["Activity based costing" in radiology].

PubMed

Klose, K J; Böttcher, J

2002-05-01

The introduction of diagnosis related groups for reimbursement of hospital services in Germany (g-drg) demands for a reconsideration of utilization of radiological products and costs related to them. Traditional cost accounting as approach to internal, department related budgets are compared with the accounting method of activity based costing (ABC). The steps, which are necessary to implement ABC in radiology are developed. The introduction of a process-oriented cost analysis is feasible for radiology departments. ABC plays a central role in the set-up of decentralized controlling functions within this institutions. The implementation seems to be a strategic challenge for department managers to get more appropriate data for adequate enterprise decisions. The necessary steps of process analysis can be used for other purposes (Certification, digital migration) as well.

Launching a permanent out-of-hour interventional radiology service: single-center experience from a German University Hospital.

PubMed

Goltz, J P; Janssen, H; Petritsch, B; Kickuth, R

2014-02-01

To evaluate the feasibility, frequency of use, types of intervention and labor costs of a formal round-the-clock interventional radiology on-call service. In 11/2011 a formal and permanent out-of-hour interventional radiology rota in addition to the general radiology out-of-hour rota (OOHR) was established. We retrospectively screened the interventional radiology database for procedures completed outside regular working hours, reviewed all interventions and manually selected cases in which the on-call interventionist was called in from home. We determined the type, frequency of use and costs (€/year and procedure) of this service between 1/2012 and 12/2012. The referring physicians' (sub-) specialties were evaluated. During the 12-month period, the on-call interventionists (n = 3) performed 92 procedures OOH. The procedures included angiography and hemorrhage control (n = 36, 39.1 %), angiography and intervention for acute limb ischemia (n = 25, 27.2 %), percutaneous biliary drainage (PTCD) (n = 10, 10.9 %), angiography for non-occlusive ischemia (n = 7, 7.6 %), and other (n = 14, 15.3 %). The total labor costs for the OOHR were € 42,312.21 (€ 32,982.60 lump sum for stand-by, €  9,329.61 for hours spent on procedures). The labor costs per procedure totaled € 459.92. The referring physicians' specialties were general/visceral (n = 25), vascular surgery (n = 24), internal medicine (n = 21), cardiac/thoracic vascular (n = 9), trauma surgery (n = 5), urology (n = 5), and anesthesiology (n = 3). A formal interventional OOHR is practicable in a university hospital setting. Most procedures were requested by general, vascular, and thoracic surgery as well as internal medicine with a focus on hemorrhage control, treatment of acute limb ischemia, and PTCD. The overall labor costs for the OOHR appear moderate. • In a university setting an OOHR for IR is feasible.• Labor costs per procedure appear moderate.• Hemorrhage control and treatment of limb ischemia were the most frequent procedures. Citation Format: • Goltz JP, Janssen H, Petritsch B et al. Launching a Permanent Out-of-Hour Interventional Radiology Service: Single-Center Experience from a German University Hospital. Fortschr Röntgenstr 2014; 186: 136 - 141. © Georg Thieme Verlag KG Stuttgart · New York.

Eight years of quality control in Bulgaria: impact on mammography practice.

PubMed

Avramova-Cholakova, S; Lilkov, G; Kaneva, M; Terziev, K; Nakov, I; Mutkurov, N; Kovacheva, D; Ivanova, M; Vasilev, D

2015-07-01

The requirements for quality control (QC) in diagnostic radiology were introduced in Bulgarian legislation in 2005. Hospital medical physicists and several private medical physics groups provide QC services to radiology departments. The aim of this study was to analyse data from QC tests in mammography and to investigate the impact of QC introduction on mammography practice in the country. The study was coordinated by the National Centre of Radiobiology and Radiation Protection. All medical physics services were requested to fill in standardised forms with information about most important parameters routinely measured during QC. All QC service providers responded. Results demonstrated significant improvement of practice since the introduction of QC, with reduction of established deviations from 65 % during the first year to 7 % in the last year. The systems that do not meet the acceptability criteria were suspended from use. Performance of automatic exposure control and digital detectors are not regularly tested because of the absence of requirements in the legislation. The need of updated guidance and training of medical physicists to reflect the change in technology was demonstrated. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Solutions in radiology services management: a literature review.

PubMed

Pereira, Aline Garcia; Vergara, Lizandra Garcia Lupi; Merino, Eugenio Andrés Díaz; Wagner, Adriano

2015-01-01

The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services. Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares. In the databases, 565 papers - 120 out of them, pdf free - were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others. Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies.

75 FR 19985 - Fee for Services To Support FEMA's Offsite Radiological Emergency Preparedness Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0007] Fee for Services To Support FEMA's Offsite Radiological Emergency Preparedness Program AGENCY: Federal... Radiological Emergency Preparedness (REP) Program. DATES: This hourly rate is effective for FY 2010 (October 1...

Radiology Consultation in the Era of Precision Oncology: A Review of Consultation Models and Services in the Tertiary Setting.

PubMed

DiPiro, Pamela J; Krajewski, Katherine M; Giardino, Angela A; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H

2017-01-01

The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

White Paper Report of the RAD-AID Conference on International Radiology for Developing Countries: identifying challenges, opportunities, and strategies for imaging services in the developing world.

PubMed

Mollura, Daniel J; Azene, Ezana M; Starikovsky, Anna; Thelwell, Aduke; Iosifescu, Sarah; Kimble, Cary; Polin, Ann; Garra, Brian S; DeStigter, Kristen K; Short, Brad; Johnson, Benjamin; Welch, Christian; Walker, Ivy; White, David M; Javadi, Mehrbod S; Lungren, Matthew P; Zaheer, Atif; Goldberg, Barry B; Lewin, Jonathan S

2010-07-01

The RAD-AID Conference on International Radiology for Developing Countries was an assembly of individuals and organizations interested in improving access to medical imaging services in developing countries where the availability of radiology has been inadequate for both patient care and public health programs. The purpose of the meeting was to discuss data, experiences, and models pertaining to radiology in the developing world and to evaluate potential opportunities for future collaboration. Conference participants included radiologists, technologists, faculty members of academic medical institutions, and leadership of nongovernmental organizations involved in international health care and social entrepreneurship. Four main themes from the conference are presented in this white paper as important factors for the implementation and optimization of radiology in the developing world: (1) ensuring the economic sustainability of radiologic services through financial and administrative training support of health care personnel; (2) designing, testing, and deploying clinical strategies adapted for regions with limited resources; (3) structuring and improving the role of American radiology residents interested in global health service projects; and (4) implementing information technology models to support digital imaging in the developing world. Published by Elsevier Inc.

Computers and the supply of radiology services: anatomy of a disruptive technology.

PubMed

Levy, Frank

2008-10-01

Over the next decade, computers will augment the supply of radiology services at a time when reimbursement rules are likely to tighten. Increased supply and slower growing demand will result in a radiology market that is more competitive, with less income growth, than the market of the past 15 years.

Hanford Radiological Protection Support Services Annual Report for 1998

DOE Office of Scientific and Technical Information (OSTI.GOV)

DE Bihl; JA MacLellan; ML Johnson

1999-05-14

During calendar year (CY) 1998, the Pacific Northwest National Laboratory (PNNL) performed its customary radiological protection support services in support of the U.S. Department of Energy (DOE) Richland Operations OffIce (RL) and the Hanford contractors. These services included: 1) external dosimetry, 2) internal dosimetry, 3) in vivo measurements, 4) radiological records, 5) instrument calibra- tion and evaluation, and 6) calibration of radiation sources traceable to the National Institute of Standards and Technology (MST). The services were provided under a number of projects as summarized here.

White Paper Report of the 2010 RAD-AID Conference on International Radiology for Developing Countries: Identifying Sustainable Strategies for Imaging Services in the Developing World

PubMed Central

Welling, Rodney D.; Azene, Ezana M.; Kalia, Vivek; Pongpirul, Krit; Starikovsky, Anna; Sydnor, Ryan; Lungren, Matthew P.; Johnson, Benjamin; Kimble, Cary; Wiktorek, Sarah; Drum, Tom; Short, Brad; Cooper, Justin; Khouri, Nagi F.; Mayo-Smith, William W.; Mahesh, Mahadevappa; Goldberg, Barry B.; Garra, Brian S.; DeStigter, Kristen K.; Lewin, Jonathan S.; Mollura, Daniel J.

2015-01-01

The 2010 RAD-AID Conference on International Radiology for Developing Countries was a multidisciplinary meeting to discuss data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services reduce health care quality. The theme of this year’s conference was sustainability, with a focus on establishing and maintaining imaging services in resource-limited regions. Conference presenters and participants identified 4 important components of sustainability: (1) sustainable financing models for radiology development, (2) integration of radiology and public health, (3) sustainable clinical models and technology solutions for resource-limited regions, and (4) education and training of both developing and developed world health care personnel. PMID:21807349

42 CFR 415.102 - Conditions for fee schedule payment for physician services to beneficiaries in providers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... case of radiology or laboratory services, the additional requirements in § 415.120 or § 415.130... conditions for payment for radiology services) and 415.130 (concerning conditions for payment for physician...

[Teleradiology: threats and opportunities].

PubMed

Krestin, Gabriel P; Pieterman, Herman

2011-01-01

Radiological interpretation and reporting have become a commodity that may be farmed out elsewhere on the planet: teleradiology. The impact of this development fully depends on our understanding of the role of radiology as a specialty. If radiology is solely defined as the provision of medical image interpretation then commoditization of radiology through teleradiology services will lead to a deterioration in the status of radiologists. They may even become redundant as hospital specialists. However, if radiology is seen in a broader context with much more emphasis on its added value through specialized consultancy, then teleradiology may be an important instrument for improvement and optimalisation of imaging services.

Cost accounting for the radiologist.

PubMed

Gentili, Amilcare

2014-05-01

Cost accounting is the branch of managerial accounting that deals with the analysis of the costs of a product or service. This article reviews methods of classifying and allocating costs and relationships among costs, volume, and revenues. Radiology practices need to know the cost of a procedure or service to determine the selling price of a product, bid on contracts, analyze profitability, and facilitate cost control and cost reduction.

75 FR 45699 - Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... part of the office-based and ancillary radiology payment methodology. This notice updates the CY 2010... covered ancillary radiology services to the lesser of the ASC rate or the amount calculated by multiplying... procedures and covered ancillary radiology services are determined using the amounts in the MPFS final rule...

Solutions in radiology services management: a literature review*

PubMed Central

Pereira, Aline Garcia; Vergara, Lizandra Garcia Lupi; Merino, Eugenio Andrés Díaz; Wagner, Adriano

2015-01-01

Objective The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services. Materials and Methods Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares. Results In the databases, 565 papers – 120 out of them, pdf free – were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others. Conclusion Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies. PMID:26543281

21 CFR 892.1980 - Radiologic table.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiologic table. 892.1980 Section 892.1980 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1980 Radiologic table. (a) Identification. A radiologic...

Accountable care organizations and radiology: threat or opportunity?

PubMed

Abramson, Richard G; Berger, Paul E; Brant-Zawadzki, Michael N

2012-12-01

Although the anticipated rise of accountable care organizations brings certain potential threats to radiologists, including direct threats to revenue and indirect systemic changes jeopardizing the bargaining leverage of radiology groups, accountable care organizations, and other integrated health care delivery models may provide radiology with an important opportunity to reassert its leadership and assume a more central role within health care systems. Capitalizing on this potential opportunity, however, will require radiology groups to abandon the traditional "film reader" mentality and engage actively in the design and implementation of nontraditional systems service lines aimed at adding differentiated value to larger health care organizations. Important interlinked and mutually reinforcing components of systems service lines, derived from radiology's core competencies, may include utilization management and decision support, IT leadership, quality and safety assurance, and operational enhancements to meet organizational goals. Such systems-oriented service products, tailored to the needs of individual integrated care entities and supported by objective performance metrics, may provide market differentiation to shield radiology from commoditization and could become an important source of new nonclinical revenue. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Comparison of the Ministry of Health’s tariffs with the cost of radiology services using the activity-based costing method

PubMed Central

Kalhor, Rohollah; Amini, Saeed; Emami, Majid; Kakasoltani, Keivan; Rhamani, Nasim; Kalhor, Leila

2016-01-01

Introduction Efficient use of resources in organizations is one of the most important duties of managers. Appropriate allocation of resources can help managers to do this well. The aim of this study was to determine the cost of radiology services and to compare it with governmental tariffs (introduced by the Ministry of Health in Iran). Methods This was a descriptive and applied study that was conducted using the retrospective approach. First, activity centers were identified on the basis of five main groups of hospital activities. Then, resources and resource drivers, activities, and hospital activity drivers were identified. At the next step, the activities related to the delivery of radiology process were identified. Last, through allocation of activities cost to the cost objects, the cost price of 66 services that were delivered in the radiology department were calculated. The data were collected by making checklists, using the hospital’s information system, observations, and interviews. Finally, the data were analyzed using the non-parametric Wilcoxon test, Microsoft Excel, and SPSS software, version 18. Results The findings showed that from the total cost of wages, materials, and overhead obtained, the unit cost of the 66 cost objects (delivered services) in the Radiology Department were calculated using the ABC method (Price of each unit of Nephrostogram obtained $15.8 and Cystogram obtained $18.4). The Kolmogorov-Smirnov test indicated that the distribution of data of cost price using the ABC method was not normal (p = 0.000). The Wilcoxon test showed that there was a significant difference between the cost of services and the tariff of radiology services (p = 0.000). Conclusions The cost of delivered services in radiology departments was significantly higher than approved tariffs of the Ministry of Health, which can have a negative impact on the quality of services. PMID:27054013

Comparison of the Ministry of Health's tariffs with the cost of radiology services using the activity-based costing method.

PubMed

Kalhor, Rohollah; Amini, Saeed; Emami, Majid; Kakasoltani, Keivan; Rhamani, Nasim; Kalhor, Leila

2016-02-01

Efficient use of resources in organizations is one of the most important duties of managers. Appropriate allocation of resources can help managers to do this well. The aim of this study was to determine the cost of radiology services and to compare it with governmental tariffs (introduced by the Ministry of Health in Iran). This was a descriptive and applied study that was conducted using the retrospective approach. First, activity centers were identified on the basis of five main groups of hospital activities. Then, resources and resource drivers, activities, and hospital activity drivers were identified. At the next step, the activities related to the delivery of radiology process were identified. Last, through allocation of activities cost to the cost objects, the cost price of 66 services that were delivered in the radiology department were calculated. The data were collected by making checklists, using the hospital's information system, observations, and interviews. Finally, the data were analyzed using the non-parametric Wilcoxon test, Microsoft Excel, and SPSS software, version 18. The findings showed that from the total cost of wages, materials, and overhead obtained, the unit cost of the 66 cost objects (delivered services) in the Radiology Department were calculated using the ABC method (Price of each unit of Nephrostogram obtained $15.8 and Cystogram obtained $18.4). The Kolmogorov-Smirnov test indicated that the distribution of data of cost price using the ABC method was not normal (p = 0.000). The Wilcoxon test showed that there was a significant difference between the cost of services and the tariff of radiology services (p = 0.000). The cost of delivered services in radiology departments was significantly higher than approved tariffs of the Ministry of Health, which can have a negative impact on the quality of services.

42 CFR 416.171 - Determination of payment rates for ASC services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... payment rates for office-based surgical procedures and covered ancillary radiology services... relative value units under § 414.22(b)(5)(i)(B) of this subchapter multiplied by the conversion factor... ancillary radiology services that involve certain nuclear medicine procedures will be the amount determined...

42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... and other diagnostic procedures. 413.122 Section 413.122 Public Health CENTERS FOR MEDICARE & MEDICAID... radiology services and other diagnostic procedures. (a) Basis and purpose. (1) This section implements... services and other diagnostic procedures performed by a hospital on an outpatient basis. (2) For purposes...

Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

PubMed

Steele, Joseph R; Schomer, Don F

2009-07-01

Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.

UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES BIODOSIMETRY AND RADIOLOGICAL/NUCLEAR MEDICAL COUNTERMEASURE PROGRAMS.

PubMed

Homer, Mary J; Raulli, Robert; DiCarlo-Cohen, Andrea L; Esker, John; Hrdina, Chad; Maidment, Bert W; Moyer, Brian; Rios, Carmen; Macchiarini, Francesca; Prasanna, Pataje G; Wathen, Lynne

2016-09-01

The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. © World Health Organisation 2016. All rights reserved. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.

Pediatric interventional radiology workforce survey: 10-year follow-up.

PubMed

Kaufman, Claire S; James, Charles A; Harned, Roger K; Connolly, Bairbre L; Roebuck, Derek J; Cahill, Anne M; Dubois, Josee; Morello, Frank P; Morgan, Robin K; Sidhu, Manrita K

2017-05-01

Pediatric interventional radiology is a distinct subspecialty differing from both pediatric diagnostic radiology and adult interventional radiology. We conducted a workforce survey in 2005 to evaluate the state of pediatric interventional radiology at that time. Since then there have been many advancements to the subspecialty, including the founding of the Society for Pediatric Interventional Radiology (SPIR). To evaluate the current state of the pediatric interventional radiology workforce and compare findings with those of the initial 2005 workforce survey. We sent a two-part survey electronically to members of SPIR, the Society for Pediatric Radiology (SPR), the Society of Chairmen of Radiology in Children's Hospitals (SCORCH) and the Society of Interventional Radiology (SIR). Part 1 focused on individual practitioners (n=177), while part 2 focused on group practices and was answered by a leader from each group (n=88). We examined descriptive statistics and, when possible, compared the results to the study from 2005. A total of 177 individuals replied (a 331% increase over the first study) and 88 pediatric interventional radiology (IR) service sites responded (a 131.6% increase). Pediatric IR has become a more clinically oriented specialty, with a statistically significant increase in services with admitting privileges, clinics and performance of daily rounds. Pediatric IR remains diverse in training and practice. Many challenges still exist, including anesthesia/hospital support, and the unknown impact of the new IR residency on pediatric IR training, although the workforce shortage has been somewhat alleviated, as demonstrated by the decreased mean call from 165 days/year to 67.2 days/year. Pediatric interventional radiology practitioners and services have grown significantly since 2005, although the profile of this small subspecialty has changed and some challenges remain.

White Paper Report of the 2011 RAD-AID Conference on International Radiology for Developing Countries: Integrating Multidisciplinary Strategies for Imaging Services in the Developing World

PubMed Central

Mazal, Jonathan; Lexa, Frank; Starikovsky, Anna; Jimenez, Pablo; Jain, Sanjay; DeStigter, Kristen K.; Nathan, Robert; Krebs, Elizabeth; Noble, Vicki; Marks, William; Hirsh, Richard N.; Short, Brad; Sydnor, Ryan; Timmreck-Jackson, Emily; Lungren, Matthew P.; Maxfield, Charles; Azene, Ezana M.; Garra, Brian S.; Choi, Brian G.; Lewin, Jonathan S.; Mollura, Daniel J.

2016-01-01

The 2011 RAD-AID Conference on International Radiology for Developing Countries discussed data, experiences and models pertaining to radiology in the developing world, where widespread shortages of imaging services significantly reduce health care quality and increase health care disparity. This white paper from the 2011 RAD-AID Conference represents consensus advocacy of multidisciplinary strategies to improve planning, accessibility and quality of imaging services in the developing world. Conference presenters and participants discussed numerous solutions to imaging and healthcare disparities including: (1) economic development for radiology service planning, (2) public health mechanisms to address disease and prevention at the population and community levels, (3) comparative clinical models to implement various clinical and workflow strategies adapted to unique developing world community contexts, (4) education to improve training and optimize service quality, and (5) technology innovation to bring new technical capabilities to limited-resource regions. PMID:22748790

White paper report of the 2011 RAD-AID Conference on International Radiology for Developing Countries: integrating multidisciplinary strategies for imaging services in the developing world.

PubMed

Everton, Kathryn L; Mazal, Jonathan; Mollura, Daniel J

2012-07-01

The 2011 RAD-AID Conference on International Radiology for Developing Countries discussed data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services significantly reduce health care quality and increase health care disparities. This white paper from the 2011 RAD-AID conference represents consensus advocacy of multidisciplinary strategies to improve the planning, accessibility, and quality of imaging services in the developing world. Conference presenters and participants discussed numerous solutions to imaging and health care disparities, including (1) economic development for radiologic service planning, (2) public health mechanisms to address disease and prevention at the population and community levels, (3) comparative clinical models to implement various clinical and workflow strategies adapted to unique developing world community contexts, (4) education to improve training and optimize service quality, and (5) technology innovation to bring new technical capabilities to limited-resource regions. Published by Elsevier Inc.

21 CFR 892.1830 - Radiologic patient cradle.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiologic patient cradle. 892.1830 Section 892.1830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1830 Radiologic patient cradle. (a...

Time Is Not on Our Side: How Radiology Practices Should Manage Customer Queues.

PubMed

Loving, Vilert A; Ellis, Richard L; Rippee, Robert; Steele, Joseph R; Schomer, Donald F; Shoemaker, Stowe

2017-11-01

As health care shifts toward patient-centered care, wait times have received increasing scrutiny as an important metric for patient satisfaction. Long queues form when radiology practices inefficiently service their customers, leading to customer dissatisfaction and a lower perception of value. This article describes a four-step framework for radiology practices to resolve problematic queues: (1) analyze factors contributing to queue formation; (2) improve processes to reduce service times; (3) reduce variability; (4) address the psychology of queues. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Evaluation of mammography equipment performance, dose and image quality in five Latin American countries

NASA Astrophysics Data System (ADS)

Brandan, M.-E.; Ruiz-Trejo, C.; Caspani, C. E. M.; Fleitas, I.; de-la-Mora, R.; Miranda, A. A.; Plazas, M.-C.; Betancourt, C.-M.; Borras, C.

2001-10-01

Under the auspices of PAHO/WHO, a multicentric investigation is carried out in five Latin American countries. Its aim is to correlate quality indicators of radiology services with the accuracy of the radiological interpretation as determined by a panel of radiology experts. We present preliminary results from mammographic imaging facilities. Evaluation of the equipment performance and dose measurements in 21 mammographic units show that, on the average, 75% of the units comply with recommendations issued by various organizations. An independent evaluation of the quality of the clinical images show strong variations among the different radiological services.

The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations.

PubMed

Tsetis, Dimitrios; Uberoi, Raman; Fanelli, Fabrizio; Roberston, Iain; Krokidis, Miltiadis; van Delden, Otto; Radeleff, Boris; Müller-Hülsbeck, Stefan; Szerbo-Trojanowska, Malgorzata; Lee, Michael; Morgan, Robert; Brountzos, Elias; Belli, Anna Maria

2016-04-01

Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

A survey of nurse staffing levels in interventional radiology units throughout the UK.

PubMed

Christie, A; Robertson, I

2016-07-01

To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. Copyright © 2016. Published by Elsevier Ltd.

Radiological controls integrated into design

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kindred, G.W.

1995-03-01

Radiological controls are required by law in the design of commercial nuclear power reactor facilities. These controls can be relatively minor or significant, relative to cost. To ensure that radiological controls are designed into a project, the health physicist (radiological engineer) must be involved from the beginning. This is especially true regarding keeping costs down. For every radiological engineer at a nuclear power plant there must be fifty engineers of other disciplines. The radiological engineer cannot be an expert on every discipline of engineering. However, he must be knowledgeable to the degree of how a design will impact the facilitymore » from a radiological perspective. This paper will address how to effectively perform radiological analyses with the goal of radiological controls integrated into the design package.« less

Shared Medical Imaging Repositories.

PubMed

Lebre, Rui; Bastião, Luís; Costa, Carlos

2018-01-01

This article describes the implementation of a solution for the integration of ownership concept and access control over medical imaging resources, making possible the centralization of multiple instances of repositories. The proposed architecture allows the association of permissions to repository resources and delegation of rights to third entities. It includes a programmatic interface for management of proposed services, made available through web services, with the ability to create, read, update and remove all components resulting from the architecture. The resulting work is a role-based access control mechanism that was integrated with Dicoogle Open-Source Project. The solution has several application scenarios like, for instance, collaborative platforms for research and tele-radiology services deployed at Cloud.

Teleradiology in Singapore--taking stock and looking ahead.

PubMed

Cheng, Lionel T E; Ng, Samuel E S

2006-08-01

Teleradiology will have a significant impact on the delivery of healthcare and the practice of medicine. In order to ensure a positive outcome, the expected benefits, limitations and potential pitfalls of teleradiology must be carefully considered. For Singapore, teleradiology can be used to facilitate a quantum leap in the standards of radiological services. This can be achieved through the development of an integrated, nationwide, high-speed radiology network which will allow patients to have access to high-quality and responsive subspecialty radiology expertise located throughout the country. If judiciously implemented, teleradiology has the potential to propel Singapore radiology to an unprecedented level of professional quality and service delivery, and will provide the framework for sustainable radiological insourcing from other countries.

Report of the ACR's Economics Committee on Value-Based Payment Models.

PubMed

Boland, Giles W; Glenn, Lucille; Goldberg-Stein, Shlomit; Jha, Saurabh; Mangano, Mark; Patel, Samir; Schoppe, Kurt A; Seidenwurm, David; Lohnes, John; Silva, Ezequiel; Abramson, Richard; Durand, Daniel J; Pattie, Laura; Kassing, Pamela; Heller, Richard E

2017-01-01

A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services. The authors evaluated radiology operations and services using the framework of the imaging value chain, which divides radiology service into a number of discrete value-added activities, which ultimately deliver the primary product, most often the actionable report for diagnostic imaging or an effective outcome for interventional radiology. These value activities include scheduling and imaging appropriateness and stewardship, patient preparation, protocol design, modality operations, reporting, report communication, and clinical follow-up (eg, mammography reminder letters). Two further categories are hospital or health care organization citizenship and examination outcome. Each is discussed in turn, with specific activities highlighted. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr; Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk; Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it

2016-04-15

Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continuedmore » development of safe and high-quality IR services in Europe and beyond.« less

The efficacy of a continuous quality improvement (CQI) method in a radiological department. Comparison with non-CQI control material.

PubMed

Laurila, J; Standertskjöld-Nordenstam, C G; Suramo, I; Tolppanen, E M; Tervonen, O; Korhola, O; Brommels, M

2001-01-01

To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00-22:00 and a radiographer was moved from the morning shift to 15:00-22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

44 CFR 354.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PREPAREDNESS FEE FOR SERVICES TO SUPPORT FEMA'S OFFSITE RADIOLOGICAL EMERGENCY PREPAREDNESS PROGRAM § 354.1... the amounts that we anticipate to obligate for our Radiological Emergency Preparedness (REP) Program... established in the Treasury a Radiological Emergency Preparedness Fund, to be available under the Atomic...

77 FR 59001 - Fee for Services To Support FEMA's Offsite Radiological Emergency Preparedness Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-25

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2012-0028] Fee for Services To Support FEMA's Offsite Radiological Emergency Preparedness Program AGENCY: Federal... Emergency Preparedness (REP) Program. DATES: This hourly rate is effective for FY 2014 (October 1, 2013, to...

Radiology's value chain.

PubMed

Enzmann, Dieter R

2012-04-01

A diagnostic radiology value chain is constructed to define its main components, all of which are vulnerable to change, because digitization has caused disaggregation of the chain. Some components afford opportunities to improve productivity, some add value, while some face outsourcing to lower labor cost and to information technology substitutes, raising commoditization risks. Digital image information, because it can be competitive at smaller economies of scale, allows faster, differential rates of technological innovation of components, initiating a centralization-to-decentralization technology trend. Digitization, having triggered disaggregation of radiology's professional service model, may soon usher in an information business model. This means moving from a mind-set of "reading images" to an orientation of creating and organizing information for greater accuracy, faster speed, and lower cost in medical decision making. Information businesses view value chain investments differently than do small professional services. In the former model, producing a better business product will extend image interpretation beyond a radiologist's personal fund of knowledge to encompass expanding external imaging databases. A follow-on expansion with integration of image and molecular information into a report will offer new value in medical decision making. Improved interpretation plus new integration will enrich and diversify radiology's key service products, the report and consultation. A more robust, information-rich report derived from a "systems" and "computational" radiology approach will be facilitated by a transition from a professional service to an information business. Under health care reform, radiology will transition its emphasis from volume to greater value. Radiology's future brightens with the adoption of a philosophy of offering information rather than "reads" for decision making. Staunchly defending the status quo via turf wars is unlikely to constitute a forward-looking, competitive strategy. © RSNA, 2012.

NLP-based Identification of Pneumonia Cases from Free-Text Radiological Reports

PubMed Central

Elkin, Peter L.; Froehling, David; Wahner-Roedler, Dietlind; Trusko, Brett; Welsh, Gail; Ma, Haobo; Asatryan, Armen X.; Tokars, Jerome I.; Rosenbloom, S. Trent; Brown, Steven H.

2008-01-01

Radiological reports are a rich source of clinical data which can be mined to assist with biosurveillance of emerging infectious diseases. In addition to biosurveillance, radiological reports are an important source of clinical data for health service research. Pneumonias and other radiological findings on chest xray or chest computed tomography (CT) are one type of relevant finding to both biosurveillance and health services research. In this study we examined the ability of a Natural Language Processing system to accurately identify pneumonias and other lesions from within free-text radiological reports. The system encoded the reports in the SNOMED CT Ontology and then a set of SNOMED CT based rules were created in our Health Archetype Language aimed at the identification of these radiological findings and diagnoses. The encoded rule was executed against the SNOMED CT encodings of the radiological reports. The accuracy of the reports was compared with a Clinician review of the Radiological Reports. The accuracy of the system in the identification of pneumonias was high with a Sensitivity (recall) of 100%, a specificity of 98%, and a positive predictive value (precision) of 97%. We conclude that SNOMED CT based computable rules are accurate enough for the automated biosurveillance of pneumonias from radiological reports. PMID:18998791

The effects of expanding outpatient and inpatient evaluation and management services in a pediatric interventional radiology practice.

PubMed

Edalat, Faramarz; Lindquester, Will S; Gill, Anne E; Simoneaux, Stephen F; Gaines, Jennifer; Hawkins, C Matthew

2017-03-01

Despite a continuing emphasis on evaluation and management clinical services in adult interventional radiology (IR) practice, the peer-reviewed literature addressing these services - and their potential economic benefits - is lacking in pediatric IR practice. To measure the effects of expanding evaluation and management (E&M) services through the establishment of a dedicated pediatric interventional radiology outpatient clinic and inpatient E&M reporting system. We collected and analyzed E&M current procedural terminology (CPT) codes from all patients seen in a pediatric interventional radiology outpatient clinic between November 2014 and August 2015. We also calculated the number of new patients seen in the clinic who had a subsequent procedure (procedural conversion rate). For comparison, we used historical data comprising pediatric patients seen in a general interventional radiology (IR) clinic for the 2 years immediately prior. An inpatient E&M reporting system was implemented and all inpatient E&M (and subsequent procedural) services between July 2015 and September 2015 were collected and analyzed. We estimated revenue for both outpatient and inpatient services using the Medicare Physician Fee Schedule global non-facility price as a surrogate. Following inception of a pediatric IR clinic, the number of new outpatients (5.5/month; +112%), procedural conversion rate (74.5%; +19%), estimated E&M revenue (+158%), and estimated procedural revenue from new outpatients (+228%) all increased. Following implementation of an inpatient clinic reporting system, there were 8.3 consults and 7.3 subsequent hospital encounters per month, with a procedural conversion rate of 88%. Growth was observed in all meaningful metrics following expansion of outpatient and inpatient pediatric IR E&M services.

21 CFR 892.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES General Provisions § 892.1 Scope. (a) This part sets forth the classification of radiology devices... devices, as required by § 807.87. (c) To avoid duplicative listings, a radiology device that has two or...

A case series of interventional radiology in postpartum haemorrhage.

PubMed

Agarwal, N; Deinde, O; Willmott, F; Bojahr, H; MacCallum, P; Renfrew, I; Beski, S

2011-08-01

Postpartum haemorrhage (PPH) remains a significant cause of maternal morbidity and mortality in both developed and developing countries. In some instances, PPH can be anticipated and recent improvements in obstetric imaging techniques allow earlier and more reliable diagnosis of abnormalities associated with haemorrhage such as morbid placentation. However, the majority of PPH is unpredicted. Good practice notes published by the Royal College of Obstetricians and Gynaecologists state interventional radiology should be used as emergency intervention in PPH and should be considered when primary management has failed allowing arteries to be embolised to achieve haemostasis. Through collaboration between interventional radiology and maternity, appropriate guidelines need to be developed, on both emergency and elective of interventional radiology in the prevention and management of PPH. As there is mapping for neonatal services, in the future there should be consideration to develop obstetric trauma units. Maternity units which lack facilities for interventional radiology would be able to refer their cases (like placenta accreta) for safe management in units with 24 h interventional radiology services.

Antiservice Within the Medical Service Encounter: Lessons for Radiologists Beyond Service Recovery.

PubMed

Hill, Paul Armstrong; Hill, Ronald Paul

2015-12-01

Recent modifications in the metrics for reimbursement have reinforced the importance of radiology service-delivery experiences of patients. Evaluating current radiology practices calls for reflection on the various touch points with patients, as well as their overall satisfaction. If problems occur during encounters, service failure, or lack of satisfactory medical experiences can be transformed through service recovery, whereby patients-as-customers are given chances to voice their concerns, and health care providers across the spectrum can work together to resolve problematic issues. This paper takes a systemic view of the patient experience as embedded in the care continuum, recognizing that different beliefs, attitudes, and behaviors of members of the health care team can negatively affect or sabotage patient satisfaction. Although radiologists are only one of many roles in the care continuum, recommendations are discussed for how they can integrate service satisfaction as a pervasive communal goal among all health care team members. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

What causes increasing and unnecessary use of radiological investigations? a survey of radiologists' perceptions

PubMed Central

Lysdahl, Kristin B; Hofmann, Bjørn M

2009-01-01

Background Growth in use and overuse of diagnostic imaging significantly impacts the quality and costs of health care services. What are the modifiable factors for increasing and unnecessary use of radiological services? Various factors have been indentified, but little is known about their relative impact. Radiologists hold key positions for providing such knowledge. Therefore the purpose of this study was to obtain radiologists' perspective on the causes of increasing and unnecessary use of radiological investigations. Methods In a mailed questionnaire radiologist members of the Norwegian Medical Association were asked to rate potential causes of increased investigation volume (fifteen items) and unnecessary investigations (six items), using five-point-scales. Responses were analysed by using summary statistics and Factor Analysis. Associations between variables were determined using Students' t-test, Spearman rank correlation and Chi-Square tests. Results The response rate was 70% (374/537). The highest rated causes of increasing use of radiological investigations were: a) new radiological technology, b) peoples' demands, c) clinicians' intolerance for uncertainty, d) expanded clinical indications, and e) availability. 'Over-investigation' and 'insufficient referral information' were reported the most frequent causes of unnecessary investigations. Correlations between causes of increasing and unnecessary radiology use were identified. Conclusion In order to manage the growth in radiological imaging and curtail inappropriate investigations, the study findings point to measures that influence the supply and demand of services, specifically to support the decision-making process of physicians. PMID:19723302

[The balanced scorecard--applications in a radiology department].

PubMed

Maurer, M H; Teichgräber, U; Kröncke, T J; Hamm, B; Lemke, A J

2012-12-01

The balanced scorecard (BSC) represents a comprehensive management tool for organizations with the aim to focus all activities on a chosen strategy. Targets for various perspectives of the environment such as the customer, financial, process, and potential perspective are linked with concrete measures, and cause-effect relationships between the objectives are analyzed. This article shows that the BSC can also be used for the comprehensive control of a radiology department and thus provides a meaningful contribution in organizing the various diagnostic and treatment services, the management of complex clinical environment and can be of help with the tasks in research and teaching. © Georg Thieme Verlag KG Stuttgart · New York.

Developing a competitive advantage in the market for radiology services.

PubMed

Kropf, R; Szafran, A J

1988-01-01

This article describes how managers of outpatient diagnostic radiology services can develop a competitive advantage by increasing the value of services to patients and referring physicians. A method is presented to identify changes to services that increase their value. The method requires the definition of the "value chains" of patients and referring physicians. Particular attention is paid to the use of information systems technology to suggest and implement service changes. A narrow range of health services was selected because the approach requires a detailed understanding of consumers and how they use services. The approach should, however, be examined carefully by managers seeking to develop a competitive advantage for a wide range of health services.

Modelling a radiology department service using a VDL integrated approach.

