice. The model was validated with the focus group and, by using a separate group of radiologists in another country, was determined to be generalisable. Conclusion: It is widely recognised that traditional PACS must be updated to adopt recent advances in ICT. This research has identified themes that, when incorporated, will enhance the functionality of PACS and radiology workflow and provide better quality clinical practice. The findings from this empirical research can be used: as recommendations to vendors; for technology development; and by medical institutes to consider aspects when undertaking implementation of PACS and training future radiologists. Keywords: 'Picture archiving and communication system’, PACS, Future trends, next generation, Organisational efficiency, Productivity, Clinical practice, Ubiquitous.Ministry of Health, Government of Kuwai

Kontextsensitivität für den Operationssaal der Zukunft

The operating room of the future is a topic of high interest. In this thesis, which is among the first in the recently defined field of Surgical Data Science, three major topics for automated context awareness in the OR of the future will be examined: improved surgical workflow analysis, the newly developed event impact factors, and as application combining these and other concepts the unified surgical display.Der Operationssaal der Zukunft ist ein Forschungsfeld von großer Bedeutung. In dieser Dissertation, die eine der ersten im kürzlich definierten Bereich „Surgical Data Science“ ist, werden drei Themen für die automatisierte Kontextsensitivität im OP der Zukunft untersucht: verbesserte chirurgische Worflowanalyse, die neuentwickelten „Event Impact Factors“ und als Anwendungsfall, der diese Konzepte mit anderen kombiniert, das vereinheitlichte chirurgische Display

Addendum to Informatics for Health 2017: Advancing both science and practice

This article presents presentation and poster abstracts that were mistakenly omitted from the original publication