FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2396646722> ?p ?o ?g. }

• W2396646722 abstract "Background: One year after the introduction of Information and Communication Technology (ICT) to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT) reports in the Electronic Medical Record (EMR) was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients’ hospital stays (LOS). Methods: Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups. Results: There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence. Conclusion: Our results did not indicate that improved access to radiology results reduced the patients’ LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians’ interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction. Background The implementation of a Radiology Information System (RIS) and a Picture Archiving and Communication System (PACS), and the integration of these systems with the Electronic Medical Record (EMR), may improve the use of diagnostic imaging in clinical practice. This Information and Communication Technology (ICT) can reduce the radiologists’ reporting time, and make the reports and images instantly available to clinicians hospital-wide [1-10]. In May 2005, RIS and PACS (Siemens MagicSAS® and MagicView®, Erlangen, Germany) were introduced to radiologists at a Norwegian five-hundred bed universityaffiliated hospital. Both systems were integrated with the EMR (DIPS EPJ®, Bodo, Norway). This complete technology shift will be referred to below as ‘the ICT introduction’. Before the ICT introduction, radiologists read images on film. Clinicians had to walk to the Radiology Department to look at these images. Reports were printed and distributed on paper. For emergency ultrasound (US) cases, handwritten summaries accompanied the patients returning to the wards. After the ICT introduction, images were immediately (within five minutes) available hospital-wide to clinicians with legal access to the patient’s record. All radiology reports were entered directly into the EMR as soon as they were finished (also within five minutes). The reports were issued in two versions: a preliminary * Correspondence: petter@hurlen.no Helse Sor-Ost Health Services Research Centre Akershus University Hospital Sykehusveien 27, NO-1478 Lorenskog, Norway Full list of author information is available at the end of the article Hurlen et al. BMC Health Services Research 2010, 10:262 http://www.biomedcentral.com/1472-6963/10/262 © 2010 Hurlen et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. version after one radiologist’s examination of the images, and a final version once a specialist in radiology had verified the conclusion. In a previous study of the impact of this ICT introduction, we observed that the radiology turnaround time (RTAT), i.e. the time from the examinations until the reports were completed, was reduced after one year [11]. For preliminary reports, the median RTAT was reduced from 13.4 to 2.7 hours. For final reports, median RTAT was reduced from 22.6 to 15.1 hours. Two years after the ICT introduction, the RTAT for final reports was back to the pre-ICT level, and has, for various reasons, continued to increase. The RTAT for preliminary reports also increased somewhat, except for preliminary CT reports. In a study of clinicians’ use of the reports in the EMR, we observed that clinicians read reports soon after they were available [12]. The median time from a preliminary report becoming available in the EMR until it was opened was 0.8 hours for Computed Tomography (CT) reports, and 1.1 hours for Computed Radiography (CR) reports. Significantly more of the CT reports than CR reports were read (55% vs. 36%, p < 0.01). For final reports, the median time was 3.3 hours for CT and 3.5 hours for CR. Significantly more final CT reports were read than CR reports (91% vs. 87%, p < 0.01). Before the ICT introduction, the median time until the result was presented during a radiology round a meeting between clinicians and radiologists was 18 hours. However, important results were often communicated orally. The Magnetic Resonance Imaging (MRI) service was limited and varied somewhat during the observation periods. MRI reporting was consequently not studied separately. The Department did not offer MRI examinations of emergency cases. The capacity for performing the diagnostic imaging examinations did not change between the two periods. The objective of the current study was to assess whether the improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a corresponding reduction in the length of patients’ hospital stay (LOS). Methods Approval for this study was obtained from the Norwegian Social Science Data Service (NSD) and the Regional Ethics Committee, and the Duke University Medical Centre Institutional Review Board exempted this study from review. Data relating to all hospital stays for all patients discharged between February 1 and 28 2005 and between February 1 and 28 2006 were retrieved from the hospital EMR. These periods were chosen because of the documented improvement in availability and access to the results of diagnostic imaging. Patients from psychiatric and geriatric wards were excluded. All other patients were included, even if they had been admitted and discharged the same day. The data set included the date and time of admission and discharge, discharge diagnoses, number and categories of imaging examinations, and the clinical department responsible for the patient. LOS was calculated from the admission and discharge time stamps. We did not have a strong a priori hypothesis as to how the different aspects of the ICT introduction would influence clinical practice, and thereby length of stay, or if there would be differences between different modalities, patient groups or clinical departments. Rather than creating hypotheses through deduction or by performing a feasibility study, our hypothesis generation was assisted by a data splitting approach. This approach guards against (unintended) hypothesis fishing, and ensures the integrity of the computed p-values [13]. The data set was randomly split into two parts. The first part, the exploratory data set (33%), was used to assist in generating the hypotheses. The remaining data, the confirmatory data set (67%), was used to test the hypotheses. The reported p-values for changes in LOS for each modality and for the whole patient group are based on the confirmatory data set. Once a hypothesis had been verified, the complete data set was used for quantification, and is presented in the figure and tables. The purpose of splitting data in this way was to ensure that our statistical tests were performed on data that were not used to generate the hypotheses. Changes in LOS within each subgroup (e.g., Tables 1 and 2) were analyzed using the two-sided nonparametric Mann-Whitney U-test. To compare changes in LOS between subgroups (Table 2), an independent sample t-test was used. The change in the number of examinations was analysed using the chi-square test. The significance levels (predetermined at a < 0.05) are reported. SPSS (v. 15.0, © SPSS Inc.) was used for data management and analysis. Results The study included 8,892 hospital stays. A total of 1,275 different primary discharge diagnoses were used Table 1 LOS before and after the ICT introduction for all patients with one or more imaging diagnostic examinations Stays Mean Median SE Pre-ICT 4,244 3.50 days 1.72 days 0.08 days Post-ICT 4,648 3.34 days 1.50 days 0.08 days p = 0.43 Hurlen et al. BMC Health Services Research 2010, 10:262 http://www.biomedcentral.com/1472-6963/10/262 Page 2 of 5" @default.