PubMed

Guglielmino, Maria Gabriella; Celano, Giovanni; Costa, Antonio; Fichera, Sergio

2009-01-01

The healthcare industry is facing several challenges such as the reduction of costs and quality improvement of the provided services. Engineering studies could be very useful in supporting organizational and management processes. Healthcare service efficiency depends on a strong collaboration between clinical and engineering experts, especially when it comes to analyzing the system and its constraints in detail and subsequently, when it comes to deciding on the reengineering of some key activities. The purpose of this paper is to propose a case study showing how a mix of representation tools allow a manager of a radiology department to solve some human and technological resource re-organizational issues, which have to be faced due to the introduction of a new technology and a new portfolio of services. In order to simulate the activities within the radiology department and examine the relationship between human and technological resources, different visual diagrammatic language (VDL) techniques have been implemented to get knowledge about the heterogeneous factors related to the healthcare service delivery. In particular, flow charts, IDEFO diagrams and Petri nets have been integrated each other with success as a modelisation tools. The simulation study performed through the application of the aforementioned VDL techniques suggests the opportunity of re-organizing the nurse activities within the radiology department. The re-organization of a healthcare service and in particular of a radiology department by means of joint flow charts, IDEF0 diagrams and Petri nets is a poorly investigated topic in literature. This paper demonstrates how flow charts and IDEF0 can help people working within the department to understand the weak points of their organization and constitute an efficient base of knowledge for the implementation of a Petri net aimed at improving the departmental performance.

Cost accounting in radiology: new directions and importance for policy.

PubMed

Muchantef, Karl; Forman, Howard P

2005-12-01

The purpose of this article is to promote insight into radiology costs through improvements in assessing patient-level cost data. Accurate patient costing is a prerequisite for establishing a proper payment system-one where the price paid for a service approximates the cost of delivering that service. In the absence of an accurate payment scheme, margins can vary significantly from one patient to the next. The resulting financial incentives skew the radiology marketplace away from the provision of efficient and appropriate care toward the selection of patients whose costs are low relative to reimbursements.

Creating an outpatient center of excellence in CT.

PubMed

Itri, Jason N; Bakow, Eric; Woods, Jordan

2014-12-01

CT examinations represent a substantial portion of the workload for many radiology departments, and optimizing service delivery is a critical function to ensure customer satisfaction. This article describes how the Six Sigma methodology was used in the radiology department at a large academic hospital to improve the patient experience and increase CT capacity while reducing waste and improving staff satisfaction. The 5 distinct phases of Six Sigma are reviewed as they apply to our CT Center of Excellence project: define, measure, analyze, improve, and control. Process metrics used in this project include the percentage of outpatient CT exams started within 5 minutes of the scheduled appointment time, and the number of studies with protocols selected >48 hours before the CT exam is performed. Outcome metrics include monthly department expense per scan and CT Press Ganey "standard test and treatment" mean scores. An approach to developing interventions is described based on identifying critical sources of variation, ranking these by creating risk prioritization numbers, performing root cause analysis, and utilizing the failure mode and effects analysis tool to prioritize possible solutions. Finally, the key features of action plans and a control plan are reviewed. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

78 FR 41937 - Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0816] Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the Medical...: Gastroenterology-Urology Panel and Radiological Devices Panel of the Medical Devices Advisory Committee. General...

Evolution of the clinical review station for enterprise-wide multimedia radiology reporting

NASA Astrophysics Data System (ADS)

Hanlon, William B.; Valtchinov, Vladimir I.; Davis, Scott D.; Lester, James; Khorasani, Ramin; Carrino, John A.; Benfield, Andrew

2000-05-01

Efforts to develop Picture Archiving and Communications Systems (PACS) for the last ten years have concentrated mainly on developing systems for primary interpretation of digital radiological images. Much less attention has been paid to the clinical aspects of the radiology process. Clinical radiology services are an important component of the overall care delivery process, providing information and consultation services to referring physicians, the customers of radiology, in a timely fashion to aid in care decisions. Information management systems (IMS) are playing an increasingly central role in the care delivery process. No suitable commercial PACS or IMS products were available that could effectively provide for the requirements of the clinicians. We endeavored to fill this void at our institution by developing a system to deliver images and text reports electronically on-demand to the referring physicians. This system has evolved substantially since initial deployment eight years ago. As new technologies become available they are evaluated and integrated as appropriate to improve system performance and manageability. Not surprisingly, the internet and World Wide Web (WWW) technology has had the greatest impact on system design in recent years. Additional features have been added over time to provide services for teleradiology, teaching, and research needs. We also discovered that these value-added services give us a competitive edge in attracting new business to our department. Commercial web-based products are now becoming available which do a satisfactory job of providing many of these clinical services. These products are evaluated for integration into our system as they mature. The result is a system that impacts positively on patient care.

Public transparency Web sites for radiology practices: prevalence of price, clinical quality, and service quality information.

PubMed

Rosenkrantz, Andrew B; Doshi, Ankur M

2016-01-01

To assess information regarding radiology practices on public transparency Web sites. Eight Web sites comparing radiology centers' price and quality were identified. Web site content was assessed. Six of eight Web sites reported examination prices. Other reported information included hours of operation (4/8), patient satisfaction (2/8), American College of Radiology (ACR) accreditation (3/8), on-site radiologists (2/8), as well as parking, accessibility, waiting area amenities, same/next-day reports, mammography follow-up rates, examination appropriateness, radiation dose, fellowship-trained radiologists, and advanced technologies (1/8 each). Transparency Web sites had a preponderance of price (and to a lesser extent service quality) information, risking fostering price-based competition at the expense of clinical quality. Copyright © 2016 Elsevier Inc. All rights reserved.

Watch the lights. A visual communication system.

PubMed

Rahtz, S K

1989-01-01

The trend for hospitals to market their emergency care services results in a greater demand on radiology departments, states Ms. Rahtz. Radiology must provide efficient service to both departments, even when it is difficult to predict patient flow in the emergency care center. Improved communication is the key, and a light system installed at Morton Plant Hospital is one alternative for solving the problem.

Evaluation of paediatric radiology services in hospitals in the UK.

PubMed

Halliday, K; Drinkwater, K; Howlett, D C

2016-12-01

To compare paediatric radiology provision across the UK with national standards published by the Department of Health and the Royal College of Radiologists (RCR). Audit standards and indicators for paediatric imaging were derived from "Delivering quality imaging services for children", 1 "Standards for imaging in cases of suspected non-accidental injury" 2 and "Improving paediatric interventional radiology services" 3 and agreed jointly by the Clinical Radiology Audit Committee and the British Society of Paediatric Radiology. A questionnaire was sent to all hospitals and NHS trusts imaging children aged 16 or younger in the UK in October 2013. The target for all indicators was 100%. Eighty-seven of 196 (44%) eligible institutions submitted data, the size distribution of the institutions was representative when compared to data from "Facing the future: a review of paediatric services" 4 published by the Royal College of Paediatrics and Child health. Only 65% of paediatric images were obtained by staff who had had specific training and only 60% were reported by radiographers or radiologists with appropriate training. Sixty-two percent of centres did not have access to a paediatric opinion 24 hours a day, 7 days a week all year; only 34% of radiographers who regularly imaged children had had any access to continuing professional development (CPD) in the 12 months of the audit. Although all hospitals had facilities for image transfer, only 57% had any formal funding arrangements in place for external reporting of images. The standards set for a network approach to paediatric radiology provision in "Delivering quality imaging services for children" are largely unmet. This failure to make the most of the workforce and resources puts vulnerable children at risk. The authors urge NHS England to work with the RCR to organise and administer a national network for paediatric imaging. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Microbial contamination in intraoral phosphor storage plates: the dilemma.

PubMed

de Souza, Tricia Murielly Pereira Andrade; de Castro, Ricardo Dias; de Vasconcelos, Laís César; Pontual, Andréa Dos Anjos; de Moraes Ramos Perez, Flávia Maria; Pontual, Maria Luiza Dos Anjos

2017-01-01

The aims of this study were to evaluate microbial contamination in phosphor storage plates in dental radiology services and discuss the possible origin of this contamination. The sample comprised 50 phosphor plates: 14 plates from service A, 30 from service B, and 6 in the control group, consisting of plates never used. Damp sterile swabs were rubbed on the phosphor plates, and then transferred to tests tubes containing sterile saline solution. Serial dilutions were made, and then inoculated in triplicate on Mueller Hinton agar plates and incubated at 37 °C/48 h, before counting the colony-forming units (CFU). The samples were also seeded in brain-heart infusion medium to confirm contamination by turbidity of the culture medium. All solutions, turbid and clean, were seeded in selective and non-selective media. At service A and B, 50 and 73.3 % of the phosphor plates were contaminated, respectively. This contamination was mainly due to bacteria of the genus Staphylococcus. CFU counts ranged from 26.4 to 80.0 CFU/plate. Most of the phosphor plates evaluated shown to be contaminated, mainly by Staphylococcus ssp. Quantitatively, this contamination occurred at low levels, possibly arising from handling of the plates. The use of a second plastic barrier may have diminished contamination by microorganisms from the oral cavity. There is a risk of cross-contamination by phosphor storage plates used in dental radiology services.

RCT: Module 2.11, Radiological Work Coverage, Course 8777

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hillmer, Kurt T.

2017-07-20

Radiological work is usually approved and controlled by radiation protection personnel by using administrative and procedural controls, such as radiological work permits (RWPs). In addition, some jobs will require working in, or will have the potential for creating, very high radiation, contamination, or airborne radioactivity areas. Radiological control technicians (RCTs) providing job coverage have an integral role in controlling radiological hazards. This course will prepare the student with the skills necessary for RCT qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and will provide in-the-field skills.

Diversity, Inclusion, and Representation: It Is Time to Act.

PubMed

Lightfoote, Johnson B; Deville, Curtiland; Ma, Loralie D; Winkfield, Karen M; Macura, Katarzyna J

2016-12-01

Although the available pool of qualified underrepresented minority and women medical school graduates has expanded in recent decades, their representation in the radiological professions has improved only marginally. Recognizing this deficit in diversity, many professional medical societies, including the ACR, have incorporated these values as core elements of their missions and instituted programs that address previously identified barriers to a more diverse workforce. These barriers include insufficient exposure of underrepresented minorities and women to radiology and radiation oncology; misperception of these specialties as non-patient care and not community service; unconscious bias; and delayed preparation of candidates to compete successfully for residency positions. Critical success factors in expanding diversity and inclusion are well identified both outside and within the radiological professions; these are reviewed in the current communication. Radiology leaders are positioned to lead the profession in expanding the diversity and improving the inclusiveness of our professional workforce in service to an increasingly diverse society and patient population. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications.

PubMed

Harvey, H Benjamin; Tomov, Elena; Babayan, Astrid; Dwyer, Kathy; Boland, Sam; Pandharipande, Pari V; Halpern, Elkan F; Alkasab, Tarik K; Hirsch, Joshua A; Schaefer, Pamela W; Boland, Giles W; Choy, Garry

2016-02-01

The aim of this study was to compare the frequency and liability costs associated with radiology malpractice claims relative to other medical services and to evaluate the clinical context and case disposition associated with radiology malpractice claims. This HIPAA-compliant study was exempted from institutional review board approval. The Comparative Benchmarking System database, a repository of more than 300,000 medical malpractice cases in the United States, was queried for closed claims over a five-year period (2008-2012). Claims were categorized by the medical service primarily responsible for the claim and the paid total loss. For all cases in which radiology was the primary responsible service, the case abstracts were evaluated to determine injury severity, claimant type by setting, claim allegation, process of care involved, case disposition, modality involved, and body section. Intracategory comparisons were made on the basis of the frequency of indemnity payment and total indemnity payment for paid cases, using χ(2) and Wilcoxon rank-sum tests. Radiology was the eighth most likely responsible service to be implicated in a medical malpractice claim, with a median total paid loss (indemnity payment plus defense cost plus administrative expense) per closed case of $30,091 (mean, $205,619 ± $508,883). Radiology claims were most commonly associated with high- and medium-severity injuries (93.3% [820 of 879]; 95% confidence interval [CI], 91.7%-94.95%), the outpatient setting (66.3% [581 of 876]; 95% CI, 63.0%-69.2%), and diagnosis-related allegations (ie, failure to diagnose or delayed diagnosis) (57.3% [504 of 879]; 95% CI, 54.0%-60.6%). A high proportion of claims pertained to cancer diagnoses (44.0% [222 of 504]; 95% CI, 39.7%-48.3%). A total of 62.3% (548 of 879; 95% CI, 59.1%-65.5%) of radiology claims were closed without indemnity payments; 37.7% (331 of 879; 95% CI, 34.5%-40.9%) were closed with a median indemnity payment of $175,000 (range, $112-$6,691,762; mean $481,094 ± $727,636). Radiology malpractice claims most commonly involve diagnosis-related allegations in the outpatient setting, particularly cancer diagnoses, with approximately one-third of claims resulting in payouts to the claimants. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[Controlling instruments in radiology].

PubMed

Maurer, M

2013-10-01

Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.

University-Based Teleradiology in the United States.

PubMed

Hunter, Tim B; Krupinski, Elizabeth A

2014-04-15

This article reviews the University of Arizona's more than 15 years of experience with teleradiology and provides an overview of university-based teleradiology practice in the United States (U.S.). In the U.S., teleradiology is a major economic enterprise with many private for-profit companies offering national teleradiology services (i.e., professional interpretation of radiologic studies of all types by American Board of Radiology certified radiologists). The initial thrust for teleradiology was for after-hours coverage of radiologic studies, but teleradiology has expanded its venue to include routine full-time or partial coverage for small hospitals, clinics, specialty medical practices, and urgent care centers. It also provides subspecialty radiologic coverage not available at smaller medical centers and clinics. Many U.S. university-based academic departments of radiology provide teleradiology services usually as an additional for-profit business to supplement departmental income. Since academic-based teleradiology providers have to compete in a very demanding marketplace, their success is not guaranteed. They must provide timely, high-quality professional services for a competitive price. Academic practices have the advantage of house officers and fellows who can help with the coverage, and they have excellent subspecialty expertise. The marketplace is constantly shifting, and university-based teleradiology practices have to be nimble and adjust to ever-changing situations.

Extended outlook: description, utilization, and daily applications of cloud technology in radiology.

PubMed

Gerard, Perry; Kapadia, Neil; Chang, Patricia T; Acharya, Jay; Seiler, Michael; Lefkovitz, Zvi

2013-12-01

The purpose of this article is to discuss the concept of cloud technology, its role in medical applications and radiology, the role of the radiologist in using and accessing these vast resources of information, and privacy concerns and HIPAA compliance strategies. Cloud computing is the delivery of shared resources, software, and information to computers and other devices as a metered service. This technology has a promising role in the sharing of patient medical information and appears to be particularly suited for application in radiology, given the field's inherent need for storage and access to large amounts of data. The radiology cloud has significant strengths, such as providing centralized storage and access, reducing unnecessary repeat radiologic studies, and potentially allowing radiologic second opinions more easily. There are significant cost advantages to cloud computing because of a decreased need for infrastructure and equipment by the institution. Private clouds may be used to ensure secure storage of data and compliance with HIPAA. In choosing a cloud service, there are important aspects, such as disaster recovery plans, uptime, and security audits, that must be considered. Given that the field of radiology has become almost exclusively digital in recent years, the future of secure storage and easy access to imaging studies lies within cloud computing technology.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hillmer, Kurt T.

This course presents information on radiological work permits (RWPs), various types of postings used in radiological areas, radiological area setups, access controls, and releases of material from radiological areas. All of these are fundamental duties of RCTs. This course will prepare the student with the skills necessary for radiological control technician (RCT) qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and providing in-thefield skills.

Analysis of Operation TEAPOT nuclear test BEE radiological and meteorological data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Quinn, V.E.

This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the BEE nuclear test of Operation TEAPOT. Inconsistencies in the radiological data and their resolution are discussed. The methods of normalizing the radiological data to a standard time and estimating fallout-arrival times are presented. The meteorological situations on event day and the following day are described. A comparison of the WSNSO fallout analysis with an analysis performed in the 1950's is presented. The radiological data used to derive the WSNSO fallout pattern are tabulated in an appendix.

Virtual management of radiology examinations in the virtual radiology environment using common object request broker architecture services.

PubMed

Martinez, R; Rozenblit, J; Cook, J F; Chacko, A K; Timboe, H L

1999-05-01

In the Department of Defense (DoD), US Army Medical Command is now embarking on an extremely exciting new project--creating a virtual radiology environment (VRE) for the management of radiology examinations. The business of radiology in the military is therefore being reengineered on several fronts by the VRE Project. In the VRE Project, a set of intelligent agent algorithms determine where examinations are to routed for reading bases on a knowledge base of the entire VRE. The set of algorithms, called the Meta-Manager, is hierarchical and uses object-based communications between medical treatment facilities (MTFs) and medical centers that have digital imaging network picture archiving and communications systems (DIN-PACS) networks. The communications is based on use of common object request broker architecture (CORBA) objects and services to send patient demographics and examination images from DIN-PACS networks in the MTFs to the DIN-PACS networks at the medical centers for diagnosis. The Meta-Manager is also responsible for updating the diagnosis at the originating MTF. CORBA services are used to perform secure message communications between DIN-PACS nodes in the VRE network. The Meta-Manager has a fail-safe architecture that allows the master Meta-Manager function to float to regional Meta-Manager sites in case of server failure. A prototype of the CORBA-based Meta-Manager is being developed by the University of Arizona's Computer Engineering Research Laboratory using the unified modeling language (UML) as a design tool. The prototype will implement the main functions described in the Meta-Manager design specification. The results of this project are expected to reengineer the process of radiology in the military and have extensions to commercial radiology environments.

Computer-aided resource planning and scheduling for radiological services

NASA Astrophysics Data System (ADS)

Garcia, Hong-Mei C.; Yun, David Y.; Ge, Yiqun; Khan, Javed I.

1996-05-01

There exists tremendous opportunity in hospital-wide resource optimization based on system integration. This paper defines the resource planning and scheduling requirements integral to PACS, RIS and HIS integration. An multi-site case study is conducted to define the requirements. A well-tested planning and scheduling methodology, called Constrained Resource Planning model, has been applied to the chosen problem of radiological service optimization. This investigation focuses on resource optimization issues for minimizing the turnaround time to increase clinical efficiency and customer satisfaction, particularly in cases where the scheduling of multiple exams are required for a patient. How best to combine the information system efficiency and human intelligence in improving radiological services is described. Finally, an architecture for interfacing a computer-aided resource planning and scheduling tool with the existing PACS, HIS and RIS implementation is presented.

Interventional Radiology in Paediatrics.

PubMed

Chippington, Samantha J; Goodwin, Susie J

2015-01-01

As in adult practice, there is a growing role for paediatric interventional radiology expertise in the management of paediatric pathologies. This review is targeted for clinicians who may refer their patients to paediatric interventional radiology services, or who are responsible for patients who are undergoing paediatric interventional radiology procedures. The article includes a brief overview of the indications for intervention, techniques involved and the commonest complications. Although some of the procedures described are most commonly performed in a tertiary paediatric centre, many are performed in most Children's hospitals.

Clinical operations management in radiology.

PubMed

Ondategui-Parra, Silvia; Gill, Ileana E; Bhagwat, Jui G; Intrieri, Lisa A; Gogate, Adheet; Zou, Kelly H; Nathanson, Eric; Seltzer, Steven E; Ros, Pablo R

2004-09-01

Providing radiology services is a complex and technically demanding enterprise in which the application of operations management (OM) tools can play a substantial role in process management and improvement. This paper considers the benefits of an OM process in a radiology setting. Available techniques and concepts of OM are addressed, along with gains and benefits that can be derived from these processes. A reference framework for the radiology processes is described, distinguishing two phases in the initial assessment of a unit: the diagnostic phase and the redesign phase.

Breast Imaging: A Paradigm for Accountable Care Organizations.

PubMed

Parikh, Jay R; Yang, Wei T

2016-02-01

Accountable care organizations (ACOs) are being promoted by the Centers of Medicare Services as alternative payment models for radiology reimbursement. Because of its clinical orientation, focus on prevention, standardized reporting, quality orientation through mandatory accreditation, and value demonstration through established outcome metrics, breast imaging offers a unique paradigm for the ACO model in radiology. In radiology, breast imaging represents the paradigm for ACOs.

The health care value transparency movement and its implications for radiology.

PubMed

Durand, Daniel J; Narayan, Anand K; Rybicki, Frank J; Burleson, Judy; Nagy, Paul; McGinty, Geraldine; Duszak, Richard

2015-01-01

The US health care system is in the midst of disruptive changes intended to expand access, improve outcomes, and lower costs. As part of this movement, a growing number of stakeholders have advocated dramatically increasing consumer transparency into the quality and price of health care services. The authors review the general movement toward American health care value transparency within the public, private, and nonprofit sectors, with an emphasis on those initiatives most relevant to radiology. They conclude that radiology, along with other "ancillary services," has been a major focus of early efforts to enhance consumer price transparency. By contrast, radiology as a field remains in the "middle of the pack" with regard to quality transparency. There is thus the danger that radiology value transparency in its current form will stimulate primarily price-based competition, erode provider profit margins, and disincentivize quality. The authors conclude with suggested actions radiologists can take to ensure that a more optimal balance is struck between quality transparency and price transparency, one that will enable true value-based competition among radiologists rather than commoditization. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

44 CFR 354.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SECURITY PREPAREDNESS FEE FOR SERVICES TO SUPPORT FEMA'S OFFSITE RADIOLOGICAL EMERGENCY PREPAREDNESS... means emergency planning zone. Federal Radiological Preparedness Coordinating Committee (FRPCC) means a... emergency planning and preparedness activities. Plume pathway EPZ means for planning purposes, the area...

21 CFR 1000.55 - Recommendation for quality assurance programs in diagnostic radiology facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... procedure that involves irradiation of any part of the human body for the purpose of diagnosis or..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH GENERAL Radiation Protection...

Cost analysis of equipment failure of a radiology department and possible choices about maintenance.

PubMed

Grisi, Guido; Dalla Palma, Ludovico; Rimondini, Allesandra; Palmolungo, Chiara; Cuttin Zernich, Roberto; Pozzi Mucelli, Roberto

2002-01-01

Our aim was to evaluate the economic impact of equipment failures in a radiology department with a view to guiding maintenance policy decisions. We assessed the negative economic impact caused by the interruption of activity of a radiodiagnostics section due to equipment failure, taking into account: the effects occurring during the first day of equipment down-time (assuming that the equipment failure occurs in the middle of the shift) and the effects during the following days until the repair of the failure; the effects occurring in the short- and long-term. To exemplify the negative impact of inactivity due to equipment failure, we chose three radiology sections with different levels of technological and operational complexity (chest radiology, gastrointestinal radiology and remote-controlled diagnostics). For each, we evaluated the loss of contribution margin and the idle capacity costs (short- and long-term impact). The negative economic effects were: for thoracic radiology, 496,77 Euro in the first day, and 30,99 Euro from the second day onwards; for gastrointestinal radiology, 526,40 Euro for the first day, and 730,39 Euro from the second day onwards; for remote-controlled diagnostics, 786,25 Euro for the first day, and 927,67 Euro from the second days onwards. Our results indicate that the level of idle capacity costs (mainly equipment and staff) increases with the complexity of the equipment, whereas the contribution margin appears to fluctuate, because the charges are state-imposed and do not vary with the complexity of equipment. Moreover, our analysis shows that if the workload of a broken machine can easily be assigned to an additional shift using another machine, losses are considerably reduced from the second day onwards. Once the negative economic impact of equipment failures has been evaluated, the second step is to choose the best kind of maintenance. A sound calculation of the economic impact of equipment failures is very useful for guiding the head of department and the hospital manager in deciding whether to purchase maintenance services (or a long-term guarantee) from the equipment manufacturer, to set up an auxiliary centre for maintenance and repair, or to purchase a third-party maintenance contract.

Understanding and Applying the Concept of Value Creation in Radiology.

PubMed

Larson, David B; Durand, Daniel J; Siegal, Daniel S

2017-04-01

The concept of value in radiology has been strongly advocated in recent years as a means of advancing patient care and decreasing waste. This article explores the concept of value creation in radiology and offers a framework for how radiology practices can create value according to the needs of their referring clinicians. Value only exists in the eyes of a customer. We propose that the primary purpose of diagnostic radiology is to answer clinical questions using medical imaging to help guide management of patient care. Because they are the direct recipient of this service, we propose that referring clinicians are the direct customers of a radiology practice and patients are indirect customers. Radiology practices create value as they understand and fulfill their referring clinicians' needs. To narrow those needs to actionable categories, we propose a framework consisting of four major dimensions: (1) how quickly the clinical question needs to be answered, (2) the degree of specialization required to answer the question, (3) how often the referring clinician uses imaging, and (4) the breadth of imaging that the referring clinician uses. We further identify three major settings in which referring clinicians utilize radiological services: (1) emergent or urgent care, (2) primary care, and (3) specialty care. Practices best meet these needs as they engage with their referring clinicians, create a shared vision, work together as a cohesive team, structure the organization to meet referring clinicians' needs, build the tools, and continually improve in ways that help referring clinicians care for patients. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Extending health maintenance organization insurance to the uninsured. A controlled measure of health care utilization.

PubMed

Bograd, H; Ritzwoller, D P; Calonge, N; Shields, K; Hanrahan, M

1997-04-02

To investigate the utilization of health care services of previously uninsured low-income patients after becoming insured by a health maintenance organization (HMO). Retrospective study of utilization in a previously uninsured study group compared with an age- and sex-matched randomly selected control group of commercial HMO enrollees. Group model HMO. A study group of 346 previously uninsured low-income patients and 382 controls. utpatient visits for primary and specialty care, outpatient pharmacy, laboratory, and radiology use, and inpatient admissions and hospital days over a 2-year period. Self-reported health status measures were obtained to control for differences in health status. There were no differences between the study and control groups in hospital admissions, hospital days, and measures of outpatient laboratory, pharmacy, and radiology use. The odds of having an outpatient visit per patient per month was 30% higher for the study group. Approximately half the increase in the odds ratio for outpatient visits was related to the worse self-perceived health status of the study group. While both groups utilized more services in the early phase of their enrollment, the intensity of this start-up effect was similar for both groups. Compared with a commercial group of the same age and sex, the patterns of utilization were similar and the financial costs of care were only moderately more for a previously uninsured group provided with comprehensive HMO insurance. With the growth of managed care, these data should be beneficial in the development of health care programs for the growing number of uninsured Americans.

Gender Integration on U.S. Navy Submarines: Views of the First Wave

DTIC Science & Technology

2015-06-01

Radiological Controls Assistant DACOWITS Defense Advisory Committee on Women in the Services DH Department Head DINQ delinquent DO Division...Previous studies have attempted to build statistical models based on surface fleet data to forecast female sustainability in the submarine fleet, yet 2...their integration? Such questions cannot be answered by collecting the type of quantitative data that can be analyzed using statistical methods. Complex

Multi-Service Doctrine for Chemical, Biological, Radiological, and Nuclear Operations

DTIC Science & Technology

2011-07-01

currently valid OMB control number. 1. REPORT DATE JUL 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Multi...research reactors, research and development facilities, laboratories, production facilities, radioisotope thermoelectric generators, pharmaceutical...requests from the U.S. armed forces for emergency, up-to- date medical intelligence assessments. It is the nation’s premier producer and coordinator of

42 CFR 414.22 - Relative value units (RVUs).

Code of Federal Regulations, 2011 CFR

2011-10-01

... rated relative to the value of work for other physician services. (2) Special RVUs for anesthesia and radiology services)—(i) Anesthesia services. The rules for determining RVUs for anesthesia services are set...

42 CFR 414.22 - Relative value units (RVUs).

Code of Federal Regulations, 2010 CFR

2010-10-01

... rated relative to the value of work for other physician services. (2) Special RVUs for anesthesia and radiology services)—(i) Anesthesia services. The rules for determining RVUs for anesthesia services are set...

Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study.

PubMed

Napierala, Christoph; Boes, Stefan

2017-02-28

In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. However, little is known about the efficiency of specific processes within hospitals. The objective of this study is to describe the relationship between timing of radiological interventions, in particular scan and treatment day, and the length of stay (LOS) compliance in a hospital. This is a cross-sectional observational study based on administrative records of all DRG cases in a Swiss university hospital in 2013, enriched by data from the radiology information system and accounting details. The data are analysed using descriptive statistics and regression methods. Radiology and related treatment on a weekend is associated with a higher LOS compliance of approximately 22.12% (p<0.01) compared to scans and treatments on weekdays, controlling for gender, age and insurance of the patient, as well as detailed medical and radiology-related factors. The higher LOS compliance is driven by emergency cases, which supports the hypothesis that for those cases on weekends more efficient scan and treatment processes are in place. The study provides evidence on how days of radiological intervention are related to LOS compliance in a Swiss hospital under DRG and attempts to explain how this is linked to standardised operating procedures. Our results have implications regarding potential cost savings in hospital care through alignment of care processes, infrastructure planning and guidance of patient flows.

The consequences of the economic crisis in radiology.

PubMed

2015-12-01

The effects of the economic crisis have led to complex problems in radiology. The crisis has led to a reduction in the turnover of imaging equipment. This reflects on the quantity and quality of output, an aspect which is worsened by the contraction of the radiology market, late payments on supplies, and competitive procurement of medical goods centralized on a regional or national level. Many local and national institutions have operated with significant reductions of reimbursement for procedures, forcing a reorganization of facilities, manpower, and equipment. The reduction in operating margins of the industry has resulted in a reduction of invested capital for projects of industrial R&D and direct or indirect sponsorship. The quality of care will be affected with less comfortable conditions, reduction of local availability of radiologists, and failure to invest in lower dose equipment to control population medical radiation exposure. The crisis resulted in a reduction in the number of graduates in medicine and scholarships for specialization induced by linear cuts will result in a drastic reduction of radiological specialists. This will favour the development of teleradiology services, with the risk of accelerating the demedicalisation of radiology departments, and isolation of the professionals. • The economic crisis has led to reduction in the turnover of imaging equipment. • The economic crisis has led to reductions of reimbursement for procedures. • The economic crisis has led to reductions in operating margins of the industry. • The economic crisis has led to contraction of quantity and quality of output. • The economic crisis resulted in demedicalisation of radiology departments and isolation of professionals.

Pediatric radiology malpractice claims - characteristics and comparison to adult radiology claims.

PubMed

Breen, Micheál A; Dwyer, Kathy; Yu-Moe, Winnie; Taylor, George A

2017-06-01

Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation. We hypothesize that the frequency, character and outcome of malpractice claims made against pediatric radiologists differ from those seen in general radiology practice. We searched the Controlled Risk Insurance Co. (CRICO) Strategies' Comparative Benchmarking System (CBS), a private repository of approximately 350,000 open and closed medical malpractice claims in the United States, for claims related to pediatric radiology. We further queried these cases for the major allegation, the clinical environment in which the claim arose, the clinical severity of the alleged injury, indemnity paid (if payment was made), primary imaging modality involved (if applicable) and primary International Classification of Diseases, 9th revision (ICD-9) diagnosis underlying the claim. There were a total of 27,056 fully coded claims of medical malpractice in the CBS database in the 5-year period between Jan. 1, 2010, and Dec. 31, 2014. Of these, 1,472 cases (5.4%) involved patients younger than 18 years. Radiology was the primary service responsible for 71/1,472 (4.8%) pediatric cases. There were statistically significant differences in average payout for pediatric radiology claims ($314,671) compared to adult radiology claims ($174,033). The allegations were primarily diagnosis-related in 70% of pediatric radiology claims. The most common imaging modality implicated in pediatric radiology claims was radiography. The highest payouts in pediatric radiology pertained to missed congenital and developmental anomalies (average $1,222,932) such as developmental dysplasia of the hip and congenital central nervous system anomalies. More than half of pediatric radiology claims arose in the ambulatory setting. Pediatric radiology is not immune from claims of medical malpractice and these claims result in high monetary payouts, particularly for missed diagnoses of congenital and developmental anomalies. Our data suggest that efforts to reduce diagnostic error in the outpatient radiology setting, in the interpretation of radiographs, and in the improved diagnosis of fractures and congenital and developmental anomalies would be of particular benefit to the pediatric radiology community.

National entrepreneurial radiology initiatives: what are they, and what can they do to and for you?

PubMed

Muroff, Lawrence R

2013-04-01

National entrepreneurial radiology companies have evolved over the past 3 decades. In the 1990s, a few initiatives were established to implement business principles and reward shareholders with gains derived from management expertise, practice efficiencies, and economies of scale. The next decade saw the emergence of night call coverage and "specialty read" companies. As the market for these services became saturated, the established corporate entities scrambled to find new revenue streams. Hospital radiology contracts were the obvious source for this needed capital. The pursuit of these contracts led to aggressive, nontraditional competition. If radiologists are to respond appropriately, they must understand the reasons behind the strategies used by these national entrepreneurial radiology companies. The author explores the goals and actions of these entities and describes why hospitals may find these national companies to be an attractive alternative to their incumbent radiology practices. Both the benefits and the problems associated with entrepreneurial companies are covered, and concepts such as disintermediation are discussed. Finally, the author suggests appropriate actions for radiologists seeking to retain their hospital contracts. Nontraditional competition is now a way of life for many radiology practices. Relationships, subspecialization, service, and measurable quality indicators are the foundation for the maintenance of tenure at hospitals. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The Impact of Nonphysician Providers on Diagnostic and Interventional Radiology Practices: Operational and Educational Implications.

PubMed

Hawkins, C Matthew; Bowen, Michael A; Gilliland, Charles A; Walls, D Gail; Duszak, Richard

2015-09-01

The numbers of nurse practitioners (NPs) and physician assistants (PAs) are increasing throughout the entire health care enterprise, and a similar expansion continues within radiology. The use of radiologist assistants is growing in some radiology practices as well. The increased volume of services rendered by this growing nonphysician provider subset of the health care workforce within and outside radiology departments warrants closer review, particularly with regard to their potential influence on radiology education and medical imaging resource utilization. In this article (the second in a two-part series), the authors review recent literature and offer recommendations for radiology practices regarding the impact NPs, PAs, and radiologist assistants may have on interventional and diagnostic radiology practices. Their potential impact on medical education is also discussed. Finally, staffing for radiology departments, as a result of an enlarging nonradiology NP and PA workforce ordering diagnostic imaging, is considered. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study.

PubMed

Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

2016-01-01

Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. "Management and empowerment of human resources'' (weight = 0.465) and "requirements and facilities" (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country's hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards further efficiency and effectiveness of the health care evaluation systems.

Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study

PubMed Central

Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

2016-01-01

Background: Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. Objectives: The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. Materials and Methods: This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. Results: “Management and empowerment of human resources’’ (weight = 0.465) and “requirements and facilities” (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. Conclusion: The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country’s hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards further efficiency and effectiveness of the health care evaluation systems. PMID:27127577

External Factors That Influence the Practice of Radiology: Proceedings of the International Society for Strategic Studies in Radiology Meeting.

PubMed

Rubin, Geoffrey D; McNeil, Barbara J; Palkó, András; Thrall, James H; Krestin, Gabriel P; Muellner, Ada; Kressel, Herbert Y

2017-06-01

In both the United States and Europe, efforts to reduce soaring health care costs have led to intense scrutiny of both standard and innovative uses of imaging. Given that the United States spends a larger share of its gross domestic product on health care than any other nation and also has the most varied health care financing and delivery systems in the world, it has become an especially fertile environment for developing and testing approaches to controlling health care costs and value. This report focuses on recent reforms that have had a dampening effect on imaging use in the United States and provides a glimpse of obstacles that imaging practices may soon face or are already facing in other countries. On the basis of material presented at the 2015 meeting of the International Society for Strategic Studies in Radiology, this report outlines the effects of reforms aimed at (a) controlling imaging use, (b) controlling payer expense through changes in benefit design, and (c) controlling both costs and quality through "value-based" payment schemes. Reasons are considered for radiology practices on both sides of the Atlantic about why the emphasis needs to shift from providing a large volume of imaging services to increasing the value of imaging as manifested in clinical outcomes, patient satisfaction, and overall system savings. Options for facilitating the shift from volume to value are discussed, from the use of advanced management strategies that improve workflow to the creation of programs for patient engagement, the development of new clinical decision-making support tools, and the validation of clinically relevant imaging biomarkers. Radiologists in collaboration with industry must enhance their efforts to expand the performance of comparative effectiveness research to establish the value of these initiatives, while being mindful of the importance of minimizing conflicts of interest. © RSNA, 2017.

