2,431 research outputs found
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 radiographersâ 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 Barleyâs
(1986, 1990) research by explicitly demonstrating that the organizationâs 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
MammoApplet: an interactive Java applet tool for manual annotation in medical imaging
Web-based applications in computational medicine have become increasingly important during the last years. The rapid growth of the World Wide Web supposes a new paradigm in the telemedicine and eHealth areas in order to assist and enhance the prevention, diagnosis and treatment of patients. Furthermore, training of radiologists and management of medical databases are also becoming increasingly important issues in the field. In this paper, we present MammoApplet , an interactive Java applet interface designed as a web-based tool. It aims to facilitate the diagnosis of new mammographic cases by providing a set of image processing tools that allow a better visualization of the images, and a set of drawing tools, used to annotate the suspicious regions. Each annotation allows including the attributes considered by the experts when issuing the final diagnosis. The overall set of overlays is stored in a database as XML files associated with the original images. The final goal is to obtain a database of already diagnosed cases for training and enhancing the performance of novice radiologistsPeer ReviewedPostprint (author's final draft
Focal Spot, Spring 2003
https://digitalcommons.wustl.edu/focal_spot_archives/1093/thumbnail.jp
Why is it difficult to implement e-health initiatives? A qualitative study
<b>Background</b> The use of information and communication technologies in healthcare is seen as essential for high quality and cost-effective healthcare. However, implementation of e-health initiatives has often been problematic, with many failing to demonstrate predicted benefits. This study aimed to explore and understand the experiences of implementers - the senior managers and other staff charged with implementing e-health initiatives and their assessment of factors which promote or inhibit the successful implementation, embedding, and integration of e-health initiatives.<p></p>
<b>Methods</b> We used a case study methodology, using semi-structured interviews with implementers for data collection. Case studies were selected to provide a range of healthcare contexts (primary, secondary, community care), e-health initiatives, and degrees of normalization. The initiatives studied were Picture Archiving and Communication System (PACS) in secondary care, a Community Nurse Information System (CNIS) in community care, and Choose and Book (C&B) across the primary-secondary care interface. Implementers were selected to provide a range of seniority, including chief executive officers, middle managers, and staff with 'on the ground' experience. Interview data were analyzed using a framework derived from Normalization Process Theory (NPT).<p></p>
<b>Results</b> Twenty-three interviews were completed across the three case studies. There were wide differences in experiences of implementation and embedding across these case studies; these differences were well explained by collective action components of NPT. New technology was most likely to 'normalize' where implementers perceived that it had a positive impact on interactions between professionals and patients and between different professional groups, and fit well with the organisational goals and skill sets of existing staff. However, where implementers perceived problems in one or more of these areas, they also perceived a lower level of normalization.<p></p>
<b>Conclusions</b> Implementers had rich understandings of barriers and facilitators to successful implementation of e-health initiatives, and their views should continue to be sought in future research. NPT can be used to explain observed variations in implementation processes, and may be useful in drawing planners' attention to potential problems with a view to addressing them during implementation planning
Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population
Article approval pendingPaediatric radiology requires dedicated equipment, specific precautions related to ionising radiation, and specialist knowledge. Developing countries face difficulties in providing adequate imaging services for children. In many African countries, children represent an increasing proportion of the population, and additional challenges follow from extreme living conditions, poverty, lack of parental care, and exposure to tuberculosis, HIV, pneumonia, diarrhoea and violent trauma. Imaging plays a critical role in the treatment of these children, but is expensive and difficult to provide. The World Health Organisation initiatives, of which the World Health Imaging System for Radiography (WHIS-RAD) unit is one result, needs to expand into other areas such as the provision of maintenance servicing. New initiatives by groups such as Rotary and the World Health Imaging Alliance to install WHIS-RAD units in developing countries and provide digital solutions, need support. Paediatric radiologists are needed to offer their services for reporting, consultation and quality assurance for free by way of teleradiology. Societies for paediatric radiology are needed to focus on providing a volunteer teleradiology reporting group, information on child safety for basic imaging, guidelines for investigations specific to the disease spectrum, and solutions for optimising imaging in children
Focal Spot, Spring 1994
https://digitalcommons.wustl.edu/focal_spot_archives/1066/thumbnail.jp
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Radiology education in Europe: Analysis of results from 22 European countries.
AimTo assess the state of radiology education across Europe by means of a survey study.MethodsA comprehensive 23-item radiology survey was distributed via email to the International Society of Radiology members, national radiological societies, radiologists and medical physicists. Reminders to complete the survey were sent and the results were analyzed over a period of 4 mo (January-April 2016). Survey questions include length of medical school and residency training; availability of fellowship and subspecialty training; number of residency programs in each country; accreditation pathways; research training; and medical physics education. Descriptive statistics were used to analyze and summarize data.ResultsRadiology residency training ranges from 2-6 years with a median of 5 years, and follows 1 year of internship training in 55% (12 out of 22) European countries. Subspecialty fellowship training is offered in 55% (12 out of 22) European countries. Availability for specialization training by national societies is limited to eight countries. For nearly all respondents, less than fifty percent of radiologists travel abroad for specialization. Nine of 22 (41%) European countries have research requirements during residency. The types of certifying exam show variation where 64% (14 out of 22) European countries require both written and oral boards, 23% (5 out of 22) require oral examinations only, and 5% (1 out of 22) require written examinations only. A degree in medical physics is offered in 59% (13 out of 22) European countries and is predominantly taught by medical physicists. Nearly all respondents report that formal examinations in medical physics are required.ConclusionComparative learning experiences across the continent will help guide the development of comprehensive yet pragmatic infrastructures for radiology education and collaborations in radiology education worldwide
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