• W2396646722 created "2016-06-24" @default.
• W2396646722 creator A5007823954 @default.
• W2396646722 date "2011-01-01" @default.
• W2396646722 modified "2023-09-27" @default.
• W2396646722 title "Introducing Information and Communication Technology to Radiologists : impact on Process and Outcome" @default.
• W2396646722 cites W1527042114 @default.
• W2396646722 cites W1670120521 @default.
• W2396646722 cites W1826265997 @default.
• W2396646722 cites W1918863132 @default.
• W2396646722 cites W1926187246 @default.
• W2396646722 cites W1942877613 @default.
• W2396646722 cites W1970407056 @default.
• W2396646722 cites W1970506273 @default.
• W2396646722 cites W1972015626 @default.
• W2396646722 cites W1973033290 @default.
• W2396646722 cites W1974445318 @default.
• W2396646722 cites W1975787277 @default.
• W2396646722 cites W1976433481 @default.
• W2396646722 cites W1976732037 @default.
• W2396646722 cites W1978707827 @default.
• W2396646722 cites W1982998323 @default.
• W2396646722 cites W1986271138 @default.
• W2396646722 cites W1986320609 @default.
• W2396646722 cites W1987665248 @default.
• W2396646722 cites W1990513740 @default.
• W2396646722 cites W1993105424 @default.
• W2396646722 cites W1996854155 @default.
• W2396646722 cites W1997829318 @default.
• W2396646722 cites W2004063652 @default.
• W2396646722 cites W2005299116 @default.
• W2396646722 cites W2006450150 @default.
• W2396646722 cites W2006507300 @default.
• W2396646722 cites W2007568686 @default.
• W2396646722 cites W2008812708 @default.
• W2396646722 cites W2009817242 @default.
• W2396646722 cites W2010074862 @default.
• W2396646722 cites W2011125431 @default.
• W2396646722 cites W2012970079 @default.
• W2396646722 cites W2013907367 @default.
• W2396646722 cites W2019886399 @default.
• W2396646722 cites W2021249738 @default.
• W2396646722 cites W2021550297 @default.
• W2396646722 cites W2022669248 @default.
• W2396646722 cites W2023096366 @default.
• W2396646722 cites W2026006575 @default.
• W2396646722 cites W2028806801 @default.
• W2396646722 cites W2033614044 @default.
• W2396646722 cites W2035262017 @default.
• W2396646722 cites W2036223887 @default.
• W2396646722 cites W2037062111 @default.
• W2396646722 cites W2037111497 @default.
• W2396646722 cites W2038937863 @default.
• W2396646722 cites W2042345343 @default.
• W2396646722 cites W2043708883 @default.
• W2396646722 cites W2046205058 @default.
• W2396646722 cites W2046275808 @default.
• W2396646722 cites W2047061084 @default.
• W2396646722 cites W2047119130 @default.
• W2396646722 cites W2049725102 @default.
• W2396646722 cites W2051709274 @default.
• W2396646722 cites W2052186216 @default.
• W2396646722 cites W2053115136 @default.
• W2396646722 cites W2053649477 @default.
• W2396646722 cites W2059834753 @default.
• W2396646722 cites W2061595856 @default.
• W2396646722 cites W2062627538 @default.
• W2396646722 cites W2063498032 @default.
• W2396646722 cites W2064238280 @default.
• W2396646722 cites W2065012714 @default.
• W2396646722 cites W2068831740 @default.
• W2396646722 cites W2069151051 @default.
• W2396646722 cites W2071333295 @default.
• W2396646722 cites W2071459310 @default.
• W2396646722 cites W2074721633 @default.
• W2396646722 cites W2075107464 @default.
• W2396646722 cites W2076459222 @default.
• W2396646722 cites W2079565042 @default.
• W2396646722 cites W2082180354 @default.
• W2396646722 cites W2082826201 @default.
• W2396646722 cites W2084585047 @default.
• W2396646722 cites W2091810192 @default.
• W2396646722 cites W2098383865 @default.
• W2396646722 cites W2101073067 @default.
• W2396646722 cites W2101504901 @default.
• W2396646722 cites W2103361814 @default.
• W2396646722 cites W2104198823 @default.
• W2396646722 cites W2110094866 @default.
• W2396646722 cites W2112078252 @default.
• W2396646722 cites W2112754702 @default.
• W2396646722 cites W2118200909 @default.
• W2396646722 cites W2118967050 @default.
• W2396646722 cites W2122312145 @default.
• W2396646722 cites W2122426416 @default.
• W2396646722 cites W2128145977 @default.
• W2396646722 cites W2128531245 @default.
• W2396646722 cites W2132856958 @default.
• W2396646722 cites W2133138481 @default.
• W2396646722 cites W2133939844 @default.
• W2396646722 cites W2136934936 @default.

• next