44 CFR 354.2 - Scope of this regulation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF HOMELAND SECURITY PREPAREDNESS FEE FOR SERVICES TO SUPPORT FEMA'S OFFSITE RADIOLOGICAL EMERGENCY... subject to requirements for offsite radiological emergency planning and preparedness. ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Scope of this regulation. 354...

Materiel management and radiology: building a teamwork relationship.

PubMed

Burke, M D; Cirino, J C

1991-01-01

Mr. Burke and Mr. Cirino explain how a teamwork relationship between radiology and materiel management can serve both well--radiology can continually strive to provide high quality diagnostic data and superior patient care, while materiel management can provide a continuous flow of supplies and services, keep inventory investment low, and develop a competent supplier base. Effective communication is the necessary element that will allow each to achieve its respective goals.

Tools to manage the enterprise-wide picture archiving and communications system environment.

PubMed

Lannum, L M; Gumpf, S; Piraino, D

2001-06-01

The presentation will focus on the implementation and utilization of a central picture archiving and communications system (PACS) network-monitoring tool that allows for enterprise-wide operations management and support of the image distribution network. The MagicWatch (Siemens, Iselin, NJ) PACS/radiology information system (RIS) monitoring station from Siemens has allowed our organization to create a service support structure that has given us proactive control of our environment and has allowed us to meet the service level performance expectations of the users. The Radiology Help Desk has used the MagicWatch PACS monitoring station as an applications support tool that has allowed the group to monitor network activity and individual systems performance at each node. Fast and timely recognition of the effects of single events within the PACS/RIS environment has allowed the group to proactively recognize possible performance issues and resolve problems. The PACS/operations group performs network management control, image storage management, and software distribution management from a single, central point in the enterprise. The MagicWatch station allows for the complete automation of software distribution, installation, and configuration process across all the nodes in the system. The tool has allowed for the standardization of the workstations and provides a central configuration control for the establishment and maintenance of the system standards. This report will describe the PACS management and operation prior to the implementation of the MagicWatch PACS monitoring station and will highlight the operational benefits of a centralized network and system-monitoring tool.

Analysis of operation UPSHOT-KNOTHOLE nuclear test BADGER radiological and meteorological data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Quinn, V.E.

1986-04-01

This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the BADGER nuclear test of Operation UPSHOT-KNOTHOLE. Inconsistencies in the radiological data and their resolution are discussed. The methods of normalizing the radiological data to a standard time, of converting the aerial data to equivalent ground-level values, and of estimating fallout-arrival times are presented. The meteorological situations on event day and the following day are described. A comparison of the WSNSO fallout analysis with an analysis performed during the 1950's is presented. The radiological data used to derive the WSNSO falloutmore » pattern are tabulated in an appendix.« less

Formation of an environmental restoration user group for radiological controls

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morris, R.L.

1993-12-31

An Environmental Restoration User Group for Radiological Controls will be proposed. Article 116 of the Radiological Control Manual encourages contractors to establish informal working associations that promote dialogue among similar facilities. Chem-Nuclear Geotech, Inc., is willing to initially organize and lead a users group to work on common problems, define standard methods, publish a Radiological Work Practices Handbook, and recommend regulatory changes to make environmental restoration programs more cost effective without compromising radiological control. A charter for the users group will be proposed. A questionnaire will be distributed to interested persons to assist in development of focus groups and agendamore » items for the first meeting. The first meeting is planned for May 25-26, 1993, in Grand Junction Colorado. All interested persons are welcome to attend.« less

42 CFR 415.120 - Conditions for payment: Radiology services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... individual beneficiary, such as interpretation of x-ray plates, angiograms, myelograms, pyelograms, or..., administrative or supervisory services) or for provider services needed to produce the x-ray films or other items...

Analysis of Operation Dominic II SMALL BOY radiological and meteorological data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Quinn, V.E., Kennedy, N.C.; Steadman, C.R.

1984-08-01

This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the Operation Dominic II nuclear test SMALL BOY. Inconsistencies in the radiological data and their resolution are discussed. The methods of estimating fallout-arrival times are discussed. The meteorological situation on D-day and a few days following are described. A comparison of the fallout patterns resulting from these analyses and earlier (1966) analyses is presented. The radiological data used to derive the fallout pattern in this report are tabulated in an appendix. 11 references, 20 figures.

44 CFR 354.4 - Assessment of fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HOMELAND SECURITY PREPAREDNESS FEE FOR SERVICES TO SUPPORT FEMA'S OFFSITE RADIOLOGICAL EMERGENCY... CFR 50.54(q) requirements stating that offsite radiological emergency planning and preparedness are no... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Assessment of fees. 354.4...

Officer Standardized Educational Testing Data

DTIC Science & Technology

1992-11-01

HORTICULTURE /ORNAMENTAL HORTICULTURE 422 = NATURAL RESOURCES MANAGEMENT 430 = ARCHITECTURE & ENVIRONMENTAL DESIGN, GENERAL 431 = ARCHITECTURAL...SERVICES/ TECHNOLOGY 753 = NUCLEAR MEDICAL TECHNOLOGY 754 = NURSING (PRACTICAL NURSING) 755 = NURSING (REGISTERED/BSN) 756 = OCCUPATIONAL THERAPY ...ASSISTING 757 = OPTOMETRY 758 = PHARMACY 759 = PHYSICIAN ASSISTING 760 = PHYSICAL THERAPY /ASSISTING 761 = RADIOLOGY/RADIOLOGIC TECHNOLOGY 762

A resident's primer of Medicare reimbursement in radiology.

PubMed

Lee, Ryan K

2006-01-01

After having completed medical school, residency, and in many cases specialized fellowships, radiologists are well equipped to practice clinical radiology. However, they receive little if any exposure to the business of radiology, such as coding, billing, and other administrative duties that maintain the financial well-being of any medical practice. Medicare insolvency, managed care, self-referral, and increasing imaging by nonradiology specialists are all issues creating a competitive and ever changing medical environment, and understanding the economic and business aspects of health care is becoming increasingly important for both academic and private practice radiologists. The intent of this paper is to provide new radiologists as well as radiologists in training an introduction to the reimbursement system, as well as to provide a generalized review of the process for practicing radiologists. In particular, this article addresses the fundamentals of the Medicare fee-for-service reimbursement process as well as the factors considered in arriving at the valuation of radiologic services by Medicare.

Radiology operations: what you don't know could be costing you millions.

PubMed

Joffe, Sam; Drew, Donna; Bansal, Manju; Hase, Michael

2007-01-01

Rapid growth in advanced imaging procedures has left hospital radiology departments struggling to keep up with demand, resulting in loss of patients to facilities that can offer service more quickly. While the departments appear to be working at full capacity, an operational analysis of over 400 hospital radiology departments in the US by GE Healthcare has determined that, paradoxically, many departments are in fact underutilized and operating for below their potential capacity. While CT cycle time in hospitals that were studied averaged 35 minutes, top performing hospitals operated the same equipment at a cycle time of 15 minutes, yielding approximately double the throughput volume. Factors leading to suboptimal performance include accounting metrics that mask true performance, leadership focus on capital investment rather than operations, under staffing, under scheduling, poorly aligned incentives, a fragmented view of operations, lack of awareness of latent opportunities, and lack of sufficient skills and processes to implement improvements. The study showed how modest investments in radiology operations can dramatically improve access to services and profitability.

Enterprise imaging: planning and business justification.

PubMed

Avrin, David; Hou, Stephanie W

2012-02-01

To evaluate financial performance, academic radiology departments most often measure examination volume and general technical and professional expenses. Although these metrics are not standardized, their frequency of use reflects that productivity and financial health are high priorities for academic radiology departments across the United States. In this article, we discuss both of these topics, in the context of projects to expand services, particularly those with an information technology (IT) component. First, we discuss several informatics innovations that increase productivity or expand service. Second, we explain core financial analysis concepts applicable to radiology departments. Third, we discuss the unique challenge of evaluating a potential IT project for an academic radiology department, when intangible benefits are difficult to quantify. Financial models are only one of several components used for guidance in strategic decisions, but are crucial to building a business case that justifies the initial or capital investment as well as startup and ongoing operational expenses. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Should radiology residents be taught evidence-based radiology? An experiment with "the EBR Journal Club".

PubMed

Heilbrun, Marta E

2009-12-01

Introduce radiology residents to evidence-based radiology (EBR) using a journal club format based on the Radiology Alliance for Health Services Research/American Alliance of Academic Chief Residents in Radiology (RAHSR/A3CR2) Critical Thinking Skills sessions and EBR series of articles published in Radiology in 2007. The club began with a presentation outlining the process that would occur in an alternating format, with topics and articles chosen by residents. In session A, questions were rephrased in a Patient/Population, Intervention, Comparison, Outcome format, and a literature search was performed. Articles were discussed in session B, with residents assigned by year to the tasks of article summary, technology assessment, and comparison to checklists (Standards for Reporting of Diagnostic Accuracy, Consolidated Standards of Reporting Trials, or Quality of Reporting of Meta-analysis). The residents collectively assigned a level of evidence to each article, and a scribe provided a summary. Twenty-two residents participated, with 12/22 (55%) of residents submitting any question, 6/22 (27.3%) submitting more than one question, and 4 residents submitting questions in more than one session. Topics included radiation risk, emergency radiology, screening examinations, modality comparisons, and technology assessment. Of the 31 articles submitted for review, 15 were in radiology journals and 5 were published before 2000. For 2/9 topics searched, no single article that the residents selected was available through our library's subscription service. The maximum level of evidence assigned by residents was level III, "limited evidence." In each session, the residents concluded that they became less confident in the "right answer." They proposed that future reading recommendations come from attendings rather than literature searches. A journal club format is an effective tool to teach radiology residents EBR principles. Resistance comes from the difficulty in accessing good literature for review and in constructing good review questions.

The role of radiology in the Oklahoma City bombing.

PubMed

Nye, P J; Tytle, T L; Jarman, R N; Eaton, B G

1996-08-01

To evaluate the role of radiologic services in the assessment of injuries and identification of deceased victims of the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, Okla. In cooperation with the Oklahoma University Health Sciences Center Disaster Studies Group, all victims of the Oklahoma City bombing who were treated in hospitals were evaluated. All radiologic studies performed in these patients during a 4-week period after the bombing were recorded. Major injuries incurred by the victims were noted but were not documented. In addition, assistance provided by radiologic services to the medical examiner's office for identification of deceased victims was assessed. On the day of the bombing, 99% (480 of 485) of the imaging studies performed were either plain radiography, primarily of the extremities and chest, or computed tomography (CT), half of which were of the head. Six deceased victims were identified solely by means of characteristics on radiographs. Almost all bombing-related radiologic studies were either plain radiography or CT. Other modalities had only limited roles. In deceased victims, plain radiography aided identification, and in many other victims it allowed localization of materials that were potential pieces of evidence.

CT Lung Cancer Screening Program Development: Part 2.

PubMed

Yates, Teri

2015-01-01

Radiology administrators must use innovative strategies around clinical collaboration and marketing to ensure that patients access the service in sufficient numbers. Radiology Associates of South Florida in collaboration with Baptist Health South Florida have developed a successful lung cancer screening program. The biggest factors in their success have been the affordability of their service and the quality of the program. Like mammography, lung cancer screening programs serve as an entry point to other services that generate revenue for the hospital. Patients may require further evaluation in the form of more imaging or surgical services for biopsy. Part 1 provided background and laid out fundamentals for starting a program. Part 2 focuses on building patient volume, marketing, and issues related to patient management after the screen is performed.

Costing in Radiology and Health Care: Rationale, Relativity, Rudiments, and Realities.

PubMed

Rubin, Geoffrey D

2017-02-01

Costs direct decisions that influence the effectiveness of radiology in the care of patients on a daily basis. Yet many radiologists struggle to harness the power of cost measurement and cost management as a critical path toward establishing their value in patient care. When radiologists cannot articulate their value, they risk losing control over how imaging is delivered and supported. In the United States, recent payment trends directing value-based payments for bundles of care advance the imperative for radiology providers to articulate their value. This begins with the development of an understanding of the providers' own costs, as well as the complex interrelationships and imaging-associated costs of other participants across the imaging value chain. Controlling the costs of imaging necessitates understanding them at a procedural level and quantifying the costs of delivering specific imaging services. Effective product-level costing is dependent on a bottom-up approach, which is supported through recent innovations in time-dependent activity-based costing. Once the costs are understood, they can be managed. Within the high fixed cost and high overhead cost environment of health care provider organizations, stakeholders must understand the implications of misaligned top-down cost management approaches that can both paradoxically shift effort from low-cost workers to much costlier professionals and allocate overhead costs counterproductively. Radiology's engagement across a broad spectrum of care provides an excellent opportunity for radiology providers to take a leading role within the health care organizations to enhance value and margin through principled and effective cost management. Following a discussion of the rationale for measuring costs, this review contextualizes costs from the perspectives of a variety of stakeholders (relativity), discusses core concepts in how costs are classified (rudiments), presents common and improved methods for measuring costs in health care, and discusses how cost management strategies can either improve or hinder high-value health care (realities). © RSNA, 2017 Online supplemental material is available for this article.

The Technologist Function in Fields Related to Radiology: Tasks in Radiation Therapy and Diagnostic Ultrasound. Research Report No. 9; Relating Technologist Tasks in Diagnostic Radiology, Ultrasound and Radiation Therapy. Research Report No. 10.

ERIC Educational Resources Information Center

Gilpatrick, Eleanor

The two research reports included in this document describe the application of the Health Services Mobility Study (HSMS) task analysis method to two technologist functions and examine the interrelationships of these tasks with those in diagnostic radiology. (The HSMS method includes processes for using the data for designing job ladders, for…

Experience with high-performance PACS

NASA Astrophysics Data System (ADS)

Wilson, Dennis L.; Goldburgh, Mitchell M.; Head, Calvin

1997-05-01

Lockheed Martin (Loral) has installed PACS with associated teleradiology in several tens of hospitals. The PACS that have been installed have been the basis for a shift to filmless radiology in many of the hospitals. the basic structure for the PACS and the teleradiology that is being used is outlined. The way that the PACS are being used in the hospitals is instructive. The three most used areas for radiology in the hospital are the wards including the ICU wards, the emergency room, and the orthopedics clinic. The examinations are mostly CR images with 20 percent to 30 percent of the examinations being CT, MR, and ultrasound exams. The PACS are being used to realize improved productivity for radiology and for the clinicians. For radiology the same staff is being used for 30 to 50 percent more workload. For the clinicians 10 to 20 percent of their time is being saved in dealing with radiology images. The improved productivity stems from the high performance of the PACS that has been designed and installed. Images are available on any workstation in the hospital within less than two seconds, even during the busiest hour of the day. The examination management functions to restrict the attention of any one user to the examinations that are of interest. The examination management organizes the workflow through the radiology department and the hospital, improving the service of the radiology department by reducing the time until the information from a radiology examination is available. The remaining weak link in the PACS system is transcription. The examination can be acquired, read, an the report dictated in much less than ten minutes. The transcription of the dictated reports can take from a few hours to a few days. The addition of automatic transcription services will remove this weak link.

Design and Implementation of PACS at Georgetown University Hospital

NASA Astrophysics Data System (ADS)

Mun, S. K.; Benson, H.. R.; Choyke, P.; Fahey, F. H.; Wang, P. C.; Zeman, R. K...; Elliott, L. P.

1985-09-01

During the preparation and planning phase of the PACS project at Georgetown University Hospital it was realized that PACS requires truly the state of the art technology in data communication, image processing and man machine interfacing. It was also realized that un-like many other technology intensive devices used in radiology, PACS cannot be seen as an independent system that will provide well defined services. PACS will be the backbone of the department operation in clinical, educational and managerial functions. It will indeed be the nerve center of the radiologic services affecting every aspect of the department. PACS will have to be designed to perform in a cost-effective manner to widely varying needs within the radiology departments. The integration of ever changing complex technology that will impact every aspect of a radiology service is not a trivial matter. This transition period going from current manual film based PACS to Digital PACS can be long, expansive and disruptive unless careful planning preceeds the implementation. PACS is still an emerging technology at its infancy. Performance monitoring and evaluation of diversified functions have to be also established so that improvement to the system can be efficiently implemented. Thus the evaluation criteria should be also established as early as possible.

Metrics for Radiologists in the Era of Value-based Health Care Delivery.

PubMed

Sarwar, Ammar; Boland, Giles; Monks, Annamarie; Kruskal, Jonathan B

2015-01-01

Accelerated by the Patient Protection and Affordable Care Act of 2010, health care delivery in the United States is poised to move from a model that rewards the volume of services provided to one that rewards the value provided by such services. Radiology department operations are currently managed by an array of metrics that assess various departmental missions, but many of these metrics do not measure value. Regulators and other stakeholders also influence what metrics are used to assess medical imaging. Metrics such as the Physician Quality Reporting System are increasingly being linked to financial penalties. In addition, metrics assessing radiology's contribution to cost or outcomes are currently lacking. In fact, radiology is widely viewed as a contributor to health care costs without an adequate understanding of its contribution to downstream cost savings or improvement in patient outcomes. The new value-based system of health care delivery and reimbursement will measure a provider's contribution to reducing costs and improving patient outcomes with the intention of making reimbursement commensurate with adherence to these metrics. The authors describe existing metrics and their application to the practice of radiology, discuss the so-called value equation, and suggest possible metrics that will be useful for demonstrating the value of radiologists' services to their patients. (©)RSNA, 2015.

Imaging services at the Paralympic Games London 2012: analysis of demand and distribution of workload.

PubMed

Bethapudi, Sarath; Campbell, Robert S D; Budgett, Richard; Willick, Stuart E; Van de Vliet, Peter

2015-01-01

Very little data have been published on medical imaging services at disability games. 7.9 million euros (£6.6 million, US$11 million) were invested in setting up radiology facilities within purpose built polyclinics at the London 2012 Olympic and Paralympic games. This paper details imaging services at the 2012 Paralympic Games. Data analysis on imaging at 2012 Olympics has been published in a separate paper. To analyse the workload on the polyclinics' radiology services, provided for the Paralympic athletes during the London 2012 Paralympic Games. Data were prospectively collected during the period of the Paralympic games from the Picture Archive Communications System (PACS) and the Radiological Information System (RIS). Data were correlated with the medical encounter database (ATOS). 655 imaging episodes were recorded, which comprised 38.8% (n=254) MRI, 33% (n=216) plain radiographs, 24% (n=157) ultrasound scans and 4.2% (n=28) CT scans. Investigations on the Paralympic athletes accounted for 65.2% of workload, with the remainder divided between Paralympic family and workforce. MRI was the most used imaging resource and CT was the least used imaging modality at the Paralympic village polyclinic. Analysis of demographic data provides a useful index for planning radiology infrastructure and manpower at future international competitions for athletes with a disability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

21 CFR 1002.3 - Notification to user of performance and technical data.

Code of Federal Regulations, 2010 CFR

2010-04-01

... data. 1002.3 Section 1002.3 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS General Provisions § 1002.3 Notification to... Radiological Health, as authorized under delegated authority, may require a manufacturer of a radiation...

Bacterial Cleanability of Various Types of Eating Surfaces.

ERIC Educational Resources Information Center

Ridenour, Gerald M.; Armbruster, E. H.

1953-01-01

Presents a study of the capability of commercial dishwashers to remove bacteria from various kinds of service plates. Gives an account of preliminary research on the bacterial cleanability of eating surfaces of different materials by two radiological procedures--(1) radiological count, and (2) autoradiographic measurement. Among the factors…

42 CFR 51c.102 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Therapeutic radiologic services; (11) Public health services (including nutrition education and social... 42 Public Health 1 2013-10-01 2013-10-01 false Definitions. 51c.102 Section 51c.102 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY HEALTH...

The DPACS project at the University of Trieste.

PubMed

Fioravanti, F; Inchingolo, P; Valenzin, G; Dalla Palma, L

1997-01-01

The DPACS project (Data and Picture Archiving and Communication System) was undertaken at the University of Trieste by the Institute of Radiology and the DEEI (Dipartimento di Elettrotecnica, Elettronica ed Informatica), in collaboration with the CRSTBS (Centro Ricerche e Studi Tecnologie Biomediche Sanitarie) of the Area Science Park and the Azienda Ospedaliera of Trieste. The main objective of this project is to create an open system for the management of clinical data and images and for the integration of health care services. The first phase is oriented toward finding an implementation strategy for the creation of a prototype DPACS system, to serve as a starting point for the realization of a distributed structure for the extension of the service, firstly to the entire structure of the Cattinara Hospital and subsequently to all the Public Health units in Trieste. After local testing, the service will finally be expanded to a wider geographical level. The intensive computerization of the Institute of Radiology furnished the most favourable environment for the verification of the prototype, as the service provided by the existing RIS (Radiology Information System) and PACS (Picture and Archiving Communication System) has long been consolidated. One of the main goals of the project, in particular, is to replace the old, by now obsolete, PACS with the DPACS services.

Improved workflow modelling using role activity diagram-based modelling with application to a radiology service case study.

PubMed

Shukla, Nagesh; Keast, John E; Ceglarek, Darek

2014-10-01

The modelling of complex workflows is an important problem-solving technique within healthcare settings. However, currently most of the workflow models use a simplified flow chart of patient flow obtained using on-site observations, group-based debates and brainstorming sessions, together with historic patient data. This paper presents a systematic and semi-automatic methodology for knowledge acquisition with detailed process representation using sequential interviews of people in the key roles involved in the service delivery process. The proposed methodology allows the modelling of roles, interactions, actions, and decisions involved in the service delivery process. This approach is based on protocol generation and analysis techniques such as: (i) initial protocol generation based on qualitative interviews of radiology staff, (ii) extraction of key features of the service delivery process, (iii) discovering the relationships among the key features extracted, and, (iv) a graphical representation of the final structured model of the service delivery process. The methodology is demonstrated through a case study of a magnetic resonance (MR) scanning service-delivery process in the radiology department of a large hospital. A set of guidelines is also presented in this paper to visually analyze the resulting process model for identifying process vulnerabilities. A comparative analysis of different workflow models is also conducted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Marketing mix in a radiology department: challenges for future radiologists in management].

PubMed

Claikens, B

1998-08-01

Radiology has gained an enviable position among medial specialities. Developments in new technology expand its horizons and the volume of radiologic imaging techniques and procedures increase far more than the overall growth in health care services. In this position radiology has become a prime target for restrictions, cutbacks, controlled financing in an area of managed care and new national health care policy based on partially fixed budgets. Future health care takers have to choose the best available diagnostic and therapeutic techniques. Evidence based medicine, cost-utility analysis, diagnostic performance analysis, patient outcome analysis, technology assessment and guidelines for practice are means to guide us through our obligatory choice. Our major objective is to use the most performant available imaging technique or intervention to achieve the best possible outcome for our patient at lower possible costs. A strategic response from radiologists is required to meet the imperatives of this new management situation. They must do far more than interpret imaging procedures. They must work as efficient managers of imaging resources, organise their practices and define their marketing-strategies using the different, so-called, marketing-mix elements. The challenges will be great but the rewards are worth our best efforts. In this article we highlight the marketing responsibilities of future radiologists and their clinical practice in this new socio-economic environment and we present different useful marketing tools.

Thirteenth Annual Warren K. Sinclair Keynote Address: Where Are the Radiation Professionals (WARP)?

PubMed

Toohey, Richard E

2017-02-01

In July 2013, the National Council on Radiation Protection and Measurements convened a workshop for representatives from government, professional organizations, academia, and the private sector to discuss a potential shortage of radiation protection professionals in the not-too-distant future. This shortage manifests itself in declining membership of professional societies, decreasing enrollment in university programs in the radiological sciences, and perhaps most importantly, the imminent retirement of the largest birth cohort in American history, the so-called "baby boomer" generation. Consensus emerged that shortages already are, or soon will be, felt in government agencies (including state radiation control programs); membership in professional societies is declining precipitously; and student enrollments and university support for radiological disciplines are decreasing with no reversals expected. The supply of medical physicists appears to be adequate at least in the near term, although a shortage of available slots in accredited clinical training programs looms large. In general, the private sector appears stable, due in part to retirees joining the consultant ranks. However, it is clear that a severe problem exists with the lack of an adequate surge capacity to respond to a large-scale reactor accident or radiological terrorism attack in the United States. The workshop produced a number of recommendations, including increased funding of both fellowships and research in the radiological sciences, as well as creation of internships, practicums, and post-doctoral positions. A federal joint program support office that would more efficiently manage the careers of radiological professionals in the civil service would enhance recruiting and development, and increase the flexibility of the various agencies to manage their staffing needs.

Radiation Protection Knowledge, Attitude, and Practice (KAP) in Interventional Radiology

PubMed Central

Shabani, Fatemeh; Hasanzadeh, Hadi; Emadi, Alireza; Mirmohammadkhani, Majid; Bitarafan-Rajabi, Ahmad; Abedelahi, Ali; Bokharaeian, Mitra; Masoumi, Hamed; Seifi, Danial; Khani, Tahereh; Sanchooli, Mohamad; Moshfegh, Shima; Ziari, Abbas

2018-01-01

Objectives Due to increasing cardiac disease and its mortality rate, the frequency of cardiac imaging has grown and, as a result, interventional cardiologists potentially receive high radiation doses in cardiac examinations. This study aimed to assess the knowledge, attitude, and practice (KAP) level of radiation protection (RP) among interventional radiology staff in Iranian health care centers across the country. Methods We used a validated questionnaire survey consisting of 30 multiple-choice questions to perform a cross-sectional study. Participants were healthcare personnel working professionally with radiation at different levels (i.e., secretary, radiology technologists, nurse, and physician). The questionnaire was divided into three sections to assess KAP regarding RP. Results Significant differences exist in RP KAP mean scores based on educational age (p < 0.050). There was no significant difference in RP KAP mean scores when looking at sex, practice age, and hospital type (p > 0.050). We found a significant difference between RP KAP mean scores and different regions (p < 0.050). Conclusions Educational and practice age, sex, type of hospital, and geographical region affect he KAP of interventional radiology staff regarding RP. Since many of the subjective radiation harms for both medical team and patients, this can be easily controlled and prevented; a checkup for personnel of interventional radiology departments, considering samples from different parts of the country with different levels of education, continuous training, and practical courses may help map the status of KAP. The results of this study may also help authorized health physics officers design strategic plans to enhance the quality of such services in radiation departments. PMID:29657683

Radiation Protection Knowledge, Attitude, and Practice (KAP) in Interventional Radiology.

PubMed

Shabani, Fatemeh; Hasanzadeh, Hadi; Emadi, Alireza; Mirmohammadkhani, Majid; Bitarafan-Rajabi, Ahmad; Abedelahi, Ali; Bokharaeian, Mitra; Masoumi, Hamed; Seifi, Danial; Khani, Tahereh; Sanchooli, Mohamad; Moshfegh, Shima; Ziari, Abbas

2018-03-01

Due to increasing cardiac disease and its mortality rate, the frequency of cardiac imaging has grown and, as a result, interventional cardiologists potentially receive high radiation doses in cardiac examinations. This study aimed to assess the knowledge, attitude, and practice (KAP) level of radiation protection (RP) among interventional radiology staff in Iranian health care centers across the country. We used a validated questionnaire survey consisting of 30 multiple-choice questions to perform a cross-sectional study. Participants were healthcare personnel working professionally with radiation at different levels (i.e., secretary, radiology technologists, nurse, and physician). The questionnaire was divided into three sections to assess KAP regarding RP. Significant differences exist in RP KAP mean scores based on educational age (p < 0.050). There was no significant difference in RP KAP mean scores when looking at sex, practice age, and hospital type (p > 0.050). We found a significant difference between RP KAP mean scores and different regions (p < 0.050). Educational and practice age, sex, type of hospital, and geographical region affect he KAP of interventional radiology staff regarding RP. Since many of the subjective radiation harms for both medical team and patients, this can be easily controlled and prevented; a checkup for personnel of interventional radiology departments, considering samples from different parts of the country with different levels of education, continuous training, and practical courses may help map the status of KAP. The results of this study may also help authorized health physics officers design strategic plans to enhance the quality of such services in radiation departments.

Applications of process improvement techniques to improve workflow in abdominal imaging.

PubMed

Tamm, Eric Peter

2016-03-01

Major changes in the management and funding of healthcare are underway that will markedly change the way radiology studies will be reimbursed. The result will be the need to deliver radiology services in a highly efficient manner while maintaining quality. The science of process improvement provides a practical approach to improve the processes utilized in radiology. This article will address in a step-by-step manner how to implement process improvement techniques to improve workflow in abdominal imaging.

Interventional Radiology service provision and practice for the management of traumatic splenic injury across the Regional Trauma Networks of England.

PubMed

Hughes, Jane; Scrimshire, Ashley; Steinberg, Laura; Yiannoullou, Petros; Newton, Katherine; Hall, Claire; Pearce, Lyndsay; Macdonald, Andrew

2017-05-01

The management of blunt splenic injuries (BSI) has evolved toward strategies that avoid splenectomy. There is growing adoption of interventional radiology (IR) techniques in non-operative management of BSI, with evidence suggesting a corresponding reduction in emergency laparotomy requirements and increased splenic preservation rates. Currently there are no UK national guidelines for the management of blunt splenic injury. This may lead to variations in management, despite the reorganisation of trauma services in England in 2012. A survey was distributed through the British Society of Interventional Radiologists to all UK members aiming to identify availability of IR services in England, radiologists' practice, and attitudes toward management of BSI. 116 responses from respondents working in 23 of the 26 Regional Trauma Networks in England were received. 79% provide a single dedicated IR service but over 50% cover more than one hospital within the network. All offer arterial embolisation for BSI. Only 25% follow guidelines. In haemodynamically stable patients, an increasing trend for embolisation was seen as grade of splenic injury increased from 1 to 4 (12.5%-82.14%, p<0.01). In unstable patients or those with radiological evidence of bleeding, significantly more respondents offer embolisation for grade 1-3 injuries (p<0.01), compared to stable patients. Significantly fewer respondents offer embolisation for grade 5 versus 4 injuries in unstable patients or with evidence of bleeding. Splenic embolisation is offered for a variety of injury grades, providing the patient remains stable. Variation in interventional radiology services remain despite the introduction of regional trauma networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Radiology practice in Latin America: a literature review.

PubMed

Teague, Jordan

2013-01-01

To discover the status and structure of radiology in Latin America with respect to the health care systems it is part of, the effects of socioeconomics, the equipment and technology used, technologists and their training, accreditation, and professional organizations. Health-related databases and Google Scholar were searched for articles concerning radiology practice in Latin America. Articles were selected based on relevance to the research scope. Many regions in Latin America offer little to no access to radiology. Where there is access, the equipment often is old or not functioning, with limited and costly service and maintenance. Most trained technologists live in urban areas. There are no standardized accreditation practices in Latin America. However, forming professional organizations would help promote the practice of radiology and accreditation standards. International cooperative organizations enhance radiology by providing resources and opportunities for cooperation between countries. The current status of radiology in Latin America must be determined. This knowledge will help us discover opportunities for cooperation and ways to improve radiology practice. The main need in Latin America is to extend coverage to the underserved population.

Key Performance Indicators in Radiology: You Can't Manage What You Can't Measure.

PubMed

Harvey, H Benjamin; Hassanzadeh, Elmira; Aran, Shima; Rosenthal, Daniel I; Thrall, James H; Abujudeh, Hani H

2016-01-01

Quality assurance (QA) is a fundamental component of every successful radiology operation. A radiology QA program must be able to efficiently and effectively monitor and respond to quality problems. However, as radiology QA has expanded into the depths of radiology operations, the task of defining and measuring quality has become more difficult. Key performance indicators (KPIs) are highly valuable data points and measurement tools that can be used to monitor and evaluate the quality of services provided by a radiology operation. As such, KPIs empower a radiology QA program to bridge normative understandings of health care quality with on-the-ground quality management. This review introduces the importance of KPIs in health care QA, a framework for structuring KPIs, a method to identify and tailor KPIs, and strategies to analyze and communicate KPI data that would drive process improvement. Adopting a KPI-driven QA program is both good for patient care and allows a radiology operation to demonstrate measurable value to other health care stakeholders. Copyright © 2015 Mosby, Inc. All rights reserved.

Integrated Fellowship in Vascular Surgery and Intervention Radiology

PubMed Central

Messina, Louis M.; Schneider, Darren B.; Chuter, Timothy A. M.; Reilly, Linda M.; Kerlan, Robert K.; LaBerge, Jeane M.; Wilson, Mark W.; Ring, Ernest J.; Gordon, Roy L.

2002-01-01

Objective To evaluate an integrated fellowship in vascular surgery and interventional radiology initiated to train vascular surgeons in endovascular techniques and to train radiology fellows in clinical aspects of vascular diseases. Summary Background Data The rapid evolution of endovascular techniques for the treatment of vascular diseases requires that vascular surgeons develop proficiency in these techniques and that interventional radiologists develop proficiency in the clinical evaluation and management of patients who are best treated with endovascular techniques. In response to this need the authors initiated an integrated fellowship in vascular surgery and interventional radiology and now report their interim results. Methods Since 1999 vascular fellows and radiology fellows performed an identical year-long fellowship in interventional radiology. During the fellowship, vascular surgery and radiology fellows perform both vascular and nonvascular interventional procedures. Both vascular surgery and radiology-based fellows spend one quarter of the year on the vascular service performing endovascular aortic aneurysm repairs and acquiring clinical experience in the vascular surgery inpatient and outpatient services. Vascular surgery fellows then complete an additional year-long fellowship in vascular surgery. To evaluate the type and number of interventional radiology procedures, the authors analyzed records of cases performed by all interventional radiology and vascular surgery fellows from a prospectively maintained database. The attitudes of vascular surgery and interventional radiology faculty and fellows toward the integrated fellowship were surveyed using a formal questionnaire. Results During the fellowship each fellow performed an average of 1,201 procedures, including 808 vascular procedures (236 diagnostic angiograms, 70 arterial interventions, 59 diagnostic venograms, 475 venous interventions, and 43 hemodialysis graft interventions) and 393 nonvascular procedures. On average fellows performed 20 endovascular aortic aneurysm repairs per year. There was no significant difference between the vascular surgery and radiology fellows in either the spectrum or number of cases performed. Eighty-eight percent (23/26) of the questionnaires were completed and returned. Both interventional radiologists and vascular surgeons strongly supported the integrated fellowship model and favored continuation of the integrated program. Vascular surgery and interventional radiology faculty members wanted additional training in clinical vascular surgery for the radiology-based fellows. With the exception of the radiology fellows there was uniform agreement that vascular surgery fellows benefit from training in nonvascular aspects of interventional radiology. Conclusions Integration of vascular surgery and interventional radiology fellowships is feasible and is mutually beneficial to both disciplines. Furthermore, the integrated fellowship provides exceptional training for vascular surgery and interventional radiology fellows in all catheter-based techniques that far exceeds the minimum requirements for credentialing suggested by various professional societies. There is a clear need for cooperation and active involvement on the parts of the American Board of Radiology and the American Board of Surgery and its Vascular Board to create hybrid training programs that meet mutually agreed-on criteria that document sufficient acquisition of both the cognitive and technical skills required to manage patients undergoing endovascular procedures safely and effectively. PMID:12368668

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Consoles in the Radiological Control Center at NASA's Kennedy Space Center are seen during ceremonies to name the facility in honor of Randy Scott. A professional health physicist of more than 40 years, Scott served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016. Located in the Neil Armstrong Operations and Checkout building, the Randall E. Scott Radiological Control Center is staffed by technical and radiological experts from NASA, the U.S. Department of Energy, the U.S. Air Force 45th Space Wing and the state of Florida. The group performs data collection and assessment functions supporting launch site and field data collection activities.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

A portion of the Radiological Control Center at NASA's Kennedy Space Center is seen during ceremonies to name the facility in honor of Randy Scott. A professional health physicist of more than 40 years, Scott served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016. Located in the Neil Armstrong Operations and Checkout building, the Randall E. Scott Radiological Control Center is staffed by technical and radiological experts from NASA, the U.S. Department of Energy, the U.S. Air Force 45th Space Wing and the state of Florida. The group performs data collection and assessment functions supporting launch site and field data collection activities.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Space Center, presents Myrna Scott, widow of Randy Scott, with a replica of the emblem noting that the spaceport's Radiological Control Center has been named in honor of her husband who died last year. The ceremony in the center's Radiological Control Center honored the extensive contributions of Randy Scott. A professional health physicist of more than 40 years, Scott served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016.

78 FR 29141 - Center for Devices and Radiological Health Appeals Processes; Guidance for Industry and FDA Staff...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0893] Center for Devices and Radiological Health Appeals Processes; Guidance for Industry and FDA Staff... Administration (FDA) is announcing the availability of the guidance entitled ``Center for Devices and...

