Implementation of a Teleradiology System to Improve After-Hours Radiology Services in Kaiser Permanente Southern California
Autor: | Danny Chang, Jo Carol Hiatt, Bruce Horn, Julian Bendelstein |
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Rok vydání: | 2006 |
Předmět: | |
Zdroj: | The Permanente Journal. 10:47-50 |
ISSN: | 1552-5775 1552-5767 |
Popis: | For several years, the Southern California Chiefs of Radiology explored various technology options to improve the efficiency of after-hours services. Until 2002, on-call radiologists at each of the 11 medical centers provided after-hours radiology services for their local Emergency Departments (ED) in Kaiser Permanente Southern California (KPSC). This process had been in place for many years and reflected the medical group's political structure (essentially 11 separate groups of radiologists). The time lag between when a radiologist received a page and when s/he arrived at the medical center produced inevitable delays in providing radiology consultations to EDs. In most cases, the radiologist was needed only to provide image interpretation, not to perform the exam. The Chiefs discussed a variety of options, including providing each on-call radiologist with the ability to view exams and transmit interpretations from home. This and other potential solutions did not prove to be feasible for various reasons, including: concern over the quality of images viewed on home computers, the challenge of remotely supporting a variety of home systems and the Southern California Permanente Medical Group compensation structure. After much discussion, the Chiefs, with the support of administration, elected to implement a teleradiology system that would station a radiologist in a central location to provide image interpretation for CT, MRI and ultrasound exams from 7:00 pm to 7:00 am seven days a week for all KP Southern California medical centers. “Wet read” reports would be communicated via fax to the referring ED. However, when working out the final details of the implementation, two important changes were made. First, the single central location plan was abandoned. The radiologists strongly preferred an alternative option that provided the ability to access the teleradiology studies from any of KPSC's 11 medical centers. This alternative permitted each teleradiologist to work from his/her home medical center, or another if more convenient. This change was made due to concerns about the willingness of radiologists interested in working a teleradiology shift to travel to a central location (for example radiologists who normally worked in San Diego to travel more than 125 miles to Pasadena). Doing so offered the advantage of having the teleradiologist work in a familiar setting, using familiar equipment and traveling no more than for a typical workday. Second, the plan to communicate the teleradiologist's findings via fax was replaced by a Web application that would provide the ability to track a request for teleradiology services throughout the entire process, as well as communicate the findings to the referring site. |
Databáze: | OpenAIRE |
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