A Strategy to Overcome the Radiology Lottery in the Staging of Head and Neck Cancer: An Aid to Attaining the 30-Day Rule

PubMed Central

Elloy, Marianne; Jarvis, Sara; Davis, Anne

2009-01-01

INTRODUCTION Rapid access to radiological services is essential, if the British Association of Otolaryngologists – Head and Neck Surgeons Minimum Temporal Standards are to be met in the management of head and neck cancer patients. This study assesses a new initiative whereby the multidisciplinary team prioritises allocated imaging appointments rather than using the traditional radiological triage system. PATIENTS AND METHODS This study was a prospective audit of all patients referred over a 3-month period with suspected head and neck cancer. The main outcome measures were: (i) median interval in days from general practitioner (GP) referral to staging scan; and (ii) median interval in days from first clinic appointment to staging scan. RESULTS The new multidisciplinary team booking system led to a statistically significant reduction in the ‘request-to-scan time’ (from 12 days to 5 days). The time from ‘GP to scan’ also improved. CONCLUSIONS This new multidisciplinary team-led booking system, could, in the future, speed up access to radiology services lead and neck cancer patients, allowing earlier definitive treatment. PMID:19126338

An Online Change of Activity in Energy Spectrum for Detection on an Early Intervention Robot

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boudergui, K.; Laine, F.; Montagu, T.

With the growth of industrial risks and the multiplication of CBRNe (Chemical Biological Radiological and explosive) attacks through toxic chemicals, biological or radiological threats, public services and military authorities face with increasingly critical situations, whose management is strongly conditioned by fast and reliable establishment of an informative diagnostic. Right after an attack, the five first minutes are crucial to define the various scenarios and the most dangerous for a human intervention. Therefore the use of robots is considered essential by all stakeholders of security. In this context, the SISPEO project (Systeme d'Intervention Sapeurs Pompiers Robotise) aims to create/build/design a robustmore » response through a robotic platform for early intervention services such as civil and military security in hostile environments. CEA LIST has proposed an adapted solution to detect and characterize nuclear and radiological risks online and in motion, using a miniature embedded CdZnTe (CZT) crystal Gamma-ray spectrometer. This paper presents experimental results for this miniature embedded CZT spectrometer and its associated mathematical method to detect and characterize radiological threats online and in motion. (authors)« less

Columbus Closure Project Released without Radiological Restrictions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Henderson, G.

2007-07-01

The Columbus Closure Project (CCP), a historic radiological research complex, was cleaned up for future use without radiological restriction in 2006. The CCP research and development site contributed to national defense, nuclear fuel fabrication, and the development of safe nuclear reactors in the United States until 1988 when research activities were concluded for site decommissioning. In November of 2003, the Ohio Field Office of the U.S. Department of Energy contracted ECC/E2 Closure Services, LLC (Closure Services) to complete the removal of radioactive contamination from of a 1955 era nuclear sciences area consisting of a large hot cell facility, research reactormore » building and underground piping. The project known as the Columbus Closure Project (CCP) was completed in 27 months and brought to a close 16 years of D and D in Columbus, Ohio. This paper examines the project innovations and challenges presented during the Columbus Closure Project. The examination of the CCP includes the project regulatory environment, the CS safety program, accelerated clean up innovation, project execution strategies and management of project waste issues and the regulatory approach to site release 'without radiological restrictions'. (authors)« less

Will it hurt? Patients' experience of X-ray examinations: a pilot study.

PubMed

Chesson, Rosemary A; Good, Maureen; Hart, Cleone L

2002-01-01

There is a worldwide trend towards involving patients in health care, but little is known about children's expectations of routine radiological procedures. To determine children's perceptions of X-ray examinations. A convenience sample was selected from consecutive patients referred to a children's hospital in Scotland. Children were allocated either to a drawing study ( n=20) or a two-stage interview ( n=25). The investigation was restricted to first-time users of the radiological service aged 7-14 years if accompanied by a parent and consent having been obtained. Children were excluded if pain control was administered in the Accident and Emergency Department. Children's drawings were reported on by an art therapist and a child psychiatrist. All children approached agreed to participate. Seventeen children provided accurate pictures of the X-ray examination room. Concordance existed between the psychiatrist's and art therapist's reports. Children at interview had at least a minimal level of knowledge of X-rays and this was from (1) family, friends and neighbours, (2) the school classroom, and (3) television programmes. Children had anxieties revealed through drawings and interviews. We recommend drawings for establishing children's views of radiology.

A data grid for imaging-based clinical trials

NASA Astrophysics Data System (ADS)

Zhou, Zheng; Chao, Sander S.; Lee, Jasper; Liu, Brent; Documet, Jorge; Huang, H. K.

2007-03-01

Clinical trials play a crucial role in testing new drugs or devices in modern medicine. Medical imaging has also become an important tool in clinical trials because images provide a unique and fast diagnosis with visual observation and quantitative assessment. A typical imaging-based clinical trial consists of: 1) A well-defined rigorous clinical trial protocol, 2) a radiology core that has a quality control mechanism, a biostatistics component, and a server for storing and distributing data and analysis results; and 3) many field sites that generate and send image studies to the radiology core. As the number of clinical trials increases, it becomes a challenge for a radiology core servicing multiple trials to have a server robust enough to administrate and quickly distribute information to participating radiologists/clinicians worldwide. The Data Grid can satisfy the aforementioned requirements of imaging based clinical trials. In this paper, we present a Data Grid architecture for imaging-based clinical trials. A Data Grid prototype has been implemented in the Image Processing and Informatics (IPI) Laboratory at the University of Southern California to test and evaluate performance in storing trial images and analysis results for a clinical trial. The implementation methodology and evaluation protocol of the Data Grid are presented.

Workflow management systems in radiology

NASA Astrophysics Data System (ADS)

Wendler, Thomas; Meetz, Kirsten; Schmidt, Joachim

1998-07-01

In a situation of shrinking health care budgets, increasing cost pressure and growing demands to increase the efficiency and the quality of medical services, health care enterprises are forced to optimize or complete re-design their processes. Although information technology is agreed to potentially contribute to cost reduction and efficiency improvement, the real success factors are the re-definition and automation of processes: Business Process Re-engineering and Workflow Management. In this paper we discuss architectures for the use of workflow management systems in radiology. We propose to move forward from information systems in radiology (RIS, PACS) to Radiology Management Systems, in which workflow functionality (process definitions and process automation) is implemented through autonomous workflow management systems (WfMS). In a workflow oriented architecture, an autonomous workflow enactment service communicates with workflow client applications via standardized interfaces. In this paper, we discuss the need for and the benefits of such an approach. The separation of workflow management system and application systems is emphasized, and the consequences that arise for the architecture of workflow oriented information systems. This includes an appropriate workflow terminology, and the definition of standard interfaces for workflow aware application systems. Workflow studies in various institutions have shown that most of the processes in radiology are well structured and suited for a workflow management approach. Numerous commercially available Workflow Management Systems (WfMS) were investigated, and some of them, which are process- oriented and application independent, appear suitable for use in radiology.

A-Z Directory | The University of Virginia

Science.gov Websites

/cardiovascular-medicine/ Cardiovascular Nutrition (Diet and Cardiovascular Disease) http Medicine) https://med.virginia.edu/ Clinical Nutrition Services https://uvahealth.com/services/nutrition ... Nuclear Medicine, Division of https://med.virginia.edu/radiology/ Nutrition Services (Department of

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holliday, B.

Information that would allow an assessment of the standard of radiological protection in the United Kingdom is very limited. The Radiological Protection Service (now the National Radiological Protection Board) has provided a monitoring and advisory service to dentists for many years but very limited use has been made of this service. In a recent survey a total of 114 dentists was visited in representative practices in South East England and it was established that only 6.5 per cent of dentists in general practice do not use radiography as an adjunct to their practice (Smith, 1969). In the 88 x-ray setsmore » which were examined, 24 per cent had less than the recommended thickness of aluminium filtration, while 25 per cent had a fixed field size which was larger than necessary for dental radiography, in addition 27 per cent of the timers were found to have an error of greater than 20 per cent in repetition of the pre-set exposure time. These figures are consistent with the results of surveys performed by the National Radiological ProteCtion Board at the request of dentists, but the sample has been small, i.e., a few per cent of dentists in general practice. It is also possible that these results are not typical as the dentist requesting such a survey may have a greater awareness than others of the need for protection.« less

Web-based segmentation and display of three-dimensional radiologic image data.

PubMed

Silverstein, J; Rubenstein, J; Millman, A; Panko, W

1998-01-01

In many clinical circumstances, viewing sequential radiological image data as three-dimensional models is proving beneficial. However, designing customized computer-generated radiological models is beyond the scope of most physicians, due to specialized hardware and software requirements. We have created a simple method for Internet users to remotely construct and locally display three-dimensional radiological models using only a standard web browser. Rapid model construction is achieved by distributing the hardware intensive steps to a remote server. Once created, the model is automatically displayed on the requesting browser and is accessible to multiple geographically distributed users. Implementation of our server software on large scale systems could be of great service to the worldwide medical community.

Update on the diagnostic radiology employment market: findings through 2006-2007.

PubMed

Sunshine, Jonathan H; Maynard, C Douglas

2007-10-01

To describe the employment market for diagnostic radiologists in 2006-2007, with attention to differences among subspecialties. The authors conducted the most recent in a series of annual surveys of vacancies in academic departments and obtained data from the placement service of the American College of Radiology (ACR), its Professional Bureau, during its operation at the annual meeting of the Radiological Society of North America. The two data series were correlated. The percentage of academic vacancies in each subspecialty was compared with the percentage of academic radiologists in that subspecialty. Job listings per job seeker at the placement service, which serves both community and academic positions, were 0.72 for 2007 compared with approximately 1.1 to 1.2 for 2003 to 2006 and variation from 0.25 to 3.8 in the preceding decade. The correlation of the two data series was 0.84 (P = .08) for the 5 years for which both are available. Particularly high ratios of academic vacancies to academic radiologists were found for interventional radiology and breast imaging; particularly low ratios were found for neuroradiology and nuclear radiology. The job market remains very much intermediate between the highs and lows that have occurred since 1990, but finding highly desirable jobs is likely to be somewhat more difficult, and filling vacancies somewhat easier, in 2007 than in the past few years. Interventional radiology and breast imaging are the subspecialties in which academic positions are most difficult to fill; neuroradiology and nuclear radiology seem to be at the opposite end of the spectrum. The same differences across subspecialties are probably found in community practice, given the strong correlation of the two data series.

42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

Code of Federal Regulations, 2013 CFR

2013-10-01

... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... means a radiologic procedure furnished to a woman without signs or symptoms of breast disease, for the...

42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... means a radiologic procedure furnished to a woman without signs or symptoms of breast disease, for the...

42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

Code of Federal Regulations, 2011 CFR

2011-10-01

... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... means a radiologic procedure furnished to a woman without signs or symptoms of breast disease, for the...

42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... means a radiologic procedure furnished to a woman without signs or symptoms of breast disease, for the...

Hanford radiological protection support services annual report for 1994

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lyon, M.; Bihl, D.E.; Fix, J.J.

1995-06-01

Various Hanford Site radiation protection services provided by the Pacific Northwest Laboratory for the US Department of Energy Richland Operations Office and Hanford contractors are described in this annual report for the calendar year 1994. These activities include external dosimetry measurements and evaluations, internal dosimetry measurements and evaluations, in vivo measurements, radiological record keeping, radiation source calibration, and instrument calibration and evaluation. For each of these activities, the routine program and any program changes or enhancements are described, as well as associated tasks, investigations, and studies. Program- related publications, presentations, and other staff professional activities are also described.

Hanford radiological protection support services. Annual report for 1995

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lyon, M.; Bihl, D.E.; Carbaugh, E.H.

1996-05-01

Various Hanford Site radiation protection services provided by the Pacific Northwest National Laboratory for the U.S. Department of Energy Richland Operations Office and Hanford contractors are described in this annual report for calendar year 1995. These activities include external dosimetry measurements and evaluations, internal dosimetry measurements and evaluations, in vivo measurements, radiological record keeping, radiation source calibration, and instrument calibration and evaluation. For each of these activities, the routine program and any program changes or enhancements are described, as well as associated tasks, investigations, and studies. Program-related publications, presentations, and other staff professional activities are also described.

Technical basis for implementation of remote reading capabilities for radiological control instruments at tank farms

DOE Office of Scientific and Technical Information (OSTI.GOV)

PIERSON, R.M.

1999-10-27

This document provides the technical basis for use of remote reading capabilities with radiological control instruments at River Protection Project facilities. The purpose of this document is to evaluate applications of remote reading capabilities with Radiological Control instrumentation to allow continuous monitoring of radiation dose rates at River Protection Project (RPP) facilities. In addition this document provides a technical basis and implementing guidelines for remote monitoring of dose rates and their potential contribution to maintaining radiation exposures ALARA.

Informatics in radiology: radiology gamuts ontology: differential diagnosis for the Semantic Web.

PubMed

Budovec, Joseph J; Lam, Cesar A; Kahn, Charles E

2014-01-01

The Semantic Web is an effort to add semantics, or "meaning," to empower automated searching and processing of Web-based information. The overarching goal of the Semantic Web is to enable users to more easily find, share, and combine information. Critical to this vision are knowledge models called ontologies, which define a set of concepts and formalize the relations between them. Ontologies have been developed to manage and exploit the large and rapidly growing volume of information in biomedical domains. In diagnostic radiology, lists of differential diagnoses of imaging observations, called gamuts, provide an important source of knowledge. The Radiology Gamuts Ontology (RGO) is a formal knowledge model of differential diagnoses in radiology that includes 1674 differential diagnoses, 19,017 terms, and 52,976 links between terms. Its knowledge is used to provide an interactive, freely available online reference of radiology gamuts ( www.gamuts.net ). A Web service allows its content to be discovered and consumed by other information systems. The RGO integrates radiologic knowledge with other biomedical ontologies as part of the Semantic Web. © RSNA, 2014.

Predicting No-Shows in Radiology Using Regression Modeling of Data Available in the Electronic Medical Record.

PubMed

Harvey, H Benjamin; Liu, Catherine; Ai, Jing; Jaworsky, Cristina; Guerrier, Claude Emmanuel; Flores, Efren; Pianykh, Oleg

2017-10-01

To test whether data elements available in the electronic medical record (EMR) can be effectively leveraged to predict failure to attend a scheduled radiology examination. Using data from a large academic medical center, we identified all patients with a diagnostic imaging examination scheduled from January 1, 2016, to April 1, 2016, and determined whether the patient successfully attended the examination. Demographic, clinical, and health services utilization variables available in the EMR potentially relevant to examination attendance were recorded for each patient. We used descriptive statistics and logistic regression models to test whether these data elements could predict failure to attend a scheduled radiology examination. The predictive accuracy of the regression models were determined by calculating the area under the receiver operator curve. Among the 54,652 patient appointments with radiology examinations scheduled during the study period, 6.5% were no-shows. No-show rates were highest for the modalities of mammography and CT and lowest for PET and MRI. Logistic regression indicated that 16 of the 27 demographic, clinical, and health services utilization factors were significantly associated with failure to attend a scheduled radiology examination (P ≤ .05). Stepwise logistic regression analysis demonstrated that previous no-shows, days between scheduling and appointments, modality type, and insurance type were most strongly predictive of no-show. A model considering all 16 data elements had good ability to predict radiology no-shows (area under the receiver operator curve = 0.753). The predictive ability was similar or improved when these models were analyzed by modality. Patient and examination information readily available in the EMR can be successfully used to predict radiology no-shows. Moving forward, this information can be proactively leveraged to identify patients who might benefit from additional patient engagement through appointment reminders or other targeted interventions to avoid no-shows. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Cutting costs: the impact of price lists on the cost development at the emergency department.

PubMed

Schilling, Ulf Martin

2010-12-01

It was shown that physicians working at the Swedish emergency department (ED) are unaware of the costs for investigations performed. This study evaluated the possible impact of price lists on the overall laboratory and radiology costs at the ED of a Swedish university hospital. Price lists including the most common laboratory analyses and radiological investigations at the ED were created. The lists were distributed to all internal medicine physicians by e-mail and exposed above their working stations continually. No lists were provided for the orthopaedic control group. The average costs for laboratory and radiological investigations during the months of June and July 2007 and 2008 were calculated. Neither clinical nor admission procedures were changed. The physicians were blinded towards the study. Statistical analysis was performed using the Student's t-test. A total of 1442 orthopaedic and 1585 medical patients were attended to in 2007. In 2008, 1467 orthopaedic and 1637 medical patients required emergency service. The average costs per patient were 980.27 SKR (98€)/999.41 SKR (100€, +1.95%) for orthopaedic and 1081.36 SKR (108€)/877.3 SKR (88€, -18.8%) for medical patients. Laboratory costs decreased by 9% in orthopaedic and 21.4% in medical patients. Radiology costs changed +5.4% in orthopaedic and -20.59% in medical patients. The distribution and promotion of price lists as a tool at the ED to heighten cost awareness resulted in a major decrease in the investigation costs. A significant decrease in radiological costs could be observed. It can be concluded that price lists are an effective tool to cut costs in public healthcare.

42 CFR 37.40 - General provisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations...; or (2) By a radiologic technologist as defined in § 37.2. ...

[Analysis of activities of the preventive dentistry service in the Health Area 8 of the Valencia Autonomous Region].

PubMed

Llena Puy, M C; Ausina Márquez, V

1996-02-29

We describe and analize the activities we carried out in a surgery from a preventive dentistry unit. Longitudinal descriptive study from 1993 since 1994. Health Area 8 from the Valencian Autonomous Region. Children from 3 to 14 year-old attendant to the preventive dentistry unit's surgery (2.497). We visited 5.012 children. The highest percentage of population corresponded to the zona 4, where began at first the preventive service. The activities distribution was as follow: oral explorations and plaque control (100%), fluoride topic aplication (90.38%), diet control (36.81%), pit and fisure sealants (6.46%), profilaxis (8.71%), radiological diagnosis (6.46%), dental emergencies (2.17%). The users origin was: 38.88% school oral explorations made over 6- and 10-year-old children; 63.71% from self-request; and 16.45% sent by other health professionals. 41.42% were continuated visits. Demand of preventive dental services is very high in our health area, although incorporation of therapeutic techniques is wished by the population. This demand increase as well as the surgery is closer to the user. People from big cities are stubborn using these services from smallest villages, even having transport facilities. Children start coming to the consults between 5-6 year-old, keeping an acceptable control until 12 approximately.

The decision-making matrix of propensity to outsourcing hospital services in Bandar Abbas, Iran.

PubMed

Hayati, Ramin; Setoodehzadeh, Fateme; Heydarvand, Sanaz; Khammarnia, Mohammad; Ravangard, Ramin; Sadeghi, Ahmad; Sobhani, Ghasem

2015-12-01

To determine the level of managers' propensity for outsourcing the services in hospitals using decision-making matrix. The applied, cross-sectional study was conducted at three hospitals affiliated to Bandar Abbas University of Medical Sciences, Iran, in 2013, and comprised managers and employees of four service units: radiology, laboratory, nursing, and nutrition services. Data was collected using two questionnaires and face-to-face interviews. Data was analysed using SPSS 16 and by using decision-making matrix. Of the 122 subjects in the study, 12(9.8%) were managers and 110(90.2%) were other employees. The highest and lowest propensities for outsourcing were related to nutrition (66.6%) and nursing services one (8.33%). The decision-making matrix showed low outsourcing of the nursing, radiology, and laboratory services based on the services' features. However, there were difference between the results obtained from laboratory service decision-making matrix and the propensity for laboratory service outsourcing. The difference between the results obtained from the matrix and managers' viewpoint can be due to the lack of managers' sufficient attention to the features of hospital services when making decisions on outsourcing them.

Assessing the impact of a radiology information management system in the emergency department

NASA Astrophysics Data System (ADS)

Redfern, Regina O.; Langlotz, Curtis P.; Lowe, Robert A.; Horii, Steven C.; Abbuhl, Stephanie B.; Kundel, Harold L.

1998-07-01

To evaluate a conventional radiology image management system, by investigating information accuracy, and information delivery. To discuss the customization of a picture archival and communication system (PACS), integrated radiology information system (RIS) and hospital information system (HIS) to a high volume emergency department (ED). Materials and Methods: Two data collection periods were completed. After the first data collection period, a change in work rules was implemented to improve the quality of data in the image headers. Data from the RIS, the ED information system, and the HIS as well as observed time motion data were collected for patients admitted to the ED. Data accuracy, patient waiting times, and radiology exam information delivery were compared. Results: The percentage of examinations scheduled in the RIS by the technologists increased from 0% (0 of 213) during the first period to 14% (44 of 317) during the second (p less than 0.001). The percentage of images missing identification numbers decreased from 36% (98 of 272) during the first data collection period to 10% (56 of 562) during the second period (p less than 0.001). Conclusions: Radiologic services in a high-volume ED, requiring rapid service, present important challenges to a PACS system. Strategies can be implemented to improve accuracy and completeness of the data in PACS image headers in such an environment.

DR AVRAM JOZEF VINAVER (1862-1915) - PIONEER OF RADIOLOGY IN SERBIA.

PubMed

Babić, Rade Radomir; Stanković Babić, Gordana

2015-01-01

Dr Abraham Joseph Vinaver (1862-1915), a Jew from Poland, was a pioneer of radiology in Serbia. He graduated from the Faculty of Medicine in Warsaw (1887), but lived and worked in abac (the Kingdom of Serbia) since 1890. Dr Abraham Joseph Vinarev - Career Development. He procured the first X-ray machine and developed radiological service in Sabac five years after the discovery of X-rays. These were the beginnings of radiology in Serbia. He introduced the application of artesian wells. Dr Abraham Joseph Vinarev - a Participant at the First Congress of Serbian Physicians and Naturalists, Belgrade 1904. "The diagnostic importance of X-rays in lung disease, especially in initial tuberculosis" and "Five Years of Treatment by X-Ray Machines" were the first works in the field of radiology in Serbia by this author. Dr Abraham Joseph Vinaver - Reserve Medical Officer in the Serbian Army. During the Balkan Wars, he was a volunteer with the rank of major engaged in military corps and he participated in the First World War as well. He died of malaria in 1915 in Gevgelija. "Dr Avram Vinaver"- Stanislav Vinarev. His dedication to work during the typhus epidemics was put into verses of a poem by his son Stanislav Vinarev. Dr Avram Vinaver Joseph was a noble man with a great heart, who selflessly sacrificed himself for the Serbian people and Serbia. He gave his contribution to the development of health services in Serbia, both in peacetime and wartime conditions. Dr Abraham Joseph Vinaver laid the foundations for today's radiology in Serbia.

Westinghouse corporate development of a decision software program for Radiological Evaluation Decision Input (REDI)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bush, T.S.

1995-03-01

In December 1992, the Department of Energy (DOE) implemented the DOE Radiological Control Manual (RCM). Westinghouse Idaho Nuclear Company, Inc. (WINCO) submitted an implementation plan showing how compliance with the manual would be achieved. This implementation plan was approved by DOE in November 1992. Although WINCO had already been working under a similar Westinghouse RCM, the DOE RCM brought some new and challenging requirements. One such requirement was that of having procedure writers and job planners create the radiological input in work control procedures. Until this time, that information was being provided by radiological engineering or a radiation safety representative.more » As a result of this requirement, Westinghouse developed the Radiological Evaluation Decision Input (REDI) program.« less

Radiological control manual. Revision 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kloepping, R.

1996-05-01

This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPPmore » and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP.« less

Telemedicine and pediatric radiology: a new environment for training, learning, and interactive discussions.

PubMed

Monteiro, Alexandra M V; Corrêa, Diogo Goulart; Santos, Alair Augusto Sarmet M D; Cavalcanti, Silvio A; Sakuno, Telma; Filgueiras, Tereza; Just, Eduardo; Santos, Munique; Messina, Luiz Ary; Haddad, Ana Estela; Marchiori, Edson

2011-12-01

To report the experience of the Brazilian Program of Pediatric Teleradiology in combining teleconferencing and a virtual learning environment for services integration, collaborative research, and continuing education in pediatric radiology. We performed virtual meetings from March 2005 to October 2010 on pediatric radiology-related themes, using a combination of videoconferences and Web conferences, which were recorded and made available in an open-source software (Moodle) for reuse. We performed 58 virtual sessions: 29 anatomical-clinical-radiological sessions, 28 on upgrading themes, and 1 virtual symposium. The average of connected points was 12 by videoconference and 39 by Web conference, and of 450 participants per event. At the time of this writing, 318 physicians and students are registered in the virtual learning environment, with a total of 14,678 accesses. Telemedicine is being included in pediatric radiology practice, as a means for distance education, training, and continuing integration between groups.

Radiology Architecture Project Primer.

PubMed

Sze, Raymond W; Hogan, Laurie; Teshima, Satoshi; Davidson, Scott

2017-12-19

The rapid pace of technologic advancement and increasing expectations for patient- and family-friendly environments make it common for radiology leaders to be involved in imaging remodel and construction projects. Most radiologists and business directors lack formal training in architectural and construction processes but are expected to play significant and often leading roles in all phases of an imaging construction project. Avoidable mistakes can result in significant increased costs and scheduling delays; knowledgeable participation and communication can result in a final product that enhances staff workflow and morale and improves patient care and experience. This article presents practical guidelines for preparing for and leading a new imaging architectural and construction project. We share principles derived from the radiology and nonradiology literature and our own experience over the past decade completely remodeling a large pediatric radiology department and building a full-service outpatient imaging center. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

42 CFR 416.171 - Determination of payment rates for ASC services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... services. (d) Limitation on payment rates for office-based surgical procedures and covered ancillary... nonfacility practice expense relative value units under § 414.22(b)(5)(i)(B) of this subchapter multiplied by... payment rate for covered ancillary radiology services that involve certain nuclear medicine procedures...

42 CFR 416.171 - Determination of payment rates for ASC services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... services. (d) Limitation on payment rates for office-based surgical procedures and covered ancillary... nonfacility practice expense relative value units under § 414.22(b)(5)(i)(B) of this subchapter multiplied by... payment rate for covered ancillary radiology services that involve certain nuclear medicine procedures...

Building a leadership team that works.

PubMed

Blomenberg, Emily M

2005-01-01

Radiology administrators often are challenged to do more with less. In today's fast-paced work environment, leaders must be creative. They must surround themselves with good people in order to successfully achieve their organizations' goals. Once a radiology administrator is satisfied and comfortable that he or she has, the right staff involved, a leadership team can be formally establislished. Howard Regional Health System established an Imaging Services Leadership Team with a vision to provide leaders for the staff to "follow," just as team members learn from the radiology administrator. In addition, team members are vital in assisting the radiology administrator in managing the department The process of building the team consisted of 3 steps: selecting team members (the most challenging and time-consuming component), formalizing a functional team, and putting the team into action. Finding the right people, holding regular meetings, and making those team meetings meaningful are keys to a successful leadership team. The implementation of the team has had a positive effect on imaging services: the number of procedures has increased, the team is used as a communication tool for front-line staff, front-line staff are becoming more comfortable with making decisions.

Impact of chiropractic services at an on-site health center.

PubMed

Kindermann, Sylvia L; Hou, Qingjiang; Miller, Ross M

2014-09-01

To compare the influence of employer-sponsored, on-site chiropractic care against community-obtained care on health care utilization. This was a retrospective claims analysis of members of a single employee health plan receiving chiropractic care on-site or off-site from 2010 to 2012. Utilization differences were evaluated by having 1 health care event or more, including radiology or clinical visits. There were 876 on-site and 759 off-site participants. The off-site group received more radiology services overall (55.5% vs 38.2%; P < 0.001) including magnetic resonance imaging, ultrasound, and radiograph (all P < 0.0001); had higher outpatient (P < 0.0001) and emergency department (P = 0.022) utilization; and demonstrated greater use of chiropractic care and physical therapy (both P < 0.0001). Compared with off-site care, on-site chiropractic services are associated with lower health care utilization. These results support the value of chiropractic services offered at on-site health centers.

A national survey exploring UK trainees' perceptions, core training experience, and decisions to pursue advanced training in breast radiology.

PubMed

Lowes, S; Bydder, M; Sinnatamby, R

2017-11-01

To investigate UK radiology trainees' perceptions of breast radiology and the factors that influenced their decision whether or not to choose breast radiology as an area of special interest. An online survey was compiled and distributed to all UK specialty trainees in clinical radiology via the Royal College of Radiologists Junior Radiologists' Forum (JRF) regional representatives. There were 275 respondents, representing 22% of all UK radiology trainees. Responses were received from all regions. A significant factor identified in influencing whether or not trainees decide to pursue advanced training in breast radiology is the timing and quality of their initial core training experience. Specific positive aspects of breast radiology that were repeatedly identified included the high level of patient contact and frequent use of interventional procedures. Recurring negative aspects of breast radiology included isolation from general radiology and finding the subject matter boring. Breast radiology faces a significant workforce shortfall that is predicted to worsen in the coming years. There has never been a greater need to recruit specialty trainees into this field, and action is urgently needed to help ensure the sustainability of breast services and drive further improvements to patient care. The findings from this survey should be regarded as a challenge to all breast radiologists to engage with trainees from an early stage in their training and to enthuse them with the many positive aspects of a career in breast radiology. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

ACR white paper on teleradiology practice: a report from the Task Force on Teleradiology Practice.

PubMed

Silva, Ezequiel; Breslau, Jonathan; Barr, Robert M; Liebscher, Lawrence A; Bohl, Michael; Hoffman, Thomas; Boland, Giles W L; Sherry, Cynthia; Kim, Woojin; Shah, Samir S; Tilkin, Mike

2013-08-01

Teleradiology services are now embedded into the workflow of many radiology practices in the United States, driven largely by an expanding corporate model of services. This has brought opportunities and challenges to both providers and recipients of teleradiology services and has heightened the need to create best-practice guidelines for teleradiology to ensure patient primacy. To this end, the ACR Task Force on Teleradiology Practice has created this white paper to update the prior ACR communication on teleradiology and discuss the current and possible future state of teleradiology in the United States. This white paper proposes comprehensive best-practice guidelines for the practice of teleradiology, with recommendations offered regarding future actions. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[The Mexican Institute of Social Security Institute (IMSS) in Numbers. Functional inventory of imaging medical equipment, 2003].

PubMed

2005-01-01

Medical technology is a fundamental instrument for the provision of health services in the Mexican Institute of Social Security (IMSS) and as a support for diagnostic and therapeutic interventions. The inventory of relevant medical equipment describes the needs for upgrading the technological infrastructure, organize its distribution and plan its renovation in order to guarantee the quality of health services. In this report we describe the type of equipment used in radiology and other imaging services, its geographical distribution, median age in operation and its productivity. The inventory reported 2091 pieces of equipment, ultrasonography and radiology were the most common types (31%) followed by fluoroscopic equipment (20%). Follow-up in the inventory should help in planning the acquisition and maintenance of sophisticated technology used for medical purposes.

CONFIRMATORY SURVEY OF THE DEFENSE LOGISTICS AGENCY, DEFENSE NATIONAL STOCKPILE CENTER NEW HAVEN DEPOT, NEW HAVEN, INDIANA

DOE Office of Scientific and Technical Information (OSTI.GOV)

E.M. Harpenau

2010-02-19

The objectives of the radiological confirmatory survey were to collect adequate radiological data for use in evaluating the radiological condition of NHD land areas, warehouses, and support buildings. The data generated from the confirmatory survey activities were used to evaluate the results of the Final Status Survey Report (FSSR) submitted by Cabrera Services (Cabrera 2009). Cabrera has stated that all radioactive materials have been removed and that remediation of the open land areas and structure surfaces was complete, and that the NHD meets the criteria for unrestricted use.

42 CFR 37.40 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations... quality to best ascertain the presence of pneumoconiosis; or (2) By a radiologic technologist as defined...

26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... illustrated by the following example. Example. An organization performs industrial engineering services on a...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial engineering (including the installation, maintenance and repair of biomedical and similar equipment...

26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... illustrated by the following example. Example. An organization performs industrial engineering services on a...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial engineering (including the installation, maintenance and repair of biomedical and similar equipment...

26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... illustrated by the following example. Example. An organization performs industrial engineering services on a...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial engineering (including the installation, maintenance and repair of biomedical and similar equipment...

26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... illustrated by the following example. Example. An organization performs industrial engineering services on a...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial engineering (including the installation, maintenance and repair of biomedical and similar equipment...

26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... illustrated by the following example. Example. An organization performs industrial engineering services on a...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial engineering (including the installation, maintenance and repair of biomedical and similar equipment...

Edith (1869-1938) and Florence (1870-1932) Stoney, two Irish sisters and their contribution to radiology during the World War I.

PubMed

Guy, Jean M

2013-05-01

Edith and Florence Stoney, two sisters born in Dublin and working in London, responded to the summons of suffragists and offered themselves for medical service in World War I. Each had a strong scientific background and experience that they were able to use in setting up and running radiological services in Belgium, France, Serbia and Macedonia. The British War Office was reluctant to employ women doctors but the work Florence and her colleagues achieved persuaded Sir Alfred Keogh that Florence should be the first woman doctor to be employed in a military hospital in England.

Administration of the Radiation Control for Health and Safety Act of 1968, Public Law 90-602, April 1, 1985 (1984 annual report). Report for 1 January-31 December 1984

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The Secretary of Health and Human Services is required by Subpart 3, Part F of Title III of the Public Health Service Act; 42 USC 263b et seq. (Public Law 90-602) to submit an annual report to the President for transmittal to the Congress on or before April 1 on the administration of the Radiation Control for Health and Safety Act. The detailed information required to be included in the report is outlined in Section 360D of the Public Health Service Act. The Food and Drug Administration, through its Center for Devices and Radiological Health, is responsible for the day-to-daymore » administration of the Act. The report covers the detailed operation of the Agency in carrying out that responsibility for calendar year 1984. Manufacturers of electronic products are required by 21 CFR 1002.20 to report accidental radiation occurrences to the CDRH, FDA. During the calendar year 1984, the Radiation Incidents Registry received 11 reports alleging injury involving 235 persons.« less

The RAC program: what can radiology providers expect as RACs begin auditing?

PubMed

Pendleton, Abby; Gustafson, Jessica L

2009-01-01

The Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program has been made permanent and is expanding nationwide. Radiology providers should be ready for increased Medicare auditing activity as the RAC expands. Should a provider or supplier be subject to a RAC audit, effective strategies are available that can be successfully employed in the appeals process to challenge denials.

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

Annual radiological environmental operating report: Browns Ferry Nuclear Plant, 1992. Operations Services/Technical Programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-04-01

This report describes the environmental radiological monitoring program conducted by TVA in the vicinity of Browns Ferry Nuclear Plant (BFN) in 1992. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiationmore » levels. Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts of plant operations. Small amounts of Co-60 and Cs-134 were found in sediment samples downstream from the plant. This activity in stream sediment would result in no measurable increase over background in the dose to the general public.« less

TRENCADIS--a WSRF grid MiddleWare for managing DICOM structured reporting objects.

PubMed

Blanquer, Ignacio; Hernandez, Vicente; Segrelles, Damià

2006-01-01

The adoption of the digital processing of medical data, especially on radiology, has leaded to the availability of millions of records (images and reports). However, this information is mainly used at patient level, being the extraction of information, organised according to administrative criteria, which make the extraction of knowledge difficult. Moreover, legal constraints make the direct integration of information systems complex or even impossible. On the other side, the widespread of the DICOM format has leaded to the inclusion of other information different from just radiological images. The possibility of coding radiology reports in a structured form, adding semantic information about the data contained in the DICOM objects, eases the process of structuring images according to content. DICOM Structured Reporting (DICOM-SR) is a specification of tags and sections to code and integrate radiology reports, with seamless references to findings and regions of interests of the associated images, movies, waveforms, signals, etc. The work presented in this paper aims at developing of a framework to efficiently and securely share medical images and radiology reports, as well as to provide high throughput processing services. This system is based on a previously developed architecture in the framework of the TRENCADIS project, and uses other components such as the security system and the Grid processing service developed in previous activities. The work presented here introduces a semantic structuring and an ontology framework, to organise medical images considering standard terminology and disease coding formats (SNOMED, ICD9, LOINC..).

Medical examinations for radiation workers

NASA Technical Reports Server (NTRS)

Alexander, R. E.

1969-01-01

The NASA radiological protection policy allows an employee to be assigned work in a radiologically controlled area only if all of the following conditions are met: (1) The area must be radiologically safe for the intended operations; (2) the employee must be medically fit; (3) the employee must be properly trained; (4) appropriate radiation protection procedures must be prepared; (5) appropriate dosimetric, survey, surveillance and reporting procedures must be implemented; and (6) adequate controls and records must be established.

JOURNAL CLUB: Radiologists' Online Identities: What Patients Find When They Search Radiologists by Name.

PubMed

Vijayasarathi, Arvind; Loehfelm, Thomas; Duszak, Richard; Hawkins, C Matthew

2016-11-01

Patients are increasingly seeking online information regarding their health and their health care providers. Concurrently, more patients are accessing their electronic medical records, including their radiology reports, via online portals. Thus, this study aims to characterize what patients find when they search for radiologists online. All Medicare-participating U.S. radiologists were identified using the Physician Compare National Downloadable File dataset obtained from the Centers for Medicare & Medicaid Services (CMS). Using a custom application, the top 10 Google search results for each radiologist in the national dataset were retrieved, and 90.5% of website domains with more than one occurrence were categorized as follows: physician or institution controlled, third party-controlled physician information systems, social media, or other. Aggregate and subgroup analyses were performed. Of all U.S. health care providers recognized by CMS, 30,601 self-identified as radiologists. There was at least one search result for 30,600 radiologists (99.997%), for a total of 305,795 websites. Of all the domains, 69.8% were third party-controlled physician information systems, 17.7% were physician or institution controlled, 1.0% were social media platforms, 2.1% were other, and 9.5% were not classified. Nine of the top 10 most commonly encountered domains were commercially controlled third-party physician information systems. Most U.S. radiologists lack self-controlled online content within the first page of Google search results. Opportunities exist for individual radiologists, radiology groups, academic departments, and professional societies to amend their online presence, control the content patients discover, and improve the visibility of the field at large.

Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination.

PubMed

Grayson, James; Basciano, Peter; Rawson, James V; Klein, Kandace

2015-12-01

The aim of this study was to examine the referral pattern of imaging studies requested in a single state compared with the potential location of interpretation. Analysis of Medicare patients in a DocGraph data set was performed to identify sequential different physician services claims for the same patient for which the second claim was for services provided by a radiologist. In the 2011 Medicare population, radiology referrals from physicians practicing in Georgia resulted in 76.5% of radiology interpretations by radiologists inside the state of Georgia. The states bordering Georgia accounted for 11.6% of interpretations in the Georgia market. The remaining interpretations were distributed throughout the remainder of the country. A significant proportion of routine imaging interpretation occurs outside the state in which an examination is performed. Additional studies are needed to identify complex drivers of imaging referral patterns, such as patient geographic location and demographics, radiologist workforce distribution, contractual obligations, and social relationships. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Assessment of medical occupational radiation doses in Costa Rica.

PubMed

Mora, P; Acuña, M

2011-09-01

Participation of the University of Costa Rica (UCR) in activities in an IAEA Regional Project RLA/9/066 through training, equipment and expert missions, has enabled to setting up of a national personal monitoring laboratory. Since 2007, the UCR has been in charge of monitoring around 1800 medical radiation workers of the Social Security System. Individual external doses are measured with thermoluminescent dosemeter using a Harshaw 6600 Plus reader. The service has accreditation with ISO/IEC 17025:2005. Distribution of monitored medical personnel is as follows: 83 % in diagnostic radiology, 6 % in nuclear medicine and 6 % in radiotherapy. Preliminary values for the 75 percentile of annual H(p)(10) in mSv are: radiology 0.37; interventional radiology 0.41; radiotherapy 0.53 and nuclear medicine 1.55. The service provided by the UCR in a steady and reliable way can help to implement actions to limit the doses received by the medical workers and optimise their radiation protection programs.

WE-E-16A-01: Medical Physics Economics Update

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goodwin, J; Dirksen, B; White, G

Radiology and Medical Physics reimbursement for Medicare services is constantly changing. In this presentation we will review the proposed reimbursement rules and levels for 2015 and compare them with those currently in effect for 2014. In addition, we will discuss the challenges that may lie ahead for the medical physics profession as the Centers for Medicare and Medicaid Services (CMS) moves away from a fee for service payment model and towards one of prospective payment. Learning Objectives: Understand the differences in the Medicare reimbursement systems for outpatient departments as opposed to physicians and free standing centers. Learn the proposed Medicaremore » rules for 2015 and how they may affect Radiology and Medical Physics revenues. Be aware of possible long term changes in reimbursement and how they may affect our employers, our pocket books and our profession.« less

42 CFR 37.40 - General provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic Examinations Specifications for... the presence of pneumoconiosis; or (2) By a radiologic technologist as defined in § 37.2. [77 FR 56729...

77 FR 38071 - Statement of Organization, Functions and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

... countermeasures against chemical, biological, radiological and nuclear agents of terrorism, epidemics, and... engineering services and ensuring compliance with historic preservation and other laws and regulations related...) provides architectural and engineering services to other Agencies such as the Administration for Children...

Cooperative Efforts within the US Military Health Services System

DTIC Science & Technology

1985-05-01

sultation provi’dtd in the diagnosis of disease. The Center for Advanced Pathology includes such specialized areas as forensic , radiologic, dental and...medical entomology programs within the three Military Medical- Services were-reorganized into a single Department of Defense Organizational Board

Modeling of workflow-engaged networks on radiology transfers across a metro network.

PubMed

Camorlinga, Sergio; Schofield, Bruce

2006-04-01

Radiology metro networks bear the challenging proposition of interconnecting several hospitals in a region to provide a comprehensive diagnostic imaging service. Consequences of a poorly designed and implemented metro network could cause delays or no access at all when health care providers try to retrieve medical cases across the network. This could translate into limited diagnostic services to patients, resulting in negative impacts to the patients' medical treatment. A workflow-engaged network (WEN) is a new network paradigm. A WEN appreciates radiology workflows and priorities in using the network. A WEN greatly improves the network performance by guaranteeing that critical image transfers experience minimal delay. It adjusts network settings to ensure the application's requirements are met. This means that high-priority image transfers will have guaranteed and known delay times, whereas lower-priority traffic will have increased delays. This paper introduces a modeling to understand the benefits that WEN brings to a radiology metro network. The modeling uses actual data patterns and flows found in a hospital metro region. The workflows considered are based on the Integrating the Healthcare Enterprise profiles. This modeling has been applied to metropolitan workflows of a health region. The modeling helps identify the kind of metro network that supports data patterns and flows in a metro area. The results of the modeling show that a 155-Mb/s metropolitan area network (MAN) with WEN operates virtually equal to a normal 622-Mb/s MAN without WEN, with potential cost savings for leased line services measured in the millions of dollars per year.

Reinventing radiology reimbursement.

PubMed

Marshall, John; Adema, Denise

2005-01-01

Lee Memorial Health System (LMHS), located in southwest Florida, consists of 5 hospitals, a home health agency, a skilled nursing facility, multiple outpatient centers, walk-in medical centers, and primary care physician offices. LMHS annually performs more than 300,000 imaging procedures with gross imaging revenues exceeding dollar 350 million. In fall 2002, LMHS received the results of an independent audit of its IR coding. The overall IR coding error rate was determined to be 84.5%. The projected net financial impact of these errors was an annual reimbursement loss of dollar 182,000. To address the issues of coding errors and reimbursement loss, LMHS implemented its clinical reimbursementspecialist (CRS) system in October 2003, as an extension of financial services' reimbursement division. LMHS began with CRSs in 3 service lines: emergency department, cardiac catheterization, and radiology. These 3 CRSs coordinate all facets of their respective areas' chargemaster, patient charges, coding, and reimbursement functions while serving as a resident coding expert within their clinical areas. The radiology reimbursement specialist (RRS) combines an experienced radiologic technologist, interventional technologist, medical records coder, financial auditor, reimbursement specialist, and biller into a single position. The RRS's radiology experience and technologist knowledge are key assets to resolving coding conflicts and handling complex interventional coding. In addition, performing a daily charge audit and an active code review are essential if an organization is to eliminate coding errors. One of the inherent effects of eliminating coding errors is the capturing of additional RVUs and units of service. During its first year, based on account level detail, the RRS system increased radiology productivity through the additional capture of just more than 3,000 RVUs and 1,000 additional units of service. In addition, the physicians appreciate having someone who "keeps up with all the coding changes" and looks out for the charges. By assisting a few physicians' staff with coding questions, providing coding updates, and allowing them to sit in on educational sessions, at least 2 physicians have transferred some their volume to LMHS from a competitor. The provision of a "clean account," without coding errors, allows the biller to avoid the rework and billing delays caused by coding issues. During the first quarter of the RRS system, the billers referred an average of 9 accounts per day for coding resolution. During the fourth quarter of the system, these referrals were reduced to less than one per day. Prior to the RRS system, resolving these issues took an average of 4 business days. Now the conflicts are resolved within 24 hours.

Cervical Spine Status of Pilots and Air-Controllers of Airborne Early Warning and Control Aircraft.

PubMed

Shin, Young Ho; Yun, Chul; Han, Andrew Hogyu

2017-05-01

Many countries have developed their own airborne early warning and control (AEW&C) systems for use in surveying their territorial sky in real time. However, a review of the literature suggests that no studies have been conducted to analyze the cervical spine of pilots and air-controllers of AEW&C aircraft. The study subjects were 80 pilots and air-controllers of AEW&C aircraft with a period of service of > 1 yr and had data on physical examinations, simple radiographs and functional scores of the axial skeleton, and questionnaires about lifestyle and working conditions. Information about physical characteristics and experience of neck pain were collected. Functional scores including the neck disability index and short-form 36-item health survey were obtained. Radiological measurements were performed for the C2-7 Cobb angle and degree of forward head posture. Of the 80 subjects, 33 (41.3%) had experienced neck pain and 63 (78.8%) had impaired cervical lordosis. The results of functional and radiological evaluations were not significantly different between pilots and air-controllers. In multivariate analysis, only the age was significantly related to the occurrence of impaired cervical lordosis. However, there were no significant factors related to the occurrence of neck pain. The results of this study suggest that the working environment of pilots and air-controllers of AEW&C aircraft has a negative effect on their cervical spine. Age seemed to be the most significant factor affecting the occurrence of impaired cervical lordosis in these subjects.Shin YH, Yun C, Han AH. Cervical spine status of pilots and air-controllers of airborne early warning and control aircraft. Aerosp Med Hum Perform. 2017; 88(5):476-480.

Inpatient Complexity in Radiology-a Practical Application of the Case Mix Index Metric.

PubMed

Mabotuwana, Thusitha; Hall, Christopher S; Flacke, Sebastian; Thomas, Shiby; Wald, Christoph

2017-06-01

With ongoing healthcare payment reforms in the USA, radiology is moving from its current state of a revenue generating department to a new reality of a cost-center. Under bundled payment methods, radiology does not get reimbursed for each and every inpatient procedure, but rather, the hospital gets reimbursed for the entire hospital stay under an applicable diagnosis-related group code. The hospital case mix index (CMI) metric, as defined by the Centers for Medicare and Medicaid Services, has a significant impact on how much hospitals get reimbursed for an inpatient stay. Oftentimes, patients with the highest disease acuity are treated in tertiary care radiology departments. Therefore, the average hospital CMI based on the entire inpatient population may not be adequate to determine department-level resource utilization, such as the number of technologists and nurses, as case length and staffing intensity gets quite high for sicker patients. In this study, we determine CMI for the overall radiology department in a tertiary care setting based on inpatients undergoing radiology procedures. Between April and September 2015, CMI for radiology was 1.93. With an average of 2.81, interventional neuroradiology had the highest CMI out of the ten radiology sections. CMI was consistently higher across seven of the radiology sections than the average hospital CMI of 1.81. Our results suggest that inpatients undergoing radiology procedures were on average more complex in this hospital setting during the time period considered. This finding is relevant for accurate calculation of labor analytics and other predictive resource utilization tools.

Pediatric interventional radiology clinic - how are we doing?

PubMed

Rubenstein, Jonathan; Zettel, Julie C; Lee, Eric; Cote, Michelle; Aziza, Albert; Connolly, Bairbre L

2016-07-01

Development of a pediatric interventional radiology clinic is a necessary component of providing a pediatric interventional radiology service. Patient satisfaction is important when providing efficient, high-quality care. To analyze the care provided by a pediatric interventional radiology clinic from the perspective of efficiency and parent satisfaction, so as to identify areas for improvement. The prospective study was both quantitative and qualitative. The quantitative component measured clinic efficiency (waiting times, duration of clinic visit, nurse/physician time allocation and assessments performed; n = 91). The qualitative component assessed parental satisfaction with their experience with the pediatric interventional radiology clinic, using a questionnaire (5-point Likert scale) and optional free text section for feedback (n = 80). Questions explored the family's perception of relevance of information provided, consent process and overall satisfaction with their pediatric interventional radiology clinic experience. Families waited a mean of 11 and 10 min to meet the physician and nurse, respectively. Nurses and physicians spent a mean of 28 and 21 min with the families, respectively. The average duration of the pediatric interventional radiology clinic consultation was 56 min. Of 80 survey participants, 83% were satisfied with their experience and 94% said they believed providing consent before the day of the procedure was helpful. Only 5% of respondents were not satisfied with the time-efficiency of the interventional radiology clinic. Results show the majority of patients/parents are very satisfied with the pediatric interventional radiology clinic visit. The efficiency of the pediatric interventional radiology clinic is satisfactory; however, adherence to stricter scheduling can be improved.

WE-D-16A-01: ACR Radiology Leadership Institute

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rubin, G

The Radiology Leadership Institute (RLI) was established in 2011 by the American College of Radiology with a mission to prepare leaders who will shape the future of radiology to ensure quality, elevate service and deliver extraordinary patient care. Leadership skills are critical to medical physicists in order for them to assure that imaging and therapy are safe and of the highest quality possible. This session will provide an introduction to the RLI and its programs with an emphasis on how medical physicists can get involved and what they might expect to gain through their engagement with the RLI. The sessionmore » will also provide a framework for leadership in healthcare with an emphasis on roles and opportunities for medical physicists to enhance their effectiveness as members of the healthcare, medical education, and research communities.« less

Branching out with filmless radiology.

PubMed

Carbajal, R; Honea, R

1999-05-01

Texas Children's Hospital, a 456 bed pediatric hospital located in the Texas Medical Center, has been constructing a large-scale picture archiving and communications system (PACS), including ultrasound (US), computed tomography (CT), magnetic resonance (MR), and computed radiography (CR). Until recently, filmless radiology operations have been confined to the imaging department, the outpatient treatment center, and the emergency center. As filmless services expand to other clinical services, the PACS staff must engage each service in a dialog to determine the appropriate level of support required. The number and type of image examinations, the use of multiple modalities and comparison examinations, and the relationship between viewing and direct patient care activities have a bearing on the number and type of display stations provided. Some of the information about customer services is contained in documentation already maintained by the imaging department. For example, by a custom report from the radiology information system (RIS), we were able to determine the number and type of examinations ordered by each referring physician for the previous 6 months. By compiling these by clinical service, we were able to determine our biggest customers by examination type and volume. Another custom report was used to determine who was requesting old examinations from the film library. More information about imaging usage was gathered by means of a questionnaire. Some customers view images only where patients are also seen, while some services view images independently from the patient. Some services use their conference rooms for critical image viewing such as treatment planning. Additional information was gained from geographical surveys of where films are currently produced, delivered by the film library, and viewed. In some areas, available space dictates the type and configuration of display station that can be used. Active participation in the decision process by the clinical service is a key element to successful filmless operations.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

A Mars Science Laboratory cap is displayed in the Randall E. Scott Radiological Control Center at NASA's Kennedy Space Center. The facility was recently named in honor of Randy Scott, a professional health physicist of more than 40 years. He served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016. Launched Nov. 26, 2011, the Mars Science Laboratory with the Curiosity lander was powered by a radioisotope thermalelectric generator. Located in the Neil Armstrong Operations and Checkout building, the Randall E. Scott Radiological Control Center is staffed by technical and radiological experts from NASA, the U.S. Department of Energy, the U.S. Air Force 45th Space Wing and the state of Florida. The group performs data collection and assessment functions supporting launch site and field data collection activities during launces involving plutonium-powered spacecraft such as the Mars Science Laboratory.

Provision of out-of-hours interventional radiology services in the London strategic health authority.

PubMed

Illing, R O; Clark, C L Ingham; Allum, C

2010-04-01

To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An "ad-hoc" service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24h service. Only two hospitals providing a 24h service had six radiologists on the rota. Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.

Method and apparatus for in-cell vacuuming of radiologically contaminated materials

DOEpatents

Spadaro, Peter R.; Smith, Jay E.; Speer, Elmer L.; Cecconi, Arnold L.

1987-01-01

A vacuum air flow operated cyclone separator arrangement for collecting, handling and packaging loose contaminated material in accordance with acceptable radiological and criticality control requirements. The vacuum air flow system includes a specially designed fail-safe prefilter installed upstream of the vacuum air flow power supply. The fail-safe prefilter provides in-cell vacuum system flow visualization and automatically reduces or shuts off the vacuum air flow in the event of an upstream prefilter failure. The system is effective for collecting and handling highly contaminated radiological waste in the form of dust, dirt, fuel element fines, metal chips and similar loose material in accordance with radiological and criticality control requirements for disposal by means of shipment and burial.

Creating a successful relationship with customers.

PubMed

Cotton, L; Sparrow, E

1998-01-01

In 1997, several employers commissioned an inpatient survey for a group of businesses that included hospitals in southeast Michigan. Its results indicated that the University of Michigan Health System (UMHS) needed to become more customer-focused. To meet this challenge, UMHS mandated that customer service to its patients and their families should be its first priority. A pilot project in the radiology department's pediatric division was established to recognize and reward employees for outstanding service to customers. The program is now used to reward employees throughout the radiology department, on the assumption that when employees feel special, so will their customers. Management's focus is on employees--they are the health system. The department also invested in employee development, a continuous training program that centers on customer service and teaches tools and skills for better communication. The goal of the development program at UMHS is to exceed the needs of its customers.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Family members of Randy Scott gather in the Radiological Control Center at NASA's Kennedy Space Center following ceremonies to name the facility in his honor. A professional health physicist of more than 40 years, Scott served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016.

Alternative Payment Models in Radiology: The Legislative and Regulatory Roadmap for Reform.

PubMed

Silva, Ezequiel; McGinty, Geraldine B; Hughes, Danny R; Duszak, Richard

2016-10-01

The Medicare Access and CHIP Reauthorization Act (MACRA) replaces the sustainable growth rate with a payment system based on the Merit-Based Incentive Payment System and incentives for alternative payment model participation. It is important that radiologists understand the statutory requirements of MACRA. This includes the nature of the Merit-Based Incentive Payment System composite performance score and its impact on payments. The timeline for MACRA implementation is fairly aggressive and includes a robust effort to define episode groups, which include radiologic services. A number of organizations, including the ACR, are commenting on the structure of MACRA-directed initiatives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[Management of acute and subacute clinical situations by interventional radiology: non-vascular interventions and treatment for hemoptysis].

PubMed

Nemes, Balázs; Doros, Attila

2015-04-26

Interventional radiology provides fast, straightforward and tolerable solutions for many medical problems including acute and subacute situations. Aspiration and drainage of fluid collections, biliary and endourologic interventions and gastrointestinal interventions are parts of non-vascular interventions. In addition, the authors discuss in detail interventional radiological treatment options in patients with hemoptysis. In acute cases interventions must be performed within 12-24 hours. For background, an everyday 24 hours service should be provided with well-trained personnel, high quality equipment and devices, and a reasonable financial reimbursement should be included, too. Multidisciplinary teamwork, consultations, consensus in indications and structured education should make these centers function most effectively.

Coping in a calamity: Radiology during the cloudburst at Leh

PubMed Central

Sen, Debraj

2013-01-01

The service hospital at Leh is a multispeciality hospital situated at an altitude of 11000 feet above mean sea level. On the nights of 4 and 5 Aug 2010, Leh was struck by a cloudburst leading to mudslides and consequently extensive damage to life and property. Being the only functional hospital, over a period of about 48 hours, 331 casualties were received. 549 casualties were received over the week with 108 admissions, 16 major surgeries and 138 minor surgeries. 178 radiographs, 17 CT scans and 09 ultrasound-colour Doppler examinations were performed on an urgent basis over 48 hours apart from the routine radiological investigations. Apart from chronicling the event, we hope that sharing the unique experience of the Radiology Department in dealing with the large influx of patients would provide an insight into the role of Radiology during the disaster and help in planning and developing management protocols during other calamities. PMID:23986626

Does gender impact upon application rejection rate among Canadian radiology residency applicants?

PubMed

Baerlocher, Mark O; Walker, Michelle

2005-10-01

To determine if and how gender ratios have changed within Canadian radiology, and to determine if gender discrimination occurs at the level of the radiology resident selection committee. The Canadian Medical Association, Canadian Association of Radiologists, Canadian Institute for Health Information, Royal College of Physicians and Surgeons of Canada, and Canadian Residency Matching Service provided gender-specific data. We compared the proportion of female applicants who ranked a radiology program as their top choice and were rejected from any radiology program with the corresponding proportion for male applicants. The numbers of women and men being awarded an MD from a Canadian university equalized nearly a decade ago. Women continue to be numerically underrepresented among practicing radiologists; however, the proportion of women continues to increase so that there is 1 female radiologist in practice to every 3 male radiologists in practice in 2005. More male medical students ranked a radiology residency training program as their top choice in the residency match; however, of those who did, they were as likely as women to be rejected from a radiology residency training program. Grouping all female and male graduating medical students participating in the residency match and ranking a radiology residency as their top choice between 1993 and 2004, the odds of men being rejected were 1.4 times (95% CI 0.99-1.9, p = 0.07) greater than for women. There continues to be more men than women radiologists in practice; however, the female-to-male ratio continues to increase. Our data suggest that discrimination against female applicants at the level of radiology residency selection does not occur.

Using technology assessment as the picture archiving and communication system spreads outside radiology to the enterprise.

PubMed

Maliff, R P; Launders, J

2000-05-01

Picture archiving and communication systems (PACS) are being implemented within radiology departments, and many facilities are entering the next stage of PACS use by deploying PACS to departments outside of radiology and to other facilities located at a distance. Many PACS vendors and department administrators have based cost-justification analyses on the anticipated savings from expanding PACS to these areas. However, many of these cost-savings analyses can be highly suspect in their assumptions and findings. Technology assessment (TA) at the hospital/health system level is an organized, systematic approach to examining the efficacy of a technology in relation to the health system's mission and clinical needs. It can be an organized and unifying approach to aid in the distribution of limited capital resources. As extra-radiology PACS deployment is a costly endeavor, TA may be used to plan for PACS implementation throughout the enterprise. In many organizations, PACS is thought of as a radiology domain as its first uses were centered on this image-producing service. Now, as PACS technology spreads to other service areas, such as cardiology, dermatology, pathology, orthopedics, obstetrics, etc, the need to incorporate other viewpoints in a system-based PACS is necessary to avoid having independent PACS that may duplicate archives and may not communicate with each other. How to meet the diverse PACS needs of clinical services can be a challenging task; a TA program has been demonstrated to effectively handle the clinical needs, demands, and timeframes of PACS planning and support throughout hospitals and health systems. A hospital-based TA program can assist health care organizations to present PACS as a system-wide need and program rather than a radiology-based program gobbling up the capital budget. Submitting PACS to the TA review process can identify essential elements in planning and help avoid many of the pitfalls of PACS implementation and operations. Thorough cost and/or return on investment analyses, phasing decisions, workflow re-engineering, and outcomes assessment programs are a few of the issues that a TA program can address to help in the transition to a complete electronic image environment. The TA process includes clinician selection, evaluation criteria and their selection for technologies under review, a policy for review/authorization/denial, and measurement of expected outcomes.

Assessment of medical radiation exposure to patients and ambient doses in several diagnostic radiology departments

NASA Astrophysics Data System (ADS)

Sulieman, A.; Elhadi, T.; Babikir, E.; Alkhorayef, M.; Alnaaimi, M.; Alduaij, M.; Bradley, D. A.

2017-11-01

In many countries diagnostic medical exposures typically account for a very large fraction of the collective effective dose that can be assigned to anthropological sources and activities. This in part flags up the question of whether sufficient steps are being taken in regard to potential dose saving from such medical services. As a first step, one needs to survey doses to compare against those of best practice. The present study has sought evaluation of the radiation protection status and patient doses for certain key radiological procedures in four film-based radiology departments within Sudan. The radiation exposure survey, carried out using a survey meter and quality control test tools, involved a total of 299 patients their examinations being carried out at one or other of these four departments. The entrance surface air kerma (ESAK) was determined from exposure settings using DosCal software and an Unfors -Xi-meter. The mean ESAK for x-ray examination of the chest was 0.30±0.1 mGy, for the skull it was 0.96±0.7 mGy, for the abdomen 0.85±0.01 mGy, for spinal procedures 1.30±0.6 mGy and for procedures involving the limbs it was 0.43±0.3 mGy. Ambient dose-rates in the reception area, at the closed door of the x-ray room, recorded instantaneous values of up to 100 μSv/h. In regard to protection, the associated levels were found to be acceptable in three of the four departments, corrective action being required for one department, regular quality control also being recommended.

Privacy and security in teleradiology.

PubMed

Ruotsalainen, Pekka

2010-01-01

Teleradiology is probably the most successful eHealth service available today. Its business model is based on the remote transmission of radiological images (e.g. X-ray and CT-images) over electronic networks, and on the interpretation of the transmitted images for diagnostic purpose. Two basic service models are commonly used teleradiology today. The most common approach is based on the message paradigm (off-line model), but more developed teleradiology systems are based on the interactive use of PACS/RIS systems. Modern teleradiology is also more and more cross-organisational or even cross-border service between service providers having different jurisdictions and security policies. This paper defines the requirements needed to make different teleradiology models trusted. Those requirements include a common security policy that covers all partners and entities, common security and privacy protection principles and requirements, controlled contracts between partners, and the use of security controls and tools that supporting the common security policy. The security and privacy protection of any teleradiology system must be planned in advance, and the necessary security and privacy enhancing tools should be selected (e.g. strong authentication, data encryption, non-repudiation services and audit-logs) based on the risk analysis and requirements set by the legislation. In any case the teleradiology system should fulfil ethical and regulatory requirements. Certification of the whole teleradiology service system including security and privacy is also proposed. In the future, teleradiology services will be an integrated part of pervasive eHealth. Security requirements for this environment including dynamic and context aware security services are also discussed in this paper. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Carcinoma of unknown primary: key radiological issues from the recent National Institute for Health and Clinical Excellence guidelines

PubMed Central

Taylor, M B; Bromham, N R; Arnold, S E

2012-01-01

Carcinoma of unknown primary origin (CUP) accounts for 3–5% of cancer cases and is the fourth most common cause of cancer death in the UK. CUP management is challenging, partly owing to the heterogeneity of the condition and its presentation, but also owing to the lack of dedicated clinical services for these patients. The recent National Institute for Health and Clinical Excellence (NICE) guidelines on metastatic malignancy of unknown primary origin were developed to improve the co-ordination of diagnostic and clinical services at hospitals treating cancer patients in England and Wales, in particular by the setting up of CUP teams to manage these patients. Radiologists have a vital role in the diagnosis of these patients and should work closely with the CUP team to streamline the diagnostic pathway. This article summarises areas of the NICE guidelines relevant to radiology and discusses the radiological management of patients with CUP, including initial investigation, the importance of biopsy, the management of specific presentations, special investigations and organisational issues. PMID:22374278

Five years' experience in a (really) rural teleradiology practice. Was it worth it? The successes and the failures

NASA Astrophysics Data System (ADS)

Telepak, Robert J.; Freede, Emily; Jaramillo, Richard E.; Alverson, Dale C.

1998-07-01

During the past 5 years (1992 - 1997) the Department of Radiology of the University of New Mexico Health Sciences Center has developed an active teleradiology program. Contracts are in place to provide both routine and emergency image interpretations 24 hours per day, every day of the year. Several rural hospitals are served as well as the Navajo Indian Health Service. Areas of success: include significantly improved radiologic service to the rural sites, specialty consultations to general radiologists, successful teaching of teleradiology practice to radiology residents and staff, good diagnostic quality images, a small but real profit, improved quality assurance for the rural sites, and no significant medical-legal problems. Failures include: significant telecommunications problems, lack of acceptance and utilization by some of the rural sites, poor QA compliance by some sites, a long period of disappointing technical support by equipment vendors, and slow acceptance of DICOM by equipment manufacturers. The successes outweigh the failures. We would do it again -- but somewhat differently. We offer advice to institutions developing a new rural teleradiology operation.

Parlaying digital imaging and communications in medicine and open architecture to our advantage: the new Department of Defense picture archiving and communications system.

PubMed

Cawthon, M A

1999-05-01

The Department of Defense (DoD) undertook a major systems specification, acquisition, and implementation project of multivendor picture archiving and communications system (PACS) and teleradiology systems during 1997 with deployment of the first systems in 1998. These systems differ from their DoD predecessor system in being multivendor in origin, specifying adherence to the developing Digital Imaging and Communications in Medicine (DICOM) 3.0 standard and all of its service classes, emphasizing open architecture, using personal computer (PC) and web-based image viewing access, having radiologic telepresence over large geographic areas as a primary focus of implementation, and requiring bidirectional interfacing with the DoD hospital information system (HIS). The benefits and advantages to the military health-care system accrue through the enabling of a seamless implementation of a virtual radiology operational environment throughout this vast healthcare organization providing efficient general and subspecialty radiologic interpretive and consultative services for our medical beneficiaries to any healthcare provider, anywhere and at any time of the night or day.

Informing radiography curriculum development: The views of UK radiology service managers concerning the 'fitness for purpose' of recent diagnostic radiography graduates.

PubMed

Sloane, C; Miller, P K

2017-09-01

Recent years have seen significant changes in the way medical imaging services are delivered, rapid changes in technology and big increases in the number and ranges of examinations undertaken. Given these changes the study aimed to critically evaluate the fitness for purpose of newly qualified diagnostic radiography. The study employed a grounded theory approach to analyse the interviews of 20 radiology managers from a range of medical imaging providers across the UK. Four key themes emerged from the analysis. These were: curriculum content and structure review; diversification in the role of the radiographer; professionalism and coping and the reformation of career structures. The results indicate the role of the radiographer is now in a state of flux and challenge radiology managers and educators to design curricula and career structures which are better matched the role of the radiographer in the very rapidly changing technological, organisational and social contexts of modern society. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

The radiology conglomerate: optimizing the structure and function of the 50-plus radiology organizations--a summary of the 2010 Intersociety Conference.

PubMed

Dodd, Gerald D

2011-08-01

There has been a substantial proliferation in the number of radiology organizations over the past 30 years. This has occurred without integrated planning or the development of a central administration. Although each of the 50-plus organizations was created for specific reasons, the lack of coordination among them has led to considerable duplication of missions, services, and resources. The majority of the members attending the 2010 meeting of the Intersociety Conference believe that radiology as a whole would benefit from collaboration and consolidation of our organizations. Specific opportunities for collaboration include joint annual meetings between 2 or more organizations, the creation of a clearinghouse for meeting scheduling that would minimize meeting conflicts, coordinated development of self-assessment modules, the development of an online site for "one-stop shopping" for paying dues and making foundation contributions, consolidation of the 15-plus radiology foundations to increase the investment corpus and allow larger targeted investments in specific research projects that would benefit radiology as a whole, and the creation of a new Web site that would link all radiology organizations to facilitate information access and collaboration. To move forward with meaningful and successful collaboration or consolidation will require an accurate database of the mission, structure, and function of our organizations; a careful analysis of potential synergies; and, full buy-in by the participating organizations. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Spanish Radiology in the second half of the XX Century: a view from inside.

PubMed

Bonmatí, José

2008-09-01

Radiology was born in 1896 with the immediate recognition of the diagnostic value of X-rays in medicine and progressed throughout the XX Century with the increasing knowledge of its properties and clinical applications. By mid-century Radiology was a respected clinical specialty in advanced countries, the radiological report was a requirement in hospital practice and radiologists' opinions requested in scientific meetings. In the last decades of the century has had a spectacular expansion with the emergence of new imaging modalities and revolutionary technologies that have transformed the specialty worldwide. In Spain Radiology lagged behind needs and demand in 1950. Radiological practice was unregulated and performance of X-ray exams by non-radiologists was common. Teaching of Radiology was non-existent in Medical Schools or postgraduation. The diagnostic value of the specialty was unrecognized by physicians and the role of radiologists ignored. Most hospital radiology services were poorly equipped and functionally inadequate. The shadow of the Civil War (1936-39) was conditioning Radiology in the country. The point of inflexion in the development of Radiology in Spain was the inclusion of film reading sessions in the 1965 academic program of the Society of Radiology. It was in the presentation of cases at these conferences that Clinical Radiology found the finest demonstration ground and as a result was immediately adopted by radiologists and progressively applied in scientific meetings, clinical practices and training programs. Its influence was important in reforming hospital practice, legislation on specialization and education, as well as in national health care plans. At the end of the century radiology in Spain was at a par with the standards of other western nations. The author was a witness of the evolution of Radiology during his 50 years of professional life. This article does not pretend to be exhaustive in names or contributions. It is an overview of the period from the perspective of his past experience and seen from the distance of events that influenced the course of developments. I hope that those interested in the subject find that the effort has been worthwhile and helpful.

Determinants of Mental Health Services Utilization Among Deployed Service Members and Their Families

DTIC Science & Technology

2008-02-11

Introduction Health and the Purpose of a Health Care System The World Health Organization (WHO) defines health as "a state of complete physical , mental and...surgical conditions, pharmacy services, physical examinations, dental care, and diagnostic, laboratory and radiological tests and services. There...over 23,000 have returned home with physical injuries and a range of permanent disabilities; e.g., limb loss, burns and traumatic brain injury (APA

Home-based radiology transcription and a productivity pay plan.

PubMed

Kerr, K

1997-01-01

Shands Hospital in Gainesville, Fla., decided to evaluate the way it provided transcription services in its radiology department. It identified four goals: increased productivity, decreased operating expense, finding much needed space in the radiology department and increasing employee morale. The department performs 165,000 procedures annually, with 66 radiologists, 29 faculty, and 37 residents and fellows on staff. Six FTEs comprised the transcription pool in the radiology department, with transcription their only duty. Transcriptionists were paid an hourly rate based on their years of service, not their productivity. Evaluation and measurement studies were undertaken by the hospital's management systems engineering department. The transcriptionists' hours were then changed to provide coverage during the periods of heaviest dictation. The productivity level of the transcription staff was also measured and various methods of measurement reviewed. The goal was a pure incentive pay plan that would reward employees for every increase in productivity. The incentive pay plan was phased in over a three-month period. Transcriptionists were paid for work performed, with no base pay beyond minimum wage. The move to home-based transcription was planned. The necessary equipment was identified and various issues specific to working at home were addressed. Approximately six months later, the transcriptionists were set up to work at home. The astounding results achieved are presented: 28% increase in productivity, operational cost savings exceeding $25,000 and a space savings of 238 square feet.

Information management of a department of diagnostic imaging.

PubMed

Vincenzoni, M; Campioni, P; Vecchioli Scaldazza, A; Capocasa, G; Marano, P

1998-01-01

It is well-known that while RIS allows the management of all input and output data of a Radiology service, PACS plays a major role in the management of all radiologic images. However, the two systems should be closely integrated: scheduling of a radiologic exam requires direct automated integration with the system of image management for retrieval of previous exams and storage of the exam just completed. A modern information system of integration of data and radiologic images should be based on an automated work flow management in al its components, being at the same time flexible and compatible with the ward organization to support and computerize each stage of the working process. Similarly, standard protocols (DICOM 3.0, HL7) defined for interfacing with the Diagnostic Imaging (D.I.) department and the other components of modules of a modern HIS, should be used. They ensure the system to be expandable and accessible to ensure share and integration of information with HIS, emergency service or wards. Correct RIS/PACS integration allows a marked improvement in the efficiency of a modern D.I. department with a positive impact on the daily activity, prompt availability of previous data and images with sophisticated handling of diagnostic images to enhance the reporting quality. The increased diffusion of internet and intranet technology predicts future developments still to be discovered.

[Changing the internal cost allocation (ICA) on DRG shares : Example of computed tomography in a university radiology setting].

PubMed

Wirth, K; Zielinski, P; Trinter, T; Stahl, R; Mück, F; Reiser, M; Wirth, S

2016-08-01

In hospitals, the radiological services provided to non-privately insured in-house patients are mostly distributed to requesting disciplines through internal cost allocation (ICA). In many institutions, computed tomography (CT) is the modality with the largest amount of allocation credits. The aim of this work is to compare the ICA to respective DRG (Diagnosis Related Groups) shares for diagnostic CT services in a university hospital setting. The data from four CT scanners in a large university hospital were processed for the 2012 fiscal year. For each of the 50 DRG groups with the most case-mix points, all diagnostic CT services were documented including their respective amount of GOÄ allocation credits and invoiced ICA value. As the German Institute for Reimbursement of Hospitals (InEK) database groups the radiation disciplines (radiology, nuclear medicine and radiation therapy) together and also lacks any modality differentiation, the determination of the diagnostic CT component was based on the existing institutional distribution of ICA allocations. Within the included 24,854 cases, 63,062,060 GOÄ-based performance credits were counted. The ICA relieved these diagnostic CT services by € 819,029 (single credit value of 1.30 Eurocent), whereas accounting by using DRG shares would have resulted in € 1,127,591 (single credit value of 1.79 Eurocent). The GOÄ single credit value is 5.62 Eurocent. The diagnostic CT service was basically rendered as relatively inexpensive. In addition to a better financial result, changing the current ICA to DRG shares might also mean a chance for real revenues. However, the attractiveness considerably depends on how the DRG shares are distributed to the different radiation disciplines of one institution.

Utility of simultaneous interventional radiology and operative surgery in a dedicated suite for seriously injured patients.

PubMed

D'Amours, Scott K; Rastogi, Pratik; Ball, Chad G

2013-12-01

In recent years, combined interventional radiology and operative suites have been proposed and are now becoming operational in select trauma centres. Given the infancy of this technology, this review aims to review the rationale, benefits and challenges of hybrid suites in the management of seriously injured patients. No specific studies exist that investigate outcomes within hybrid trauma suites. Endovascular and interventional radiology techniques have been successfully employed in thoracic, abdominal, pelvic and extremity trauma. Although the association between delayed haemorrhage control and poorer patient outcomes is intuitive, most supporting scientific data are outdated. The hybrid suite model offers the potential to expedite haemorrhage control through synergistic operative, interventional radiology and resuscitative platforms. Maximizing the utility of these suites requires trained multidisciplinary teams, ergonomic and workplace considerations, as well as a fundamental paradigm shift of trauma care. This often translates into a more damage-control orientated philosophy. Hybrid suites offer tremendous potential to expedite haemorrhage control in trauma patients. Outcome evaluations from trauma units that currently have operational hybrid suites are required to establish clearer guidelines and criteria for patient management.

A presentation system for just-in-time learning in radiology.

PubMed

Kahn, Charles E; Santos, Amadeu; Thao, Cheng; Rock, Jayson J; Nagy, Paul G; Ehlers, Kevin C

2007-03-01

There is growing interest in bringing medical educational materials to the point of care. We sought to develop a system for just-in-time learning in radiology. A database of 34 learning modules was derived from previously published journal articles. Learning objectives were specified for each module, and multiple-choice test items were created. A web-based system-called TEMPO-was developed to allow radiologists to select and view the learning modules. Web services were used to exchange clinical context information between TEMPO and the simulated radiology work station. Preliminary evaluation was conducted using the System Usability Scale (SUS) questionnaire. TEMPO identified learning modules that were relevant to the age, sex, imaging modality, and body part or organ system of the patient being viewed by the radiologist on the simulated clinical work station. Users expressed a high degree of satisfaction with the system's design and user interface. TEMPO enables just-in-time learning in radiology, and can be extended to create a fully functional learning management system for point-of-care learning in radiology.

Financial ratios in diagnostic radiology practices: variability and trends.

PubMed

Hogan, Christopher; Sunshine, Jonathan H

2004-03-01

To evaluate variation in financial ratios for radiology practices nationwide and trends in these ratios and in payments. In 1999, the American College of Radiology surveyed radiology practices by mail. The final response rate was 66%. Weighting was used to make responses representative of all radiology practices in the United States. Self-reported financial ratios (payments, charges, accounts receivable turnover) were analyzed; 449 responses had usable data on these ratios. Comparison with results of a similar 1992 survey and combined analysis with Medicare data on billed charges provided information on trends. All measures of payment collections declined sharply from 1992 to 1999, with the gross collections rate (revenues as percentage of billed charges) decreasing from 71% to 55%. Average payment for a typical radiology service decreased approximately 4% in dollar terms or approximately 19% in inflation-adjusted terms. In 1999, nonmetropolitan practices appeared to fare better than others. Among insurers, Medicaid stood out as a low and slow payer, but neither managed care nor Medicare had a consistent effect on financial ratios. The gross collections rate varied substantially across geographic areas, as did, in an inverse pattern, the level of billed charges. One-quarter of practices had accounts receivable equal to 90 or more days of billings. The opposing geographic pattern of billed charges and gross collection rate suggests that geographic variation in the latter is driven more by variation in billed charges than by variation in payment levels. Radiologists saw a substantial decrease in the real (inflation-adjusted) value of payment per service during the 1990s. The large fraction of practices with accounts receivable of 90 or more days of billings-a level considered potentially imprudent by financial management advisors-suggests that many practices should improve financial management and that state prompt-payment laws have not had a substantial positive effect. Copyright RSNA, 2004

Common object request broker architecture (CORBA)-based security services for the virtual radiology environment.

PubMed

Martinez, R; Cole, C; Rozenblit, J; Cook, J F; Chacko, A K

2000-05-01

The US Army Great Plains Regional Medical Command (GPRMC) has a requirement to conform to Department of Defense (DoD) and Army security policies for the Virtual Radiology Environment (VRE) Project. Within the DoD, security policy is defined as the set of laws, rules, and practices that regulate how an organization manages, protects, and distributes sensitive information. Security policy in the DoD is described by the Trusted Computer System Evaluation Criteria (TCSEC), Army Regulation (AR) 380-19, Defense Information Infrastructure Common Operating Environment (DII COE), Military Health Services System Automated Information Systems Security Policy Manual, and National Computer Security Center-TG-005, "Trusted Network Interpretation." These documents were used to develop a security policy that defines information protection requirements that are made with respect to those laws, rules, and practices that are required to protect the information stored and processed in the VRE Project. The goal of the security policy is to provide for a C2-level of information protection while also satisfying the functional needs of the GPRMC's user community. This report summarizes the security policy for the VRE and defines the CORBA security services that satisfy the policy. In the VRE, the information to be protected is embedded into three major information components: (1) Patient information consists of Digital Imaging and Communications in Medicine (DICOM)-formatted fields. The patient information resides in the digital imaging network picture archiving and communication system (DIN-PACS) networks in the database archive systems and includes (a) patient demographics; (b) patient images from x-ray, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US); and (c) prior patient images and related patient history. (2) Meta-Manager information to be protected consists of several data objects. This information is distributed to the Meta-Manager nodes and includes (a) radiologist schedules; (b) modality worklists; (c) routed case information; (d) DIN-PACS and Composite Health Care system (CHCS) messages, and Meta-Manager administrative and security information; and (e) patient case information. (3) Access control and communications security is required in the VRE to control who uses the VRE and Meta-Manager facilities and to secure the messages between VRE components. The CORBA Security Service Specification version 1.5 is designed to allow up to TCSEC's B2-level security for distributed objects. The CORBA Security Service Specification defines the functionality of several security features: identification and authentication, authorization and access control, security auditing, communication security, nonrepudiation, and security administration. This report describes the enhanced security features for the VRE and their implementation using commercial CORBA Security Service software products.

An Advanced Microcosting System for Forecasting and Managing Radiology Expenses

PubMed Central

Arenson, Ronald; Viale, Richard; van der Voorde, Frans

1985-01-01

The new prospective payment system encourages hospital cost containment and necessitates understanding actual costs for radiology procedures. The automated microcosting system described here, utilizing data from the Radiology Information Management System, hospital expense reports, and payroll management reports, calculates an accurate unit cost for each procedure type. This data is very useful for cost control, enhancement of department efficiency, and planning.

Radiological Weapons Control: A Soviet and US Perspective. Occasional Paper 29.

ERIC Educational Resources Information Center

Issraelyan, Victor L.; Flowerree, Charles C.

Two international diplomats from the Soviet Union and the United States focus on the need for a treaty to ban the use of radiological weapons. Radiological weapons are those based on the natural decay of nuclear material such as waste from military or civilian nuclear reactors. Such devices include both weapons and equipment, other than a nuclear…

Asbestotic radiological abnormalities among United States merchant marine seamen.

PubMed

Selikoff, I J; Lilis, R; Levin, G

1990-05-01

There has been limited information concerning the prevalence of radiologically evident parenchymal and pleural fibrosis consistent with prior exposure to asbestos among merchant marine seamen, despite the wide use of asbestos in ship construction until the late 1970s and subsequent exposure of seamen to the asbestos that had been installed. A total of 3324 chest radiographs (1985-7) of long term United States seamen were reviewed. One third (34.8%) had parenchymal or pleural abnormalities, or both (ILO classification); pleural changes were predominant. Abnormalities increased with longer duration from onset of shipboard exposure (as defined by first year at sea). The prevalence of asbestotic changes was greater among seamen who had served in the engine department (391/420; 42.5%) compared with seamen in other departments, including deck (301/820; 36.6%), steward (278/981; 28.4%), or with service in multiple departments (167/541; 30.9%). Since many vessels, particularly those built before 1978, contain asbestos materials, appropriate engineering controls (including complete removal, if possible) are required as well as appropriate medical surveillance for those who served aboard such ships.

Asbestotic radiological abnormalities among United States merchant marine seamen.

PubMed Central

Selikoff, I J; Lilis, R; Levin, G

1990-01-01

There has been limited information concerning the prevalence of radiologically evident parenchymal and pleural fibrosis consistent with prior exposure to asbestos among merchant marine seamen, despite the wide use of asbestos in ship construction until the late 1970s and subsequent exposure of seamen to the asbestos that had been installed. A total of 3324 chest radiographs (1985-7) of long term United States seamen were reviewed. One third (34.8%) had parenchymal or pleural abnormalities, or both (ILO classification); pleural changes were predominant. Abnormalities increased with longer duration from onset of shipboard exposure (as defined by first year at sea). The prevalence of asbestotic changes was greater among seamen who had served in the engine department (391/420; 42.5%) compared with seamen in other departments, including deck (301/820; 36.6%), steward (278/981; 28.4%), or with service in multiple departments (167/541; 30.9%). Since many vessels, particularly those built before 1978, contain asbestos materials, appropriate engineering controls (including complete removal, if possible) are required as well as appropriate medical surveillance for those who served aboard such ships. PMID:2357448

Radiology scheduling: preferences of users of radiologic services and impact on referral base and extension.

PubMed

Mozumdar, Biswita C; Hornsby, Douglas Neal; Gogate, Adheet S; Intriere, Lisa A; Hanson, Richard; McGreal, Karen; Kelly, Pauline; Ros, Pablo

2003-08-01

To study end-user attitudes and preferences with respect to radiology scheduling systems and to assess implications for retention and extension of the referral base. A study of the institution's historical data indicated reduced satisfaction with the process of patient scheduling in recent years. Sixty physicians who referred patients to a single, large academic radiology department received the survey. The survey was designed to identify (A) the preferred vehicle for patient scheduling (on-line versus telephone scheduling) and (B) whether ease of scheduling was a factor in physicians referring patients to other providers. Referring physicians were asked to forward the survey to any appropriate office staff member in case the latter scheduled appointments for patients. Users were asked to provide comments and suggestions for improvement. The statistical method used was the analysis of proportions. Thirty-three responses were received, corresponding to a return rate of 55%. Twenty-six of the 33 respondents (78.8%, P < .01) stated they were willing to try an online scheduling system; 16 of which tried the system. Twelve of the 16 (75%, P < .05) preferred the on-line application to the telephone system, stating logistical simplification as the primary reason for preference. Three (18.75%) did not consider online scheduling to be more convenient than traditional telephone scheduling. One respondent did not indicate any preference. Eleven of 33 users (33.33%, P < .001) stated that they would change radiology service providers if expectations of scheduling ease are not met. On-line scheduling applications are becoming the preferred scheduling vehicle. Augmenting their capabilities and availability can simplify the scheduling process, improve referring physician satisfaction, and provide a competitive advantage. Referrers are willing to change providers if scheduling expectations are not met.

Understanding Patient Satisfaction Ratings for Radiology Services

PubMed Central

Lang, Elvira V.; Yuh, William T.C.; Kelly, Ronda; Macadam, Luke; Potts, Richard; Mayr, Nina A.

2015-01-01

Under the Hospital Value-Based Purchasing Program of the Centers for Medicare & Medicaid Services patient satisfaction accounts for 30% of the measures of and payments for quality of care. Understanding what drives satisfaction data, how it is obtained, converted into scores, and formulated into rankings, is increasingly critical for imaging departments. PMID:24261356

Marketing imaging services.

PubMed

Bouchard, E A

1992-01-01

"Communication with physicians and patients is critical to successfully marketing technology," says Mr. Bouchard, author of a new handbook for radiology managers. In this section from his book, he describes the components of a successful marketing plan and tries to dispel several myths about marketing. He also describes benchmarks for success, and provides a sample plan to promote mammography services.

Marketing mobile imaging services.

PubMed

McCue, P

1987-09-01

Competition in the mobile imaging arena has put radiologists, radiology directors, and other health care professionals in the unfamiliar position of being marketing agents for their services. Mobile imaging is being promoted through consumer advertising as well as through the traditional route of physician referral. This article offers some of the marketing lessons being learned in the mobile arena.

Medical errors arising from outsourcing laboratory and radiology services.

PubMed

Chasin, Brian S; Elliott, Sean P; Klotz, Stephen A

2007-09-01

Document errors and the nuisance factor inherent in the informational exchange that occurs with the outsourcing of laboratory and radiology examinations. Three infectious diseases physicians at a tertiary care hospital recorded problems involving data transmitted by telephone or fax from outsource providers for 4 months. This included in- and outpatients, and those in transition from one status to another. Outsourcing laboratory and radiology examinations of insured outpatients is a common practice. Insurance companies determine which healthcare facility performs these tests based on contractual agreements with outsource providers. This leads to confusion and frustration for the doctor and patient alike, and occasionally, to medical error. The exchange of patient data involved in outsourcing is subject to systemic errors that do not allow of easy solution.

Design of an image-distribution service from a clinical PACS

NASA Astrophysics Data System (ADS)

Gehring, Dale G.; Persons, Kenneth R.; Rothman, Melvyn L.; Felmlee, Joel P.; Gerhart, D. J.; Hangiandreou, Nicholas J.; Reardon, Frank J.; Shirk, M.; Forbes, Glenn S.; Williamson, Byrn, Jr.

1994-05-01

A PACS system has been developed through a multi-phase collaboration between the Mayo Clinic and IBM/Rochester. The current system has been fully integrated into the clinical practice of the Radiology Department for the primary purpose of digital image archival, retrieval, and networked workstation review. Work currently in progress includes the design and implementation of a gateway device for providing digital image data to third-party workstations, laser printers, and other devices, for users both within and outside of the Radiology Department.

Managerial accounting applications in radiology.

PubMed

Lexa, Frank James; Mehta, Tushar; Seidmann, Abraham

2005-03-01

We review the core issues in managerial accounting for radiologists. We introduce the topic and then explore its application to diagnostic imaging. We define key terms such as fixed cost, variable cost, marginal cost, and marginal revenue and discuss their role in understanding the operational and financial implications for a radiology facility by using a cost-volume-profit model. Our work places particular emphasis on the role of managerial accounting in understanding service costs, as well as how it assists executive decision making.

Radiologic-pathologic Correlation-An Advanced Fourth-year Elective: How We Do It.

PubMed

Hartman, Matthew; Silverman, Jan; Spruill, Laura; Hill, Jeanne

2016-07-01

Traditionally, the radiology elective has been designed to teach medical students the fundamentals of radiologic interpretation. When questioned, many students state that they want to take a radiology elective so they can "interpret images." For the students on radiology, rotation/elective education was often passive, consisting of didactic conferences and observational shadowing of radiologists as they interpreted images. Students had only a superficial appreciation of how radiologists interacted with clinical services, multidisciplinary teams, and pathology. There was very little emphasis on imaging appropriateness or the most efficient and effective imaging for various clinical problems. With the expansion of numerous imaging modalities and the emphasis on patient-centered care, including imaging safety and dose reduction, it is important to change the focus of radiology education from interpretation to the optimal integration of imaging into clinical medicine. Radiology-pathology (rad path) electives were created at Allegheny General Hospital and the Medical University of South Carolina as a new option to provide a high-quality advanced elective for fourth-year medical students. These electives enable students to correlate radiologic images with gross and microscopic pathology specimens, thus increasing their knowledge and understanding of both. The rad path elective combines aspects of surgery, radiology, and pathology and requires students to be active learners. The implementation of this elective is an exciting work in progress that has been evolving over the past 2 and 4 years at Medical University of South Carolina and Allegheny General Hospital, respectively. We will discuss the historical basis for the elective, the advantages and challenges of having such an integrated course, and some different strategies for creating a rad path elective. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Implementation of Certified EHR, Patient Portal, and "Direct" Messaging Technology in a Radiology Environment Enhances Communication of Radiology Results to Both Referring Physicians and Patients.

PubMed

Reicher, Joshua Jay; Reicher, Murray Aaron

2016-06-01

Since 2009, the Federal government distributed over $29 billion to providers who were adopting compliant electronic health record (EHR) technology. With a focus on radiology, we explore how EHR technology impacts interoperability with referring clinicians' EHRs and patient engagement. We also discuss the high-level details of contributing supporting frameworks, specifically Direct messaging and health information service provider (HISP) technology. We characterized Direct messaging, a secure e-mail-like protocol built to allow exchange of encrypted health information online, and the new supporting HISP infrastructure. Statistics related to both the testing and active use of this framework were obtained from DirectTrust.org, an organization whose framework supports Direct messaging use by healthcare organizations. To evaluate patient engagement, we obtained usage data from a radiology-centric patient portal between 2014 and 2015, which in some cases included access to radiology reports. Statistics from 2013 to 2015 showed a rise in issued secure Direct addresses from 8724 to 752,496; a rise in the number of participating healthcare organizations from 667 to 39,751; and a rise in the secure messages sent from 122,842 to 27,316,438. Regarding patient engagement, an average of 234,679 patients per month were provided portal access, with 86,400 patients per month given access to radiology reports. Availability of radiology reports online was strongly associated with increased system usage, with a likelihood ratio of 2.63. The use of certified EHR technology and Direct messaging in the practice of radiology allows for the communication of patient information and radiology results with referring clinicians and increases patient use of patient portal technology, supporting bidirectional radiologist-patient communication.

[No exchange of information without technology : modern infrastructure in radiology].

PubMed

Hupperts, H; Hermann, K-G A

2014-01-01

Modern radiology cannot accomplish the daily numbers of examinations without supportive technology. Even though technology seems to be becoming increasingly more indispensable, business continuity should be ensured at any time and if necessary even with a limited technical infrastructure by business continuity management. An efficient information security management system forms the basis. The early radiology information systems were islands of information processing. A modern radiology department must be able to be modularly integrated into an informational network of a bigger organization. The secondary use of stored data for clinical decision-making support poses new challenges for the integrity of the data or systems because medical knowledge is displayed and provided in a context of treatment. In terms of imaging the creation and distribution radiology services work in a fully digital manner which is often different for radiology reports. Legally secure electronic diagnostic reports require a complex technical infrastructure; therefore, diagnostic findings still need to be filed as a paper document. The internal exchange and an improved dose management can be simplified by systems which continuously and automatically record the doses and thus provide the possibility of permanent analysis and reporting. Communication between patient and radiologist will gain ongoing importance. Intelligent use of technology will convey this to the radiologist and it will facilitate the understanding of the information by the patient.

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures.

PubMed

López, P Ortiz; Dauer, L T; Loose, R; Martin, C J; Miller, D L; Vañó, E; Doruff, M; Padovani, R; Massera, G; Yoder, C

2018-03-01

In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

Changes in radiological protection and quality control in Spanish dental installations: 1996-2003.

PubMed

Alcaraz-Baños, Miguel; Parra-Pérez, María del Carmen; Armero-Barranco, David; Velasco-Hidalgo, Francisco; Velasco-Hidalgo, Esteban

2009-10-01

The European Union has established specific directives concerning radiological protection which are obligatory for member States. In addition, all Spanish dental clinics with radiological equipment are required to have an annual quality control check. To analyze the effect of new European legislation on dental radiological practice in Spain and to determine whether it has resulted in lower doses being administered to patients. A total of 10,171 official radiological quality control reports on Spanish dental clinics, covering 16 autonomous regions, were studied following the passing of Royal Decree 2071/1995 on quality criteria in radiodiagnostic installations. The reports, compiled by U.T.P.R Asigma S.A., a company authorised by the Nuclear Safety Council, cover the years 1996 to 2003, which has enabled us to monitor the evolution of radiological procedures in dental clinics over a seven year period. According to the reports for 2003, 77.3 % of clinics complied with EU requirements, using equipment of 70 kVp, 8 mA, 1.5 mm Al filters, with a collimator length of 20 cm. However, non-compliance was detected in approximately a third (30.8%) of the equipment inspected: alterations in the kilovoltage used, exposure time, performance of the tubing, dosage, linearity/intensity of current and acoustic-luminous signal 6.86%. The mean skin dose reached 3.11 mGy for patients who received an x-ray of an upper molar, representing a decrease of 18% over the seven years studied. there has obviously been a general improvement in the parameters studied, but only 77.3% of the installations complied fully with official EU regulations concerning dental radiological protection.

Logistics of Three-dimensional Printing: Primer for Radiologists.

PubMed

Hodgdon, Taryn; Danrad, Raman; Patel, Midhir J; Smith, Stacy E; Richardson, Michael L; Ballard, David H; Ali, Sayed; Trace, Anthony Paul; DeBenedectis, Carolynn M; Zygmont, Matthew E; Lenchik, Leon; Decker, Summer J

2018-01-01

The Association of University Radiologists Radiology Research Alliance Task Force on three-dimensional (3D) printing presents a review of the logistic considerations for establishing a clinical service using this new technology, specifically focused on implications for radiology. Specific topics include printer selection for 3D printing, software selection, creating a 3D model for printing, providing a 3D printing service, research directions, and opportunities for radiologists to be involved in 3D printing. A thorough understanding of the technology and its capabilities is necessary as the field of 3D printing continues to grow. Radiologists are in the unique position to guide this emerging technology and its use in the clinical arena. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

North by Northwestern: initial experience with PACS at Northwestern Memorial Hospital

NASA Astrophysics Data System (ADS)

Channin, David S.; Hawkins, Rodney C.; Enzmann, Dieter R.

2000-05-01

This paper describes the initial phases and configuration of the Picture Archive and Communication System (PACS) deployed at Northwestern Memorial Hospital. The primary goals of the project were to improve service to patients, improve service to referring physicians, and improve the process of radiology. Secondary goals were to enhance the academic mission, and modernize institutional information systems. The system consists of a large number of heterogeneous imaging modalities sending imaging studies via DICOM to a GE medical Systems PathSpeed PACS. The radiology department workflow is briefly described. The system is currently storing approximately 140,000 studies and over 5 million images, growing by approximately 600 studies and 25,000 images per day. Data reflecting use of the short term and long term storage is provided.

A Guide to Writing Academic Portfolios for Radiologists.

PubMed

Thomas, John V; Sanyal, Rupan; O'Malley, Janis P; Singh, Satinder P; Morgan, Desiree E; Canon, Cheri L

2016-12-01

The academic educator's portfolio is a collection of materials that document academic performance and achievements, supplementing the curriculum vitae, in order to showcase a faculty member's most significant accomplishments. A decade ago, a survey of medical schools revealed frustration in the nonuniform methods of measuring faculty's medical education productivity. A proposed solution was the use of an academic educator's portfolio. In the academic medical community, compiling an academic portfolio is always a challenge because teaching has never been confined to the traditional classroom setting and often involves active participation of the medical student, resident, or fellow in the ongoing care of the patient. Diagnostic radiology in addition requires a knowledge base that encompasses basic sciences, imaging physics, technology, and traditional and molecular medicine. Teaching and performing research that involves this complex mix, while providing patient care that is often behind the scenes, provides unique challenges in the documentation of teaching, research, and clinical service for diagnostic radiology faculty. An academic portfolio is seen as a way to explain why relevant academic activities are significant to promotions committee members who may have backgrounds in unrelated academic areas and may not be familiar with a faculty member's work. The academic portfolio consists of teaching, research, and service portfolios. The teaching portfolio is a collection of materials that document teaching performance and documents the educator's transition to a more effective educator. A research portfolio showcases the most significant research accomplishments. The service portfolio documents service responsibilities and highlight any service excellence. All portfolios should briefly discuss the educator's philosophy, activities, methods used to implement activities, leadership, mentoring, or committee roles in these respective areas. Recognizing that academic programs have differing needs, this article will attempt to provide some basic guidelines that may help junior faculty in diagnostic radiology develop their teaching, research, and service portfolios. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Comparison of resource utilization and clinical outcomes between teaching and nonteaching medical services.

PubMed

Khaliq, Amir A; Huang, Chiung-Yu; Ganti, Apar Kishor; Invie, Kristie; Smego, Raymond A

2007-05-01

To compare the resource utilization and clinical outcomes of medical care delivered on general internal medicine inpatient services at teaching and nonteaching services at an academic hospital. From February to October 2002, 2189 patients admitted to a 450-bed university-affiliated community hospital were assigned either to a resident-staffed teaching service (n = 1637) or to a hospitalist- or clinic-based internist nonteaching service (n = 552). We compared total hospital costs per patient, length of hospital stay (LOS), hospital readmission within 30 days, in-hospital mortality, and costs for pharmacy, laboratory, radiology, and others between teaching and nonteaching services. Care on a teaching service was not associated with increased overall patient care costs ($5572 vs. $5576; P = .99), LOS (4.92 days vs. 5.10 days; P = .43), readmission rate (12.3% vs. 10.3%; P = .21), or in-hospital mortality (3.7% vs. 4.5%; P = .40). Mean laboratory and radiology costs were higher on the teaching service, but costs for the pharmacy and for speech therapy, occupational therapy, physical therapy, respiratory therapy, pulmonary function testing, and GI endoscopy procedures were not statistically different between the 2 services, and residents did not order more tests or procedures. Case mix and illness severity, as reflected by the distribution of the most frequent DRGs and mean number of secondary diagnoses per patient and DRG-specific LOS, were similar on the 2 services. At our academic hospital, admission to a general internal medicine teaching service resulted in patient care costs and clinical outcomes comparable to those admitted to a nonteaching service. (c) 2007 Society of Hospital Medicine.

Facing the future: the effects of the impending financial drought on NHS finances and how UK radiology services can contribute to expected efficiency savings

PubMed Central

Grant, L; Appleby, J; Griffin, N; Adam, A; Gishen, P

2012-01-01

The recent turmoil within the banking sector has led to the development of the most significant recession since the “great depression” of the 1930s. Although the coalition government has promised to “guarantee that health spending increases in real terms in each year of Parliament”, this may still not be enough to meet future needs over the coming years due to increasing demand and cost pressures. The expected mismatch between actual National Health Service (NHS) funding post-2011 and that required to satisfy increasing demand has been estimated by the Department of Health to require efficiency savings representing up to one-fifth of the overall NHS budget. This paper explains the reasons behind the anticipated slowdown in the growth of real NHS funding, and how, as a discipline, radiology can increase the efficiency of the services it provides in anticipation of future financial austerity within the NHS. PMID:22167516

Improved understanding of human anatomy through self-guided radiological anatomy modules.

PubMed

Phillips, Andrew W; Smith, Sandy G; Ross, Callum F; Straus, Christopher M

2012-07-01

To quantifiably measure the impact of self-instructed radiological anatomy modules on anatomy comprehension, demonstrated by radiology, gross, and written exams. Study guides for independent use that emphasized structural relationships were created for use with two online radiology atlases. A guide was created for each module of the first year medical anatomy course and incorporated as an optional course component. A total of 93 of 96 eligible students participated. All exams were normalized to control for variances in exam difficulty and body region tested. An independent t-test was used to compare overall exam scores with respect to guide completion or incompletion. To account for aptitude differences between students, a paired t-test of each student's exam scores with and without completion of the associated guide was performed, thus allowing students to serve as their own controls. Twenty-one students completed no study guides; 22 completed all six guides; and 50 students completed between one and five guides. Aggregate comparisons of all students' exam scores showed significantly improved mean performance when guides were used (radiology, 57.8% [percentile] vs. 45.1%, P < .001; gross, 56.9% vs. 46.5%, P = .001; written, 57.8% vs. 50.2%, P = .011). Paired comparisons among students who completed between one and five guides demonstrated significantly higher mean practical exam scores when guides were used (radiology, 49.3% [percentile] vs. 36.0%, P = .001; gross, 51.5% vs. 40.4%, P = .005), but not higher written scores. Radiological anatomy study guides significantly improved anatomy comprehension on radiology, gross, and written exams. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Effects of instructional strategies using cross sections on the recognition of anatomical structures in correlated CT and MR images.

PubMed

Khalil, Mohammed K; Paas, Fred; Johnson, Tristan E; Su, Yung K; Payer, Andrew F

2008-01-01

This research is an effort to best utilize the interactive anatomical images for instructional purposes based on cognitive load theory. Three studies explored the differential effects of three computer-based instructional strategies that use anatomical cross-sections to enhance the interpretation of radiological images. These strategies include: (1) cross-sectional images of the head that can be superimposed on radiological images, (2) transparent highlighting of anatomical structures in radiological images, and (3) cross-sectional images of the head with radiological images presented side-by-side. Data collected included: (1) time spent on instruction and on solving test questions, (2) mental effort during instruction and test, and (3) students' performance to identify anatomical structures in radiological images. Participants were 28 freshmen medical students (15 males and 13 females) and 208 biology students (190 females and 18 males). All studies used posttest-only control group design, and the collected data were analyzed by either t test or ANOVA. In self-directed computer-based environments, the strategies that used cross sections to improve students' ability to recognize anatomic structures in radiological images showed no significant positive effects. However, when increasing the complexity of the instructional materials, cross-sectional images imposed a higher cognitive load, as indicated by higher investment of mental effort. There is not enough evidence to claim that the simultaneous combination of cross sections and radiological images has no effect on the identification of anatomical structures in radiological images for novices. Further research that control for students' learning and cognitive style is needed to reach an informative conclusion.

Evaluation of the effectiveness of Haemophilus influenzae type b conjugate vaccine introduction against radiologically-confirmed hospitalized pneumonia in young children in Ukraine.

PubMed

Pilishvili, Tamara; Chernyshova, Liudmyla; Bondarenko, Anastasia; Lapiy, Fedir; Sychova, Irina; Cohen, Adam; Flannery, Brendan; Hajjeh, Rana

2013-07-01

Haemophilus influenzae type b (Hib) conjugate vaccine was included into the national vaccination schedule of Ukraine in 2006. The objective of this study was to demonstrate the effectiveness of Hib conjugate vaccine against radiologically-confirmed hospitalized pneumonia in children. Children <2 years old with radiologically confirmed pneumonia admitted to 11 participating hospitals in Kiev and Dnepropetrovsk between April 2007 and June 2009 were included in a case-control evaluation. Four controls were matched to each case by date of birth (within 14 days) and outpatient clinic. We estimated ORs for vaccination and vaccine effectiveness ((1 - OR)*100%) using conditional logistic regression, adjusting for comorbid conditions and contraindications for vaccination. We enrolled 188 case-children and 735 controls. Median age was 16 months (range 4-24 months). Fifty-one percent of cases and 67% of controls received ≥1 doses of Hib conjugate vaccine; 26% of cases and 37% of controls received ≥3 doses. The effectiveness of ≥1 dose Hib conjugate vaccine was estimated at 45% (95% CI 18%-63%). Our study showed that Hib infections are important causes of hospitalized radiologically confirmed pneumonia in young children in Ukraine. Copyright © 2013. Published by Mosby, Inc.

Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective.

PubMed

Tan, Lh; Kamarulzaman, A

2006-01-01

Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.

Radiology preparedness in ebola virus disease: guidelines and challenges for disinfection of medical imaging equipment for the protection of staff and patients.

PubMed

Mollura, Daniel J; Palmore, Tara N; Folio, Les R; Bluemke, David A

2015-05-01

The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. The purpose of this article is to consider the effect of EVD on radiology departments and imaging equipment, with particular consideration of guidelines currently available from the Centers for Disease Control and Prevention that may be applicable to radiology. (©) RSNA, 2015.

Proving Value in Radiology: Experience Developing and Implementing a Shareable Open Source Registry Platform Driven by Radiology Workflow.

PubMed

Gichoya, Judy Wawira; Kohli, Marc D; Haste, Paul; Abigail, Elizabeth Mills; Johnson, Matthew S

2017-10-01

Numerous initiatives are in place to support value based care in radiology including decision support using appropriateness criteria, quality metrics like radiation dose monitoring, and efforts to improve the quality of the radiology report for consumption by referring providers. These initiatives are largely data driven. Organizations can choose to purchase proprietary registry systems, pay for software as a service solution, or deploy/build their own registry systems. Traditionally, registries are created for a single purpose like radiation dosage or specific disease tracking like diabetes registry. This results in a fragmented view of the patient, and increases overhead to maintain such single purpose registry system by requiring an alternative data entry workflow and additional infrastructure to host and maintain multiple registries for different clinical needs. This complexity is magnified in the health care enterprise whereby radiology systems usually are run parallel to other clinical systems due to the different clinical workflow for radiologists. In the new era of value based care where data needs are increasing with demand for a shorter turnaround time to provide data that can be used for information and decision making, there is a critical gap to develop registries that are more adapt to the radiology workflow with minimal overhead on resources for maintenance and setup. We share our experience of developing and implementing an open source registry system for quality improvement and research in our academic institution that is driven by our radiology workflow.

Audit of radiology communication systems for critical, urgent, and unexpected significant findings.

PubMed

Duncan, K A; Drinkwater, K J; Dugar, N; Howlett, D C

2016-03-01

To determine the compliance of UK radiology departments and trusts/healthcare organisations with National Patient Safety Agency and Royal College of Radiologist's published guidance on the communication of critical, urgent, and unexpected significant radiological findings. A questionnaire was sent to all UK radiology department audit leads asking for details of their current departmental policy regarding the issuing of alerts; use of automated electronic alert systems; methods of notification of clinicians of critical, urgent, and unexpected significant radiological findings; monitoring of results receipt; and examples of the more common types of serious pathologies for which alerts were issued. One hundred and fifty-four of 229 departments (67%) responded. Eighty-eight percent indicated that they had a policy in place for the communication of critical, urgent, and unexpected significant radiological findings. Only 34% had an automated electronic alert system in place and only 17% had a facility for service-wide electronic tracking of radiology reports. In only 11 departments with an electronic acknowledgement system was someone regularly monitoring the read rate. There is wide variation in practice across the UK with regard to the communication and monitoring of reports with many departments/trusts not fully compliant with published UK guidance. Despite the widespread use of electronic systems, only a minority of departments/trusts have and use electronic tracking to ensure reports have been read and acted upon. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

A Java viewer to publish Digital Imaging and Communications in Medicine (DICOM) radiologic images on the World Wide Web.

PubMed

Setti, E; Musumeci, R

2001-06-01

The world wide web is an exciting service that allows one to publish electronic documents made of text and images on the internet. Client software called a web browser can access these documents, and display and print them. The most popular browsers are currently Microsoft Internet Explorer (Microsoft, Redmond, WA) and Netscape Communicator (Netscape Communications, Mountain View, CA). These browsers can display text in hypertext markup language (HTML) format and images in Joint Photographic Expert Group (JPEG) and Graphic Interchange Format (GIF). Currently, neither browser can display radiologic images in native Digital Imaging and Communications in Medicine (DICOM) format. With the aim to publish radiologic images on the internet, we wrote a dedicated Java applet. Our software can display radiologic and histologic images in DICOM, JPEG, and GIF formats, and provides a a number of functions like windowing and magnification lens. The applet is compatible with some web browsers, even the older versions. The software is free and available from the author.

IRQN award paper: Operational rounds: a practical administrative process to improve safety and clinical services in radiology.

PubMed

Donnelly, Lane F; Dickerson, Julie M; Lehkamp, Todd W; Gessner, Kevin E; Moskovitz, Jay; Hutchinson, Sally

2008-11-01

As part of a patient safety program in the authors' department of radiology, operational rounds have been instituted. This process consists of radiology leaders' visiting imaging divisions at the site of imaging and discussing frontline employees' concerns about patient safety, the quality of care, and patient and family satisfaction. Operational rounds are executed at a time to optimize the number of attendees. Minutes that describe the issues identified, persons responsible for improvement, and updated improvement plan status are available to employees online. Via this process, multiple patient safety and other issues have been identified and remedied. The authors believe that the process has improved patient safety, the quality of care, and the efficiency of operations. Since the inception of the safety program, the mean number of days between serious safety events involving radiology has doubled. The authors review the background around such walk rounds, describe their particular program, and give multiple illustrative examples of issues identified and improvement plans put in place.

A model to determine payments associated with radiology procedures.

PubMed

Mabotuwana, Thusitha; Hall, Christopher S; Thomas, Shiby; Wald, Christoph

2017-12-01

Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards. The main challenge with current reporting systems is that the information is presented only at an aggregated level, and often not broken down further, for instance, by type of exam. As such, the primary objective of this research is to provide better visibility into payments associated with individual radiology procedures in order to better calibrate expense/capital structure of the imaging enterprise to the actual revenue or value-add to the organization it belongs to. We propose a methodology that can be used to determine technical payments at a procedure level. We use a proportion based model to allocate payments to individual radiology procedures based on total charges (which also includes non-radiology related charges). Using a production dataset containing 424,250 radiology exams we calculated the overall average technical charge for Radiology to be $873.08 per procedure and the corresponding average payment to be $326.43 (range: $48.27 for XR and $2750.11 for PET/CT) resulting in an average payment percentage of 37.39% across all exams. We describe how charges associated with a procedure can be used to approximate technical payments at a more granular level with a focus on Radiology. The methodology is generalizable to approximate payment for other services as well. Understanding payments associated with each procedure can be useful during strategic practice planning. Charge-to-total charge ratio can be used to approximate radiology payments at a procedure level. Copyright © 2017 Elsevier B.V. All rights reserved.

The Evolution of the Federal Monitoring and Assessment Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

NSTec Aerial Measurement System

2012-07-31

The Federal Radiological Monitoring and Assessment Center (FRMAC) is a federal emergency response asset whose assistance may be requested by the Department of Homeland Security (DHS), the Department of Defense (DoD), the Environmental Protection Agency (EPA), the Nuclear Regulatory Commission (NRC), and state and local agencies to respond to a nuclear or radiological incident. It is an interagency organization with representation from the Department of Energy’s National Nuclear Security Administration (DOE/NNSA), the Department of Defense (DoD), the Environmental Protection Agency (EPA), the Department of Health and Human Services (HHS), the Federal Bureau of Investigation (FBI), and other federal agencies. FRMAC,more » in its present form, was created in 1987 when the radiological support mission was assigned to the DOE’s Nevada Operations Office by DOE Headquarters. The FRMAC asset, including its predecessor entities, was created, grew, and evolved to function as a response to radiological incidents. Radiological emergency response exercises showed the need for a coordinated approach to managing federal emergency monitoring and assessment activities. The mission of FRMAC is to coordinate and manage all federal radiological environmental monitoring and assessment activities during a nuclear or radiological incident within the United States in support of state,local, tribal governments, DHS, and the federal coordinating agency. Radiological emergency response professionals with the DOE’s national laboratories support the Radiological Assistance Program (RAP), National Atmospheric Release Advisory Center (NARAC), the Aerial MeasuringSystem (AMS), and the Radiation Emergency Assistance Center/Training Site (REAC/TS). These teams support the FRMAC to provide: Atmospheric transport modeling; Radiation monitoring; Radiological analysis and data assessments; and Medical advice for radiation injuries In support of field operations, the FRMAC provides geographic information systems, communications, mechanical, electrical, logistics, and administrative support. The size of the FRMAC is tailored to the incident and is comprised of emergency response professionals drawn from across the federal government. State and local emergency response teams may also integrate their operations with FRMAC, but are not required to.« less

The effect of radiology services outsourcing on patients’ satisfaction in Tehran city hospitals

PubMed Central

Mousavi, H; Khodamoradi, F; Rostami Zarinabadi, CH; Mozafar Saadati, H; Mohammadi, M; Mahboubi, M; Mousavi, N

2015-01-01

Background: To have a developed society we should have healthy, active, and happy individuals and present that extended healthcare services perform an essential function in increasing the society’s health level. Health in a society includes the society’s, and people comfort with the condition and an assuring the situation that they can live healthily. Also, considering the self-governing plan of hospitals from 1995, the hospital authorities should choose a method of presenting services, and, the hospital is ready to present those activities during its own activities from an economic viewpoint. The current study was done while trying to discover the effect of the Outsourcing of the Radiology Unit on the patients’ satisfaction in hospitals of Tehran. Method: The present research was done in a case-evidence and sectional study. Considering the weight of a month’s references to the Radiology Unit, which included around 1200 individuals, the volume of samples for measuring the frequency of the patients’ satisfaction with the means of Morgan table was similar to 291 individuals. To decrease the error percentage in each hospital we questioned 300 individuals. (n+10) were questioned and the gathered information were examined by what means SPSS application variant 21 and were then studied by climagraph – Smirnoph, Du Whitman – Vitney K tests. Findings: the mean of the patients’ satisfaction of turned over and non-turned over Radiology Unit services were 41.46 and 45, respectively (from the maximum score of 60). A meaningful variation was seen among the patients' Satisfaction in the two hospitals from the analytical viewpoint (p-value<0.001) and there was also a significant difference between the patients’ waiting time (p-value<0.001). The research’s findings showed that the outsourcing has a negative influence on the patients’ satisfaction and the duration of their waiting time. Conclusion: Many times, managers do the outsourcing without considering individual and organizational dimensions and characteristics by just justifying it based on decreasing the expenses. Therefore, it is essential for authorities to consider not only the economic characters but also the individual and human aspects while setting the outsourcing contracts and arrangements. PMID:28316662

Exploring Ways to Implement the Health Services Mobility Study: A Feasibility Study.

ERIC Educational Resources Information Center

Lavine, Eileen M.; Moore, Audrey

A feasibility study was aimed at developing a strategy for implementing and utilizing the job analysis methodology which resulted from the Health Services Mobility Study (HSMS), particularly as it can be applied to the field of diagnostic radiology. (The HSMS method of job analysis starts with task descriptions analyzing the tasks that make up a…

How are the costs of care for medical falls distributed? The costs of medical falls by component of cost, timing, and injury severity.

PubMed

Bohl, Alex A; Phelan, Elizabeth A; Fishman, Paul A; Harris, Jeffrey R

2012-10-01

To examine the components of cost that drive increased total costs after a medical fall over time, stratified by injury severity. We used 2004-2007 cost and utilization data for persons enrolled in an integrated care delivery system. We used a longitudinal cohort study design, where each individual provides 2-3 years of administrative data grouped into 3-month intervals relative to an index date. We identified 8,969 medical fallers through International Classification of Diseases, 9th Revision, codes and E-Codes and used 8,956 nonfaller controls, identified through age and gender frequency matching. Total costs were partitioned into 7 components: inpatient, outpatient, emergency, radiology, pharmacy, postacute care, and "other." The large increase in costs after a hospitalized fall is mainly associated with inpatient and postacute care components. The spike in costs after a nonhospitalized fall is attributable to outpatient and "other" (e.g., ambulatory surgery or community health services) components. Hospitalized fallers' inpatient, emergency, postacute care, outpatient, and radiology costs are not always greater than those for nonhospitalized fallers. Components associated with increased costs after a medical fall vary over time and by injury severity. Future studies should compare if delivering certain acute and postacute health services improve health and reduce cost trajectories after a medical fall more than others. Additionally, since the older adult population and the problem of falls are growing, health care delivery systems should develop standardized methodology to monitor medical fall rates.

The business of radiology: cost accounting.

PubMed

Camponovo, Ernest J

2004-08-01

Radiology practices confront questions of resource allocation every day. Unfortunately, practices frequently fail to adequately analyze revenues and expenses, which are at the heart of success or failure in any business endeavor. Cost allocation problems permeate nearly all aspects of cost analysis and accumulation and exist throughout all types of private-sector and public-sector organizations. "Managerial" or "cost" accounting is the discipline concerned with measuring and assigning the costs of delivering services or producing products. In contrast to financial accounting, management accounting produces relevant information for internal decision making and in general is designed to answer a firm's specific operational questions. Because costs play such a critical role in deriving and planning for revenues and profits, managerial accounting is in large part devoted to measuring and accumulating costs with the aims of control and continuous cost reduction. Because radiologists' salaries are at record highs, when accounting for a practice's clinical activities, such as the provision of mammography services, some allocation of radiologist costs themselves must be made, or the practice will not be able to achieve its goal of efficient allocation of resources. Whatever cost-accounting method is used should be specific enough to allow the differentiation of costs to as detailed a level as necessary for the strategic decision at hand. It is imperative that a practice use some rational method to gather and analyze costs and that management then use these data in decision making. Successful practices will be those most aware of their costs and the minimum acceptable reimbursements necessary for their success.

How much do cancer specialists earn? A comparison of physician fees and remuneration in oncology and radiology in high-income countries.

PubMed

Boyle, Seán; Petch, Jeremy; Batt, Kathy; Durand-Zaleski, Isabelle; Thomson, Sarah

2018-02-01

The main driver of higher spending on health care in the US is believed to be substantially higher fees paid to US physicians in comparison with other countries. We aim to compare physician incomes in radiology and oncology considering differences in relation to fees paid, physician capacity and volume of services provided in five countries: the United States, Canada, Australia, France and the United Kingdom. The fee for a consultation with a specialist in oncology varies threefold across countries, and more than fourfold for chemotherapy. There is also a three to fourfold variation in fees for ultrasound and CT scans. Physician earnings in the US are greater than in other countries in both oncology and radiology, more than three times higher than in the UK; Canadian oncologists and radiologists earn considerably more than their European counterparts. Although challenging, benchmarking earnings and fees for similar health care activities across countries, and understanding the factors that explain any differences, can provide valuable insights for policy makers trying to enhance efficiency and quality in service delivery, especially in the face of rising care costs. Copyright © 2017 Elsevier B.V. All rights reserved.

Exclusive contracts in the hospital setting: a two-edged sword: part 2: pros and cons, avoidance strategies, and negotiating tips.

PubMed

Portman, Robert M

2007-06-01

Hospitals routinely enter into contracts with radiology groups for the right to be the exclusive providers of radiologic services at the facilities in exchange for the groups' agreeing to provide and manage all aspects of those services within the hospitals. These exclusive contracts generally result in radiology departments and associated equipment being closed off to physicians who are not part of the contracting groups. Although exclusive contracts offer obvious benefits to the physicians who receive them and obvious disadvantages for those who are excluded, they also present pitfalls for physicians in the chosen group. Part 1 of this article discussed the legal issues raised by exclusive contracts. Part 2 weighs the practical advantages and disadvantages of exclusive contracts for physicians covered and not covered by such contracts and strategies for avoiding them, as well as provisions that can be included in medical staff bylaws to protect physicians from the automatic termination of privileges when a hospital enters into or terminates an exclusive contract. The remainder of the article provides tips on specific provisions of exclusive contracts that should be included or avoided.

Translating New Lung Cancer Screening Guidelines into Practice: The Experience of One Community Hospital.

PubMed

Ledford, Christy J W; Gawrys, Breanna L; Wall, Jessica L; Saas, Patrick D; Seehusen, Dean A

2016-01-01

In December 2013 the US Preventive Services Task Force issued a recommendation for lung cancer screening with annual low-dose computed tomography (LDCT). As screening guidelines emerge and change, this creates an environment for studying the translation of these guidelines into practice. This study assessed how these guidelines were implemented in a community hospital setting and the resulting radiologic findings. This observational study examined the radiologic outcomes of LDCT lung cancer screening guidelines and the resulting notification. During the first year after publication of the guidelines, 94 screening LDCT scans were ordered. Of these, 21 (22.3%) did not meet the criteria outlined by the US Preventive Services Task Force. Among the 72 cases that did met published criteria, 65.3% of scans detected nodules, and among the remaining 35.6%, half had another clinically significant finding. This study shows that new lung cancer screening guidelines, as implemented at a community hospital, resulted in radiologic findings that required follow-up in more than half of patients. Clinicians must be aware of these potential incidental findings when talking to patients about the decision to order screenings. © Copyright 2016 by the American Board of Family Medicine.

[Radiological control intraoperatory of a surgical piece in non palpable breast lesions].

PubMed

Ruvalcaba Limón, Eva; Espejo Fonseca, Ruby; Bautista Piña, Verónica; Madero Preciado, Luis; Capurso Garcia, Marino; Serratos Garduño, José Eduardo; Hohenstein, Fernando Guisa; Rodríguez Cuevas, Sergio

2009-09-01

nonconcrete the mammary injuries are frequent in programs of detection of breast cancer, estereotaxic or ecographic marking is required to realize its split. The intrasurgical radiation control of the surgical piece is indispensable to evaluate the margins of the mammary cancer. to determine the effectiveness of the intrasurgical radiation control of the surgical piece in nonconcrete mammary injuries to diminish the surgical reinterventions to extend margins. women with nonconcrete mammary injuries to those who biopsy by split became, previous marking and intraoperating radiation control of the surgical piece to value margins (suitable margin the same or major of 10 mm, smaller inadequate margin of 10 mm). Intrasurgical reesicion in inadequate radiological margins became. The demographic characteristics, masto-ecographics images, histopathology of the injuries and the radiological-histopatol6gica correlation of the margins studied. Cross-sectional, prospective and descriptive study. 103 patients with 113 nonconcrete mammary injuries included themselves, with age average of 51,35 (32-73) years. In all the injuries the intrasurgical radiation control became of the surgical piece. The prevalence of mammary cancer was of 28.3% (32/113), that corresponds to stellar images (42.8%), suspicious microcalcifications with density (39.2%), microcalcifications (31.2%) and nodules (20%). Of the 32 cancers, 16 had inadequate radiological margins that required intraoperating reescision; suitable histopatologic margins in 100% were obtained (16/16). The 16 (62.5%) cancers without intraoperating reescisi6n by suitable radiological margins had suitable histopatologic margins and 37.5% (6/16) inadequate ones that required surgical reinterventionn to control the margins. The discrepancy between margins was related to microcalcifications in 83.3% of the injuries. the intrasurgical radiation control of the surgical piece is effective to evaluate margins; the intrasurgical reescisión changed inadequate margins to suitable in 50% (16/32) of the cancers; only 18.7% (6/32) of the total of cases required another surgery to control the margins.

Practical solutions for staff recruitment & retention.

PubMed

Vander Hoek, N

2001-01-01

There are three essential topics for radiology managers to consider in light of persistent staffing shortages: support of the profession and educational programs, perks as recruitment tools and incentives as retention tools. Some activities that can help support departments and educational programs for radiologic technologists are job shadowing, training for volunteer services, advanced placement for school applicants, sponsoring an educational program or clinical training site, creating a positive work environment and supporting outreach projects geared to local high schools. Traditional perks used in recruitment efforts have included relocation assistance, travel and lodging expenses during the interview process, loan repayment, scholarships and sign-on bonuses. Some common incentives for retaining employees are tuition reimbursement, cross training, availability of educational resources, continuing education opportunities, professional development and incremental increases in salary. There are many other tools that can be used, such as career ladders, creating an environment conducive to teamwork or a more personal atmosphere and showcasing talents of various staff members. There is much overlap among these suggestions in support of the profession and educational programs, recruitment and retention of qualified staff radiologic technologists. Radiology managers can and should be creative in developing different programs to build loyalty and commitment to a radiology department.

The total value equation: a suggested framework for understanding value creation in diagnostic radiology.

PubMed

Heller, Richard E

2014-01-01

As a result of macroeconomic forces necessitating fundamental changes in health care delivery systems, value has become a popular term in the medical industry. Much has been written recently about the idea of value as it relates to health care services in general and the practice of radiology in particular. Of course, cost, value, and cost-effectiveness are not new topics of conversation in radiology. Not only is value one of the most frequently used and complex words in management, entire classes in business school are taught around the concept of understanding and maximizing value. But what is value, and when speaking of value creation strategies, what is it exactly that is meant? For the leader of a radiology department, either private or academic, value creation is a core function. This article provides a deeper examination of what value is, what drives value creation, and how practices and departments can evaluate their own value creation efficiencies. An equation, referred to as the Total Value Equation, is presented as a framework to assess value creation activities and strategies. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Surveying Fourth-Year Medical Students Regarding the Choice of Diagnostic Radiology as a Specialty.

PubMed

Arleo, Elizabeth Kagan; Bluth, Edward; Francavilla, Michael; Straus, Christopher M; Reddy, Sravanthi; Recht, Michael

2016-02-01

The aim of this study was to survey fourth-year medical students, both those choosing and those not choosing diagnostic radiology as their specialty, regarding factors influencing their choice of specialty and their perceptions of radiology. A voluntary anonymous online survey hyperlink was sent to 141 US medical schools for distribution to fourth-year students. Topics included demographics, radiology education, specialty choice and influencing factors, and opinions of radiology. A representative sampling (7%) of 2015 fourth-year medical students (n = 1,219; 51% men, 49% women) participated: 7% were applying in radiology and 93% were not. For respondents applying in radiology, the most important factor was intellectual challenge. For respondents applying in nonradiology specialties, degree of patient contact was the most important factor in the decision not to choose radiology; job market was not listed as a top-three factor. Women were less likely than men to apply in radiology (P < .001), with radiology selected by 11.8% of men (56 of 476) and only 2.8% of women (13 of 459). Respondents self-identifying as Asian had a significantly higher (P = .015) likelihood of selecting radiology (19 of 156 [12.2%]) than all other races combined (44 of 723 [6.1%]). Respondents at medical schools with required dedicated medical imaging rotations were more likely to choose radiology as a specialty, but most schools still do not require the clerkship (82%). The reasons fourth-year medical students choose, or do not choose, diagnostic radiology as a specialty are multifactorial, but noncontrollable factors, such as the job market, proved less compelling than controllable factors, such as taking a radiology rotation. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

PubMed Central

Ray, David M; Srinivasan, Indu; Tang, Shou-Jiang; Vilmann, Andreas S; Vilmann, Peter; McCowan, Timothy C; Patel, Akash M

2017-01-01

Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient’s work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions. PMID:28396724

Activities carried out by the American College of Radiology in cooperation with the National Institute for Occupational Safety and Health. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1984-09-28

Activities carried out by the American College of Radiology are described. Guidelines on radiographic techniques for radiological technicians were developed. Annual training sessions for technologists and physicians were conducted by the American College of Radiology Task Force on Pneumoconiosis. Regulations for performing chest x rays were reviewed. Program activities such as the 12-point International Labor Organization (ILO) classification scale for diagnosis of coal workers' pneumoconiosis, and the reporting form for use of the 1980 ILO classification system were reviewed. The American College of Radiology maintained liaison between NIOSH and other medical specialty societies such as the American College of Chestmore » Physicians, the College of American Pathologists, the American Medical Association, and the American Osteopathic College of Radiology. The American College of Radiology assisted NIOSH with the initiation, development, and maintenance of a quality control method to monitor and advise physicians on the reading of radiographs.« less

Development and validation of a questionnaire to evaluate infection control in oral radiology.

PubMed

da Costa, Eliana D; Pinelli, Camila; da Silva Tagliaferro, Elaine P; Corrente, José E; Ambrosano, Glaucia M B

2017-04-01

To create and validate a questionnaire to evaluate infection control in oral radiology. The questionnaire was developed after review of the literature, which included published articles and the biosafety protocols available from healthcare agencies. The initial version of the questionnaire was composed of 14 multiple choice questions and was divided into 3 domains on handwashing, disinfection/protection of surfaces and disinfectant used. Content validity was assessed by two expert committees, which reviewed the content and scope of the questionnaire and the relevance of each item, respectively. Reliability was evaluated using test-retest and internal consistency methods with 115 undergraduate dentistry students. Construct validity was assessed using the known-groups technique and factor analysis. The known-groups technique involved 641 undergraduate dentistry students, 20 PhD students and 15 oral radiology professors. In the factor analysis, 3 radiology technicians also participated in addition to the 641 undergraduates, 20 PhD students and 15 oral radiology professors. The content validity results were found to be satisfactory to excellent for the ordinal variables (intraclass correlation coefficient = 0.722-1.000) and good to great for the yes/no questions (kappa = 0.662-0.913) in terms of reliability and good internal consistency (Cronbach's alpha = 0.88). After a factor analysis, some questions were excluded, and the questions were grouped into new domains. Significant differences were observed between answers from different groups. The final version of the questionnaire was composed of nine domains. The questionnaire created was found to exhibit good psychometric properties for assessing infection control in oral radiology.

Outcomes of asymptomatic anastomotic leaks found on routine postoperative water-soluble enema following anterior resection for cancer.

PubMed

Killeen, S; Souroullas, P; Ho Tin, H; Hunter, I A; O'Grady, H; Gunn, J; Hartley, J E

2013-11-01

The incidence and consequence of an anastomotic leak associated with low anterior resection for cancer mandates covering stoma in most cases. A water-soluble enema is often performed to assess anastomotic integrity prior to stoma reversal. The functional outcome following reversal in patients with occult radiologically detected leaks is poorly defined. The goal of the present study was to determine the functional outcome in patients with a radiologically detected anastomotic leak who subsequently underwent stoma reversal. This case control study used patients with and without radiologically detected occult anastomotic leak having undergone reversal of covering stomata. The study group was matched with controls for age, gender, procedure, tumor stage, and adjuvant/neoadjuvant therapy. Validated fecal incontinence quality of life (FIQL), Cleveland Clinic Fecal Incontinence Score (CCFIS), and the Memorial Sloan-Kettering Cancer Center (MSKCC) Bowel Function Index (BFI) were used. Patient satisfaction, medication use, and ancillary procedures prior to closure were also recorded. Thirteen patients with radiologically detected occult anastomotic leaks and 13 matched controls were identified from a prospectively maintained database. The FIQL, CCFIS, and MSKCC BFI scores were significantly reduced in those with occult leaks. The mean number of radiological and surgical interventions was significantly greater in the patients with occult leaks. Antidiarrheal and bulking agent use, as well as patient satisfaction, were the same for both groups. Only one patient in the occult leak group would not undergo stoma reversal again. Reversal of a defunctioning ileostomy in the presence of an occult radiological leak can be associated with poorer functional outcomes, but patient satisfaction is undiminished.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Myrna Scott holds a replica of the emblem noting that the Radiological Control Center at NASA's Kennedy Space Center has been named in honor of her husband, Randy Scott who died last year. A ceremony honored the extensive contributions of Randy Scott. A professional health physicist of more than 40 years, Scott served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016.

Radiology Reporting System Data Exchange With the Electronic Health Record System: A Case Study in Iran.

PubMed

Ahmadi, Maryam; Ghazisaeidi, Marjan; Bashiri, Azadeh

2015-03-18

In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. This study provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with the electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. This is a cross-sectional study that was conducted in 2013. The study population was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also Visual Paradigm software was used to design a conceptual model. Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, with providing the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

42 CFR 482.24 - Condition of participation: Medical record services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... consultative evaluations of the patient and appropriate findings by clinical and other staff involved in the..., radiology, and laboratory reports, and vital signs and other information necessary to monitor the patient's...

42 CFR 482.24 - Condition of participation: Medical record services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... consultative evaluations of the patient and appropriate findings by clinical and other staff involved in the..., radiology, and laboratory reports, and vital signs and other information necessary to monitor the patient's...

Conversion of Radiology Reporting Templates to the MRRT Standard.

PubMed

Kahn, Charles E; Genereaux, Brad; Langlotz, Curtis P

2015-10-01

In 2013, the Integrating the Healthcare Enterprise (IHE) Radiology workgroup developed the Management of Radiology Report Templates (MRRT) profile, which defines both the format of radiology reporting templates using an extension of Hypertext Markup Language version 5 (HTML5), and the transportation mechanism to query, retrieve, and store these templates. Of 200 English-language report templates published by the Radiological Society of North America (RSNA), initially encoded as text and in an XML schema language, 168 have been converted successfully into MRRT using a combination of automated processes and manual editing; conversion of the remaining 32 templates is in progress. The automated conversion process applied Extensible Stylesheet Language Transformation (XSLT) scripts, an XML parsing engine, and a Java servlet. The templates were validated for proper HTML5 and MRRT syntax using web-based services. The MRRT templates allow radiologists to share best-practice templates across organizations and have been uploaded to the template library to supersede the prior XML-format templates. By using MRRT transactions and MRRT-format templates, radiologists will be able to directly import and apply templates from the RSNA Report Template Library in their own MRRT-compatible vendor systems. The availability of MRRT-format reporting templates will stimulate adoption of the MRRT standard and is expected to advance the sharing and use of templates to improve the quality of radiology reports.

[Targeted methods for measuring patient satisfaction in a radiological center].

PubMed

Maurer, M H; Stein, E; Schreiter, N F; Renz, D M; Poellinger, A

2010-11-01

To investigate two event-oriented methods for evaluating patient satisfaction with radiological services like outpatient computed tomography (CT) examinations. 159 patients (55% men, 45% women) were asked to complete a questionnaire to provide information about their satisfaction with their examination. At first, patients were asked to spontaneously recall notably positive and negative aspects (so-called "critical incidents", critical incident technique = CIT) of the examination. Subsequently a flow chart containing all single steps of the examination procedure was shown to all patients. They were asked to point out the positive and negative aspects they perceived at each step (so-called sequential incident technique = SIT). The CIT-based part of the questionnaire yielded 356 comments (183 positive and 173 negative), which were assigned to one of four categories: interaction of staff with patient, procedure and organization, CT examination, and overall setting of the examination. Significantly more detailed comments regarding individual aspects of the CT examination were elicited in the second part of the survey, which was based on the SIT. There were 1413 statements with a significantly higher number of positive comments (n = 939, 66%) versus negative comments (n = 474, 34%; p < 0.001). The critical and sequential incident techniques are suitable to measure the subjective satisfaction with the delivery of radiological services such as CT examinations. Positive comments confirm the adequacy of the existing procedures, while negative comments provide direct information about how service quality can be improved. © Georg Thieme Verlag KG Stuttgart · New York.

Radiology Preparedness in Ebola Virus Disease: Guidelines and Challenges for Disinfection of Medical Imaging Equipment for the Protection of Staff and Patients

PubMed Central

Palmore, Tara N.; Folio, Les R.; Bluemke, David A.

2015-01-01

The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. The purpose of this article is to consider the effect of EVD on radiology departments and imaging equipment, with particular consideration of guidelines currently available from the Centers for Disease Control and Prevention that may be applicable to radiology. © RSNA, 2015 PMID:25654616

Online social networking for radiology.

PubMed

Auffermann, William F; Chetlen, Alison L; Colucci, Andrew T; DeQuesada, Ivan M; Grajo, Joseph R; Heller, Matthew T; Nowitzki, Kristina M; Sherry, Steven J; Tillack, Allison A

2015-01-01

Online social networking services have changed the way we interact as a society and offer many opportunities to improve the way we practice radiology and medicine in general. This article begins with an introduction to social networking. Next, the latest advances in online social networking are reviewed, and areas where radiologists and clinicians may benefit from these new tools are discussed. This article concludes with several steps that the interested reader can take to become more involved in online social networking. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Ebola virus disease: radiology preparedness.

PubMed

Bluemke, David A; Meltzer, Carolyn C

2015-02-01

At present, there is a major emphasis on Ebola virus disease (EVD) preparedness training at medical facilities throughout the United States. Failure to have proper EVD procedures in place was cited as a major reason for infection of medical personnel in the United States. Medical imaging does not provide diagnosis of EVD, but patient assessment in the emergency department and treatment isolation care unit is likely to require imaging services. The purpose of this article is to present an overview of relevant aspects of EVD disease and preparedness relevant to the radiologic community. © RSNA, 2014.

Aerial Radiological Survey of Abandoned Uranium Mines (AUM) Map Service, Navajo Nation, 1994-1999, US EPA Region 9

EPA Pesticide Factsheets

This map service contains data from aerial radiological surveys of 41 potential uranium mining areas (1,144 square miles) within the Navajo Nation that were conducted during the period from October 1994 through October 1999. The US Environmental Protection Agency (USEPA) Region 9 funded the surveys and the US Department of Energy (USDOE) Remote Sensing Laboratory (RSL) in Las Vegas, Nevada conducted the aerial surveys. The aerial survey data were used to characterize the overall radioactivity and excess Bismuth 214 levels within the surveyed areas.This US EPA Region 9 web service contains the following map layers: Total Terrestrial Gamma Activity Polygons, Total Terrestrial Gamma Activity Contours, Excess Bismuth 214 Contours, Excess Bismuth 214 Polygons, Flight AreasFull FGDC metadata records for each layer can be found by clicking the layer name at the web service endpoint and viewing the layer description.Security Classification: Public. Access Constraints: None. Use Constraints: None. Please check sources, scale, accuracy, currentness and other available information. Please confirm that you are using the most recent copy of both data and metadata. Acknowledgement of the EPA would be appreciated.

Managing a Multisite Academic-Private Radiology Practice Reading Environment: Impact of IT Downtimes on Enterprise Efficiency.

PubMed

Becker, Murray; Goldszal, Alberto; Detal, Julie; Gronlund-Jacob, Judith; Epstein, Robert

2015-06-01

The aim of this study was to assess whether the complex radiology IT infrastructures needed for large, geographically diversified, radiology practices are inherently stable with respect to system downtimes, and to characterize the nature of the downtimes to better understand their impact on radiology department workflow. All radiology IT unplanned downtimes over a 12-month period in a hybrid academic-private practice that performs all interpretations in-house (no commercial "nighthawk" services) for approximately 900,000 studies per year, originating at 6 hospitals, 10 outpatient imaging centers, and multiple low-volume off-hours sites, were logged and characterized using 5 downtime metrics: duration, etiology, failure type, extent, and severity. In 12 consecutive months, 117 unplanned downtimes occurred with the following characteristics: duration: median time = 3.5 hours with 34% <1.5 hours and 30% >12 hours; etiology: 87% were due to software malfunctions, and 13% to hardware malfunctions; failure type: 88% were transient component failures, 12% were complete component failures; extent: all sites experienced downtimes, but downtimes were always localized to a subset of sites, and no system-wide downtimes occurred; severity (impact on radiologist workflow): 47% had minimal impact, 50% moderate impact, and 3% severe impact. In the complex radiology IT system that was studied, downtimes were common; they were usually a result of transient software malfunctions; the geographic extent was always localized rather than system wide; and most often, the impacts on radiologist workflow were modest. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Mission Analysis for Using Preventive Radiological/Nuclear Detection Equipment for Consequence Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buddemeier, Brooke R.; Wood-Zika, Annmarie R.; Haynes, Daniel

The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection (PRND) equipment to provide state and local agencies with scientific guidance on how to effectively use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed by technology manufacturers and purchased by responders for preventive detection and source interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management (CM) response take place, as it is currently the most widely available and fieldedmore » radiological instrumentation by state and local agencies. This effort will provide scientific guidance on the most effective way to utilize this class of equipment for consequence management missions. Gaining a better understanding of how PRND equipment can operate and perform for these missions will allow for recommendations on the tactical approach responders can use for consequence management operations. PRND equipment has been placed into service by federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be leveraged to support the emergency response in the aftermath of a radiological or nuclear event. With several hundred makes and models of PRND equipment, often with significantly different detection capabilities that do not align with their nominal PRND equipment type, development of a streamlined categorization scheme with respect to consequence management missions was the first step to identifying safe and effective uses of PRND equipment for radiological/nuclear incident response.« less

Update on the diagnostic radiology employment market: findings through 2005.

PubMed

Licurse, Adam; Saket, Daniel D; Sunshine, Jonathan H; Maynard, C Douglas; Forman, Howard P

2006-09-01

The purpose of this study is to analyze and summarize the latest data describing the diagnostic radiologist employment market. Three sources of data--vacancies in academic radiology departments as of July 1, 2005; the ratio of job listings to job seekers at a major placement service; and the number of positions advertised in the American Journal of Roentgenology and Radiology-are presented and compared with previous data. Vacancies in academic departments averaged 4.5 in 2005, an increase of 16% from 2004 but a decrease of 16% from the 2001 peak. Vacancies increased from 2004 in all specialties except nuclear medicine and "other," and vacancies decreased from 2001 in all specialties except pediatric radiology and purely research positions. Job listings per job seeker increased 8% from 2004 but remain far below peak levels. The total number of positions advertised decreased by 6% from 2004, reaching the lowest level since 1998. In 2005, 42% of the total advertised jobs were academic, as compared with 45% in 2004. Proportional decreases were seen between 2004 and 2005 in total advertisements per region except the Northwest and California. The largest proportional increases in subspecialties occurred in general radiology, abdominal imaging, and "other." Data from the American College of Radiology Professional Bureau and a survey of academic radiology departments show an increased demand for diagnostic radiologists in 2005, whereas data from the help wanted index show a decrease. In addition, the regional distribution of advertisements and the proportion of advertisements for certain specialties have shown some shifting in 2005. We believe the job market remains strong, with regional and specialty shifting.

Update on the diagnostic radiologist employment market: findings through 2004.

PubMed

Saket, Daniel D; Nwanze, Chukwuemeka C; Maynard, C Douglas; Sunshine, Jonathan H; Forman, Howard P

2005-12-01

The objective of this article is to summarize the latest information concerning the diagnostic radiologist employment market. Three sources of data are presented and compared with previous data: vacancies in academic radiology departments as of July; the ratio of job listings to job seekers at a major placement service; and the number of positions advertised in Radiology and the American Journal of Roentgenology. Vacancies in academic radiology departments averaged 3.9 in 2004, down 29%, and decreased for all subspecialties as compared with 2001, but the number of vacancies remained very similar to that for 2003. Job listings per job seeker were 1.1 in 2004, stable over the past 2 years but at the lowest level since 1997. The overall number of positions advertised declined by 14% in 2003 compared with 2002 and by an additional 17% in 2004, reaching the lowest level since 1998. In 2004, 45.3% of positions advertised were academic. Comparing 2003-2004 with 2001-2002, all geographic regions exhibited absolute declines in advertisements except the Northeast, which showed a 1.5% increase. Absolute increases occurred for musculoskeletal and emergency radiology positions. Statistically significant proportional decreases occurred for general radiology, vascular/interventional radiology, and pediatric radiology. Three separate data sources confirm a substantial and broad-based multiyear decline in the strength of the demand for diagnostic radiologists, with some shifting in relative demand for subspecialties. It is not clear if the decrease continued in 2004 or if 2004 demand was similar to that of 2003. Data are relative and do not indicate the employment market is weak in absolute terms.

Radiological Tenckhoff catheter insertion for peritoneal dialysis: A cost-effective approach.

PubMed

Lee, James; Mott, Nigel; Mahmood, Usman; Clouston, John; Summers, Kara; Nicholas, Pauline; Gois, Pedro Henrique França; Ranganathan, Dwarakanathan

2018-04-01

Radiological insertion of Tenckhoff catheters can be an alternative option for peritoneal dialysis access creation, as compared to surgical catheter insertion. This study will review the outcomes and complications of radiological Tenckhoff catheter insertion in a metropolitan renal service and compare costs between surgical and radiological insertion. Data were collected prospectively for all patients who had a Tenckhoff catheter insertion for peritoneal dialysis (PD) under radiological guidance at our hospital from May 2014 to November 2016. The type of catheter used and complications, including peri-catheter leak, exit site infection and peritonitis were reviewed. Follow-up data were also collected at points 3, 6 and 12 months from catheter insertion. Costing data were obtained from Queensland Health Electronic Reporting System (QHERS) data, average staff salaries and consumable contract price lists. In the 30-month evaluation period, 70 catheters were inserted. Two patients had an unsuccessful procedure due to the presence of abdominal adhesions. Seven patients had an episode of peri-catheter leak, and four patients had an exit site infection following catheter insertion. Peritonitis was observed in nine patients during the study period. The majority of patients (90%) remained on peritoneal dialysis at 3-month follow-up. The average costs of surgical and radiological insertion were noted to be AUD$7788.34 and AUD$1597.35, respectively. Radiological Tenckhoff catheter insertion for peritoneal dialysis appears to be an attractive and cost-effective option given less waiting periods for the procedure, the relatively low cost of insertion and comparable rates of complications. © 2017 The Royal Australian and New Zealand College of Radiologists.

Sensitivity of autopsy and radiological examination in detecting bone fractures in an animal model: implications for the assessment of fatal child physical abuse.

PubMed

Cattaneo, C; Marinelli, E; Di Giancamillo, A; Di Giancamillo, M; Travetti, O; Vigano', L; Poppa, P; Porta, D; Gentilomo, A; Grandi, M

2006-12-20

Skeletal injuries are often strong indicators of child abuse and their detection is therefore crucial. The aim of this study was to compare the sensitivity of three diagnostic approaches, namely autopsy, traditional (conventional) radiology, and computed tomography on "battered" piglets, in order to verify the sensitivity of each method, with respect to the true number of bone fractures assessed once the piglet was skeletonised (osteological control). Four newborn cadaver piglets who had died from natural causes were severely beaten post-mortem in every district of the body. Traditional radiography, computed tomography (CT) and autopsy were performed. The piglet was then macerated until skeletonised and the number of all fractures present recorded (osteological control). On the cranium, traditional radiology revealed only 35% circa of actual fractures, autopsy detected only 31% (P<0.01 for both comparisons versus osteological control), whereas CT imaging detected all fractures actually present. For ribs, radiology detected only 47% of all fractures present, and autopsy 65% circa (P>0.05 for both comparisons versus osteological control), while CT scans detected 34% (P<0.01). In suspected cases of fatal child abuse, we suggest that the bones of specific districts be directly analysed either at autopsy or by collecting specific diagnostic sites, such as parts of the rib cage, and subjecting them to maceration. The removed areas could be replaced with artificial material for cosmetic purposes. The authors stress the importance of combined radiological, CT scan, autopsy and osteological survey in the detection of perimortem bone fractures.

Emergency management and infection control in a radiology department during an outbreak of severe acute respiratory syndrome.

PubMed

Lin, Y C; Dong, S L; Yeh, Y H; Wu, Y S; Lan, G Y; Liu, C M; Chu, T C

2005-07-01

The World Health Organization classified Taiwan as a serious epidemic-stricken area when the extent of severe acute respiratory syndrome (SARS) in Taiwan became clear. As of 11 July 2003, 671 probable SARS cases had been identified in Taiwan and 7 healthcare workers had died from the disease. Radiographers were easily infected by SARS because they had close contact with suspected or probable cases while conducting chest X-ray examinations. Three radiographers had been infected by the end of May 2003. Because of the impact of SARS on the Radiology Department, the department established a SARS emergency infection control team and re-designed the department's infection-control and emergency-management procedures based on the concept of risk-grade protection. This effort included installing a radiographic room at the fever-screening station, re-allocating human resources in the Radiology Department, training the department staff in infection control, and drafting new operational procedures for radiographers conducting X-ray examinations on SARS patients. The goal of this program was to reduce the infection rate and distribute materials efficiently in the department. This article introduces the emergency-management procedure of the Radiology Department during the SARS outbreak and the infection-protection experience of the department staff.

Non-Ionizing Radiation Used in Microwave Ovens

MedlinePlus

... Human Services (HHS), U.S. Food and Drug Administration (FDA) FDA's Center for Devices and Radiological Health (CDRH) sets ... public health. These standards can be viewed on FDA's Code of Federal Regulations on Microwave Ovens . FDA ...

Approaching the Practice Quality Improvement Project in Interventional Radiology.

PubMed

Reis, Stephen P; White, Benjamin; Sutphin, Patrick D; Pillai, Anil K; Kalva, Sanjeeva P; Toomay, Seth M

2015-12-01

An important component of maintenance of certification and quality improvement in radiology is the practice quality improvement (PQI) project. In this article, the authors describe several methodologies for initiating and completing PQI projects. Furthermore, the authors illustrate several tools that are vital in compiling, analyzing, and presenting data in an easily understandable and reproducible manner. Last, they describe two PQI projects performed in an interventional radiology division that have successfully improved the quality of care for patients. Using the DMAIC (define, measure, analyze, improve, control) quality improvement framework, interventional radiology throughput has been increased, to lessen mediport wait times from 43 to 8 days, and mediport infection rates have decreased from more than 2% to less than 0.4%. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Personal Branding: A Primer for Radiology Trainees and Radiologists.

PubMed

Kalia, Vivek; Patel, Amy K; Moriarity, Andrew K; Canon, Cheri L

2017-07-01

A radiologist's personal brand is a composite of many parts in one's professional life. In an age where work quality and digital footprints are tracked and measured more than ever before, it behooves radiologists to develop and curate their own individual brands in effective ways. Personal branding consists of the decisions we make, both consciously and unconsciously, which affect our reputation and the likelihood of seeking our services in the future for both patients and referring providers. As hospital systems are increasingly adjusting their systems to cater to better patient experiences, it is imperative that radiologists similarly adjust our practice patterns to accommodate the needs of the new paradigm of value-based care. It is no longer sufficient to only practice excellent clinical radiology; one's service experience to clinical providers, report quality, and digital presence must all be robust and compelling. Defining your brand and promoting your vision and quality standards have become as important to radiologists' future as keeping up with advancements in radiologic technology. One must select the proper platforms and types of interactions in which to engage from available social media options. Developing a consistent brand and presence in the work setting, on social media accounts, and in professional organizations at the local, national, and international levels is the ultimate goal. At present, very little, if any, formal training is provided on personal branding skills such as these in current residency curricula, and it is critical for radiologists to fill their gaps in knowledge through additional means. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology applications of financial accounting.

PubMed

Leibenhaut, Mark H

2005-03-01

A basic knowledge of financial accounting can help radiologists analyze business opportunities and examine the potential impacts of new technology or predict the adverse consequences of new competitors entering their service area. The income statement, balance sheet, and cash flow statement are the three basic financial statements that document the current financial position of the radiology practice and allow managers to monitor the ongoing financial operations of the enterprise. Pro forma, or hypothetical, financial statements can be generated to predict the financial impact of specific business decisions or investments on the profitability of the practice. Sensitivity analysis, or what-if scenarios, can be performed to determine the potential impact of changing key revenue, investment, operating cost or financial assumptions. By viewing radiology as both a profession and a business, radiologists can optimize their use of scarce economic resources and maximize the return on their financial investments.

Entrepreneurship in the academic radiology environment.

PubMed

Itri, Jason N; Ballard, David H; Kantartzis, Stamatis; Sullivan, Joseph C; Weisman, Jeffery A; Durand, Daniel J; Ali, Sayed; Kansagra, Akash P

2015-01-01

Innovation and entrepreneurship in health care can help solve the current health care crisis by creating products and services that improve quality and convenience while reducing costs. To effectively drive innovation and entrepreneurship within the current health care delivery environment, academic institutions will need to provide education, promote networking across disciplines, align incentives, and adapt institutional cultures. This article provides a general review of entrepreneurship and commercialization from the perspective of academic radiology departments, drawing on information sources in several disciplines including radiology, medicine, law, and business. Our review will discuss the role of universities in supporting academic entrepreneurship, identify drivers of entrepreneurship, detail opportunities for academic radiologists, and outline key strategies that foster greater involvement of radiologists in entrepreneurial efforts and encourage leadership to embrace and support entrepreneurship. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Hospital organization and importance of an interventional radiology inpatient admitting service: Italian single-center 3-year experience.

PubMed

Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel; Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

2009-03-01

In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p < 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of 1,009,095.35 euros. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

Hospital Organization and Importance of an Interventional Radiology Inpatient Admitting Service: Italian Single-Center 3-Year Experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela

2009-03-15

In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly highermore » for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p < 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of Euro 1,009,095.35. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.« less

The Stability of Factors Influencing the Choice of Medical Specialty Among Medical Students and Postgraduate Radiology Trainees.

PubMed

Yen, Adam J; Webb, Emily M; Jordan, Eric J; Kallianos, Kimberly; Naeger, David M

2018-06-01

To investigate whether general psychological motivating factors that guide career selection of a medical specialty differ over the course of medical school and to compare differences in motivating factors among students choosing "controllable" lifestyle specialties, students choosing "uncontrollable" lifestyle specialties, and a cohort of radiology residents. An anonymous survey was distributed to first- through fourth-year medical students and radiology residents at a single institution. Participants were asked to select their top three of seven factors that most influenced their choice of medical specialty. Fourth-year students were asked to designate the specialty to which they had applied. The survey was distributed to 259 students and 47 radiology residents with a response rate of 93.8% (243 of 259) and 95.7% (45 of 47), respectively. The top three factors indicated by medical students were finding the daily work fulfilling, work-life balance, and interest in the subject. These top three factors were common to all medical student classes and did not differ between students choosing "controllable" versus "uncontrollable" fields. The factors uncommonly selected were similar personality to others in the field, attending income, competitiveness or prestige, and job market conditions. For radiology residents, the top three motivating factors were the same as for medical students. Three out of seven motivating factors were universally important to trainees, regardless of their stage of medical training or their selection of a controllable versus uncontrollable lifestyle specialty. These data suggest the variety of career choices made by students may not derive from differing underlying values. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Development and validation of a questionnaire to evaluate infection control in oral radiology

PubMed Central

Pinelli, Camila; da Silva Tagliaferro, Elaine P; Corrente, José E; Ambrosano, Glaucia M B

2017-01-01

Objectives: To create and validate a questionnaire to evaluate infection control in oral radiology. Methods: The questionnaire was developed after review of the literature, which included published articles and the biosafety protocols available from healthcare agencies. The initial version of the questionnaire was composed of 14 multiple choice questions and was divided into 3 domains on handwashing, disinfection/protection of surfaces and disinfectant used. Content validity was assessed by two expert committees, which reviewed the content and scope of the questionnaire and the relevance of each item, respectively. Reliability was evaluated using test–retest and internal consistency methods with 115 undergraduate dentistry students. Construct validity was assessed using the known-groups technique and factor analysis. The known-groups technique involved 641 undergraduate dentistry students, 20 PhD students and 15 oral radiology professors. In the factor analysis, 3 radiology technicians also participated in addition to the 641 undergraduates, 20 PhD students and 15 oral radiology professors. Results: The content validity results were found to be satisfactory to excellent for the ordinal variables (intraclass correlation coefficient = 0.722–1.000) and good to great for the yes/no questions (kappa = 0.662–0.913) in terms of reliability and good internal consistency (Cronbach's alpha = 0.88). After a factor analysis, some questions were excluded, and the questions were grouped into new domains. Significant differences were observed between answers from different groups. The final version of the questionnaire was composed of nine domains. Conclusions: The questionnaire created was found to exhibit good psychometric properties for assessing infection control in oral radiology. PMID:28112553

POOL WATER TREATMENT AND COOLING SYSTEM DESCRIPTION DOCUMENT

DOE Office of Scientific and Technical Information (OSTI.GOV)

V. King

2000-06-19

The Pool Water Treatment and Cooling System is located in the Waste Handling Building (WHB), and is comprised of various process subsystems designed to support waste handling operations. This system maintains the pool water temperature within an acceptable range, maintains water quality standards that support remote underwater operations and prevent corrosion, detects leakage from the pool liner, provides the capability to remove debris from the pool, controls the pool water level, and helps limit radiological exposure to personnel. The pool structure and liner, pool lighting, and the fuel staging racks in the pool are not within the scope of themore » Pool Water Treatment and Cooling System. Pool water temperature control is accomplished by circulating the pool water through heat exchangers. Adequate circulation and mixing of the pool water is provided to prevent localized thermal hotspots in the pool. Treatment of the pool water is accomplished by a water treatment system that circulates the pool water through filters, and ion exchange units. These water treatment units remove radioactive and non-radioactive particulate and dissolved solids from the water, thereby providing the water clarity needed to conduct waste handling operations. The system also controls pool water chemistry to prevent advanced corrosion of the pool liner, pool components, and fuel assemblies. Removal of radioactivity from the pool water contributes to the project ALARA (as low as is reasonably achievable) goals. A leak detection system is provided to detect and alarm leaks through the pool liner. The pool level control system monitors the water level to ensure that the minimum water level required for adequate radiological shielding is maintained. Through interface with a demineralized water system, adequate makeup is provided to compensate for loss of water inventory through evaporation and waste handling operations. Interface with the Site Radiological Monitoring System provides continuous radiological monitoring of the pool water. The Pool Water Treatment and Cooling System interfaces with the Waste Handling Building System, Site-Generated Radiological Waste Handling System, Site Radiological Monitoring System, Waste Handling Building Electrical System, Site Water System, and the Monitored Geologic Repository Operations Monitoring and Control System.« less

Bulgarian experience in the establishment of reference dose levels and implementation of a quality control system in diagnostic radiology.

PubMed

Vassileva, J; Dimov, A; Slavchev, A; Karadjov, A

2005-01-01

Results from a Bulgarian patient dose survey in diagnostic radiology are presented. Reference levels for entrance surface dose (ESD) were 0.9 mGy for chest radiography (PA), 30 mGy for lumbar spine (Lat), 10 mGy for pelvis, 5 mGy for skull (AP), 3 mGy for skull (Lat) and 13 mGy for mammography. Quality control (QC) programmes were proposed for various areas of diagnostic radiology. Film processing QC warranted special attention. Proposed QC programmes included parameters to be tested, level of expertise needed and two action levels: remedial and suspension. Programmes were tested under clinical conditions to assess initial results and draw conclusions for further QC system development. On the basis of international experience, measurement protocols were developed for all parameters tested. QC equipment was provided as part of the PHARE project. A future problem for QC programme implementation may be the small number of medical physics experts in diagnostic radiology.

CHALLENGES IN SETTING UP QUALITY CONTROL IN DIAGNOSTIC RADIOLOGY FACILITIES IN NIGERIA.

PubMed

Inyang, S O; Egbe, N O; Ekpo, E

2015-01-01

The Nigerian Nuclear Regulatory Authority (NNRA) was established to regulate and control the use of radioactive and radiation emitting sources in Nigeria. Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the authorization of diagnostic radiology facilities in the Country. Some quality control tests (output, exposure linearity and reproducibility) were measured on the x-ray machines in the facilities that took part in the study. Questionnaire was developed to evaluate the frequencies at which QC tests were conducted in the facilities and the challenges in setting up QC. Results show great variation in the values of the QC parameters measured. Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study. The responses on the frequencies at which QC tests should be conducted did not correspond to the recommended standards; indicating that personnel were not familiar with QC implementation and may require further training on QC.

Technology Assessment and Roadmap for the Emergency Radiation Dose Assessment Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turteltaub, K W; Hartman-Siantar, C; Easterly, C

2005-10-03

A Joint Interagency Working Group (JIWG) under the auspices of the Department of Homeland Security Office of Research and Development conducted a technology assessment of emergency radiological dose assessment capabilities as part of the overall need for rapid emergency medical response in the event of a radiological terrorist event in the United States. The goal of the evaluation is to identify gaps and recommend general research and development needs to better prepare the Country for mitigating the effects of such an event. Given the capabilities and roles for responding to a radiological event extend across many agencies, a consensus ofmore » gaps and suggested development plans was a major goal of this evaluation and road-mapping effort. The working group consisted of experts representing the Departments of Homeland Security, Health and Human Services (Centers for Disease Control and the National Institutes of Health), Food and Drug Administration, Department of Defense and the Department of Energy's National Laboratories (see appendix A for participants). The specific goals of this Technology Assessment and Roadmap were to: (1) Describe the general context for deployment of emergency radiation dose assessment tools following terrorist use of a radiological or nuclear device; (2) Assess current and emerging dose assessment technologies; and (3) Put forward a consensus high-level technology roadmap for interagency research and development in this area. This report provides a summary of the consensus of needs, gaps and recommendations for a research program in the area of radiation dosimetry for early response, followed by a summary of the technologies available and on the near-term horizon. We then present a roadmap for a research program to bring present and emerging near-term technologies to bear on the gaps in radiation dose assessment and triage. Finally we present detailed supporting discussion on the nature of the threats we considered, the status of technology today, promising emerging technologies and references for further reading.« less

Implementation of a PACS for radiography training and clinical service in a university setting through a multinational effort

NASA Astrophysics Data System (ADS)

Tang, Fuk-hay; Law, Yuen Y.; Zhang, Jianguo; Liu, Hai L.; Chang, Tony; Matsuda, Koyo; Cao, Fei

2001-08-01

The Hong Kong Polytechnic University has a Radiography Division under the Development of Optometry and Radiography. The Division trains both diagnostic and therapeutic radiographers with 60 students/year and offers a B.Sc. degree. In addition the Division together with the University Health Service operates a radiography clinic with radiology consultation from radiologists from other hospitals and clinics. This paper describers the implementation of a PACS in the Division for radiography training, and for clinical service.

Experimental Fuels Facility Re-categorization Based on Facility Segmentation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reiss, Troy P.; Andrus, Jason

The Experimental Fuels Facility (EFF) (MFC-794) at the Materials and Fuels Complex (MFC) located on the Idaho National Laboratory (INL) Site was originally constructed to provide controlled-access, indoor storage for radiological contaminated equipment. Use of the facility was expanded to provide a controlled environment for repairing contaminated equipment and characterizing, repackaging, and treating waste. The EFF facility is also used for research and development services, including fuel fabrication. EFF was originally categorized as a LTHC-3 radiological facility based on facility operations and facility radiological inventories. Newly planned program activities identified the need to receive quantities of fissionable materials in excessmore » of the single parameter subcritical limit in ANSI/ANS-8.1, “Nuclear Criticality Safety in Operations with Fissionable Materials Outside Reactors” (identified as “criticality list” quantities in DOE-STD-1027-92, “Hazard Categorization and Accident Analysis Techniques for Compliance with DOE Order 5480.23, Nuclear Safety Analysis Reports,” Attachment 1, Table A.1). Since the proposed inventory of fissionable materials inside EFF may be greater than the single parameter sub-critical limit of 700 g of U-235 equivalent, the initial re-categorization is Hazard Category (HC) 2 based upon a potential criticality hazard. This paper details the facility hazard categorization performed for the EFF. The categorization was necessary to determine (a) the need for further safety analysis in accordance with LWP-10802, “INL Facility Categorization,” and (b) compliance with 10 Code of Federal Regulations (CFR) 830, Subpart B, “Safety Basis Requirements.” Based on the segmentation argument presented in this paper, the final hazard categorization for the facility is LTHC-3. Department of Energy Idaho (DOE-ID) approval of the final hazard categorization determined by this hazard assessment document (HAD) was required per the DOE-ID Supplemental Guidance for DOE-STD-1027-92 based on the proposed downgrade of the initial facility categorization of Hazard Category 2.« less

Workflow-enabled distributed component-based information architecture for digital medical imaging enterprises.

PubMed

Wong, Stephen T C; Tjandra, Donny; Wang, Huili; Shen, Weimin

2003-09-01

Few information systems today offer a flexible means to define and manage the automated part of radiology processes, which provide clinical imaging services for the entire healthcare organization. Even fewer of them provide a coherent architecture that can easily cope with heterogeneity and inevitable local adaptation of applications and can integrate clinical and administrative information to aid better clinical, operational, and business decisions. We describe an innovative enterprise architecture of image information management systems to fill the needs. Such a system is based on the interplay of production workflow management, distributed object computing, Java and Web techniques, and in-depth domain knowledge in radiology operations. Our design adapts the approach of "4+1" architectural view. In this new architecture, PACS and RIS become one while the user interaction can be automated by customized workflow process. Clinical service applications are implemented as active components. They can be reasonably substituted by applications of local adaptations and can be multiplied for fault tolerance and load balancing. Furthermore, the workflow-enabled digital radiology system would provide powerful query and statistical functions for managing resources and improving productivity. This paper will potentially lead to a new direction of image information management. We illustrate the innovative design with examples taken from an implemented system.

The role of open-source software in innovation and standardization in radiology.

PubMed

Erickson, Bradley J; Langer, Steve; Nagy, Paul

2005-11-01

The use of open-source software (OSS), in which developers release the source code to applications they have developed, is popular in the software industry. This is done to allow others to modify and improve software (which may or may not be shared back to the community) and to allow others to learn from the software. Radiology was an early participant in this model, supporting OSS that implemented the ACR-National Electrical Manufacturers Association (now Digital Imaging and Communications in Medicine) standard for medical image communications. In radiology and in other fields, OSS has promoted innovation and the adoption of standards. Popular OSS is of high quality because access to source code allows many people to identify and resolve errors. Open-source software is analogous to the peer-review scientific process: one must be able to see and reproduce results to understand and promote what is shared. The authors emphasize that support for OSS need not threaten vendors; most vendors embrace and benefit from standards. Open-source development does not replace vendors but more clearly defines their roles, typically focusing on areas in which proprietary differentiators benefit customers and on professional services such as implementation planning and service. Continued support for OSS is essential for the success of our field.

Referral criteria and clinical decision support: radiological protection aspects for justification.

PubMed

Pérez, M del Rosario

2015-06-01

Advanced imaging technology has opened new horizons for medical diagnostics and improved patient care. However, many procedures are unjustified and do not provide a net benefit. An area of particular concern is the unnecessary use of radiation when clinical evaluation or other imaging modalities could provide an accurate diagnosis. Referral criteria for medical imaging are consensus statements based on the best-available evidence to assist the decision-making process when choosing the best imaging procedure for a given patient. Although they are advisory rather than compulsory, physicians should have good reasons for deviation from these criteria. Voluntary use of referral criteria has shown limited success compared with integration into clinical decision support systems. These systems support good medical practice, can improve health service delivery, and foster safer, more efficient, fair, cost-effective care, thus contributing to the strengthening of health systems. Justification of procedures and optimisation of protection, the two pillars of radiological protection in health care, are implicit in the notion of good medical practice. However, some health professionals are not familiar with these principles, and have low awareness of radiological protection aspects of justification. A stronger collaboration between radiation protection and healthcare communities could contribute to improve the radiation protection culture in medical practice. © The Chartered Institution of Building Services Engineers 2014.

Radiology coding, reimbursement, and economics: a practical playbook for housestaff.

PubMed

Petrey, W Banks; Allen, Bibb; Thorwarth, William T

2009-09-01

As radiologists-in-training, residents and fellows have little time to devote to understanding the complex and often confusing world of reimbursement and radiology economics. At best, housestaff are afforded only a modicum of exposure to the economics of medicine. Although most training programs try to provide some information on the subject, between learning radiology, taking call, and juggling life outside the hospital, the majority of residents and fellows have little time or energy to learn about the economics of radiology. Furthermore, information on medical economics and radiology has only occasionally been directed specifically to housestaff or widely distributed to residents across the country. This is unfortunate because the reimbursement and economic arena will significantly affect daily practice, relationships with other specialties, and compensation. In this article, the authors briefly describe the current reimbursement and economic climate: how we got here and where we may be headed, with specific attention to coding for radiologic services. In addition, and perhaps more important, the authors highlight aspects of residents' or fellows' daily practice that may have the potential to affect reimbursement in their years of practice ahead, such as proper dictation and coding techniques, the importance of adhering to new reporting guidelines, and the need for increased radiologist involvement in professional and community activities. The authors also emphasize measures that can be taken, specifically by housestaff, to promote and preserve the image of our specialty, which ultimately is intertwined with the reimbursement and economics of our field.

Influence of physical parameters on radiation protection and image quality in intra-oral radiology

NASA Astrophysics Data System (ADS)

Belinato, W.; Souza, D. N.

2011-10-01

In the world of diagnostic imaging, radiography is an important supplementary method for dental diagnosis. In radiology, special attention must be paid to the radiological protection of patients and health professionals, and also to image quality for correct diagnosis. In Brazil, the national rules governing the operation of medical and dental radiology were specified in 1998 by the National Sanitary Surveillance Agency, complemented in 2005 by the guide "Medical radiology: security and performance of equipment." In this study, quality control tests were performed in public clinics with dental X-ray equipment in the State of Sergipe, Brazil, with consideration of the physical parameters that influence radiological protection and also the quality of images taken in intra-oral radiography. The accuracy of the exposure time was considered acceptable for equipment with digital timers. Exposure times and focal-spot size variations can lead to increased entrance dose. Increased dose has also been associated with visual processing of radiographic film, which often requires repeating the radiographic examination.

A survey of interventional radiology for the management of obstetric haemorrhage in the United Kingdom.

PubMed

Webster, V J; Stewart, R; Stewart, P

2010-07-01

Massive haemorrhage remains a leading cause of maternal death worldwide. Interventional radiology can be used to prevent or treat life-threatening haemorrhage, but evidence for its efficacy is limited to case series predominantly from large tertiary centres. The current availability of interventional radiology for management of obstetric haemorrhage in the UK is unknown. A postal questionnaire on the use of interventional radiology was sent to the lead clinician for obstetric anaesthesia in 226 UK maternity units. The response rate was 72%; 74 respondents (46%) had considered and 51 (31%) used interventional radiology for control of obstetric haemorrhage. Its use was primarily confined to large tertiary obstetric units and limited by availability of equipment and staff. Interventional radiology to assist in the management of obstetric haemorrhage is not uniformly available in the UK and experience remains limited. Access to this resource is subject to striking local variability and influenced by the size and nature of the hospital supporting the delivery unit. 2010 Elsevier Ltd. All rights reserved.

Radiology 1984. A conflict of high technology and high cost.

PubMed

Evens, R G

1984-12-01

Radiology is confronted now by exciting but challenging times. The excitement derives from dramatic technological advance; the challenge from the economic constraints on health care delivery. The large and growing expense of providing health care is readily apparent and high technology medicine can too easily be blamed for the growth. The pressures for improved service at no extra cost will demand much of the negotiating skills of our specialty and our ability to survive administrative confusion and fragmentation. Equally, manpower planning is a feature of modern medicine. Often this is done from inadequate data and as a specialty we must continue to think constructively about our own future in this context, not least in recognizing the contribution of women to our specialty. Forces also to be recognized are decentralization, electronic information transfer, concerns about radiation exposure and litigation. Not least we need to be better able to define our specialty as its scope is now changing rapidly. For the future I hope that we can be part of the development of the controls which we must inevitably face; we should lead in instituting cost-accounting in our departments; we must be at the leading edge of technological change in both imaging and data transfer, and we must be both more business-like as well as act effectively as the patient's advocate. Radiology has an important and growing responsibility in patient care and most of the technological advances both improve that care and can be justified economically. I am proud to be a radiologist in 1984.

Radiology Technician (AFSC 90370).

ERIC Educational Resources Information Center

Sobczak, James

This five-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for radiology technicians. Covered in the individual volumes are radiographic fundamentals (x-ray production; primary beams; exposure devices; film, film holders, and darkrooms; control of film quality; and environmental safety);…

Upstairs downstairs: vertical integration of a pediatric service.

PubMed

Racine, A D; Stein, R E; Belamarich, P F; Levine, E; Okun, A; Porder, K; Rosenfeld, J L; Schechter, M

1998-07-01

The combined effects of recent changes in health care financing and training priorities have compelled academic medical centers to develop innovative structures to maintain service commitments yet conform to health care marketplace demands. In 1992, a municipal hospital in the Bronx, New York, affiliated with a major academic medical center reorganized its pediatric service into a vertically integrated system of four interdependent practice teams that provided comprehensive care in the ambulatory as well as inpatient settings. One of the goals of the new system was to conserve inpatient resources. To describe the development of a new vertically integrated pediatric service at an inner-city municipal hospital and to test whether its adoption was associated with the use of fewer inpatient resources. A descriptive analysis of the rationale, goals, implementation strategies, and structure of the vertically integrated pediatric service combined with a before-and-after comparison of in-hospital resource consumption. A before-and-after comparison was conducted for two periods: the period before vertical integration, from January 1989 to December 1991, and the period after the adoption of vertical integration, from July 1992 to December 1994. Four measures of inpatient resource use were compared after adjustment for case mix index: mean certified length of stay per case, mean number of radiologic tests per case, mean number of ancillary tests per case, and mean number of laboratory tests per case. Difference-in-differences-in-differences estimators were used to control for institution-wide trends throughout the time period and regional trends in inpatient pediatric practice occurring across institutions. Results. In 1992, the Department of Pediatrics at the Albert Einstein College of Medicine reorganized the pediatric service at Jacobi Medical Center, one of its principal municipal hospital affiliates, into a vertically integrated pediatric service that combines ambulatory and inpatient activities into four interdependent practice teams composed of attending pediatricians, allied health professionals, house officers, and social workers. The new vertically integrated service was designed to improve continuity of care for patients, provide a model of practice for professional trainees, conserve scarce resources, and create a clinical research infrastructure. The vertically integrated pediatric service augmented the role of attending pediatricians, extended the use of allied health professionals from the ambulatory to the inpatient sites, established interdisciplinary practice teams that unified the care of pediatric patients and their families, and used less inpatient resources. Controlling for trends within the study institution and trends in the practice of pediatrics across institutions throughout the time period, the vertical integration was associated with a decline in 0.6 days per case, the use of 0.62 fewer radiologic tests per case, 0.21 fewer ancillary tests per case, and 2.68 fewer laboratory tests per case. We conclude that vertical integration of a pediatric service at an inner-city municipal hospital is achievable; conveys advantages of improved continuity of care, enhanced opportunities for primary care training, and increased participation of senior clinicians; and has the potential to conserve significant amounts of inpatient resources.

Managing healthcare information using short message service (SMS) in wireless broadband networks

NASA Astrophysics Data System (ADS)

Documet, Jorge; Tsao, Sinchai; Documet, Luis; Liu, Brent J.; Zhou, Zheng; Joseph, Anika O.

2007-03-01

Due to the ubiquity of cell phones, SMS (Short Message Service) has become an ideal means to wirelessly manage a Healthcare environment and in particular PACS (Picture Archival and Communications System) data. SMS is a flexible and mobile method for real-time access and control of Healthcare information systems such as HIS (Hospital Information System) or PACS. Unlike conventional wireless access methods, SMS' mobility is not limited by the presence of a WiFi network or any other localized signal. It provides a simple, reliable yet flexible method to communicate with an information system. In addition, SMS services are widely available for low costs from cellular phone service providers and allows for more mobility than other services such as wireless internet. This paper aims to describe a use case of SMS as a means of remotely communicating with a PACS server. Remote access to a PACS server and its Query-Retrieve services allows for a more convenient, flexible and streamlined radiology workflow. Wireless access methods such as SMS will increase dedicated PACS workstation availability for more specialized DICOM (Digital Imaging and Communications in Medicine) workflow management. This implementation will address potential security, performance and cost issues of applying SMS as part of a healthcare information management system. This is in an effort to design a wireless communication system with optimal mobility and flexibility at minimum material and time costs.

21 CFR 1040.20 - Sunlamp products and ultraviolet lamps intended for use in sunlamp products.

Code of Federal Regulations, 2010 CFR

2010-04-01

... irradiation of any part of the living human body, by ultraviolet radiation with wavelengths in air between 200..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR LIGHT...

21 CFR 1040.20 - Sunlamp products and ultraviolet lamps intended for use in sunlamp products.

Code of Federal Regulations, 2011 CFR

2011-04-01

... irradiation of any part of the living human body, by ultraviolet radiation with wavelengths in air between 200..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR LIGHT...

Teleradiology: a case study of the economic and legal considerations in international trade in telemedicine.

PubMed

McLean, Thomas R; Richards, Edward P

2006-01-01

Growth in the global market for telemedical services is being driven by economics. Two operational models are already recognizable. "Nighthawk" providers are virtually indistinguishable from their domestic counterparts with respect to medical malpractice liability and price for service. Indian providers, in contrast, offer deep price discounts on services, but jurisdictional loopholes are likely to allow these providers a method to avoid medical malpractice liability. Hospitals that outsource their radiology services need to be aware of these differences, because hiring Indian telemedical providers will likely result in a shift of medical malpractice liability from providers to hospitals.

A comparison of Chevron and Lindgren-Turan osteotomy techniques in hallux valgus surgery: a prospective randomized controlled study.

PubMed

Uygur, Esat; Özkan, Namık Kemal; Akan, Kaya; Çift, Hakan

2016-01-01

The aim of this prospective randomized controlled single-blind study was to compare the results of Chevron and Lindgren-Turan osteotomy techniques for treatment of moderate hallux valgus. A total of 66 female patients (34 in Chevron group, 32 Lindgren-Turan group) were recruited in this study and followed up for an average of 26.08 months. Operative procedures were performed by 2 surgeons, and patients were evaluated by an another researcher who was blinded to the surgical technique. The groups were compared for their radiological and clinical results. Both techniques was clinically and radiologically effective (p<0.01). However, no significant differences were found between the 2 groups regarding American Orthopaedic Foot and Ankle Society's clinical rating system, Painful Foot Evaluation scale of Maryland University scores, or radiologic evaluation (p>0.05). Compared to the Chevron group, the Lindgren-Turan group was found to have shorter surgical duration (p<0.05) and significantly more shortening at the first metatarsal (p<0.05). In moderate hallux valgus deformity, both the Chevron and Lindgren-Turan osteotomy techniques are clinically and radiologically safe, effective, and reliable alternatives. No superiority was detected in either technique. Although shortening at the first metatarsal in the Lindgren-Turan group was radiologically significant, the results were clinically tolerable.

Automated assessment and tracking of human body thermal variations using unsupervised clustering.

PubMed

Yousefi, Bardia; Fleuret, Julien; Zhang, Hai; Maldague, Xavier P V; Watt, Raymond; Klein, Matthieu

2016-12-01

The presented approach addresses a review of the overheating that occurs during radiological examinations, such as magnetic resonance imaging, and a series of thermal experiments to determine a thermally suitable fabric material that should be used for radiological gowns. Moreover, an automatic system for detecting and tracking of the thermal fluctuation is presented. It applies hue-saturated-value-based kernelled k-means clustering, which initializes and controls the points that lie on the region-of-interest (ROI) boundary. Afterward, a particle filter tracks the targeted ROI during the video sequence independently of previous locations of overheating spots. The proposed approach was tested during experiments and under conditions very similar to those used during real radiology exams. Six subjects have voluntarily participated in these experiments. To simulate the hot spots occurring during radiology, a controllable heat source was utilized near the subject's body. The results indicate promising accuracy for the proposed approach to track hot spots. Some approximations were used regarding the transmittance of the atmosphere, and emissivity of the fabric could be neglected because of the independence of the proposed approach for these parameters. The approach can track the heating spots continuously and correctly, even for moving subjects, and provides considerable robustness against motion artifact, which occurs during most medical radiology procedures.

Radiology system evolution in the new millennium.

PubMed

Nauert, R C

2001-01-01

For many decades the practice of radiology grew slowly in America and was largely a secondary function under the control of hospitals. In more recent times it has vastly expanded its array of diagnostic, interventional, and therapeutic abilities. There is increasing consumer logic for direct access. Motivations have grown to create large independent entities with broadly diverse capabilities in order to succeed in the new millennium. Most regional markets are evolving rapidly in terms of managed care penetration, health system formation, physician practice consolidation and aggressive purchaser behavior by employers and consumers. To understand the enormity of healthcare evolution, it is useful to look at the industry's paradigm shifts in recent decades. Virtually every aspect of organizational infrastructure, delivery approaches, and the business environment has evolved markedly during the past fifty years. These changes will accelerate. To succeed financially, radiology groups must strengthen their market positions, technical capabilities, continuums of care and geographic dominance. Equally important is the wisdom of diversifying incomes into related services and businesses that provide additional related revenues. Key factors for successful development include facility market growth, full coverage of managed care contracts, high efficiency and aggressive diversification. A fully evolved system generates significant revenues and profitability by protecting and strengthening its financial position in this environment. That is accomplished through the development of strategically located radiology groups, aggressive alliances with medical practices in allied disciplines, and managed radiology departments and facilities for partner health systems. Organizational success ultimately depends on the ability to accept capitated payments under risk-bearing arrangements. The strategic business plan should be organized with the appropriate levels of detail needed to establish executive focus and priorities. These should be woven into operational and capital budgets to reflect expectations of the revenues, expenses and investments tied to the plan. While formidable, all of these objectives are realistic and can be accomplished if the right decisions are made. Initially, the entity's principle business objective is to formulate and begin implementation of methodical yet aggressive strategies for growth that are sensitive to sustaining high levels of quality patient care. The next phase features mergers with large, independent radiology practices in key geographic areas and successful acquisition of smaller practices. The objective of the final phase is to aggressively expand into select metropolitan areas with regional coverage and full teleradiology capabilities. High levels of market strength and financial performance are necessary to succeed. Passive limitations to small geographic areas and narrow practices will undermine their market position and dissolve financial strength with no hope of recovery. Only the dominant systems will survive and prosper.

The prevalence of radiological glenohumeral osteoarthritis in long-term type 1 diabetes: the Dialong shoulder study.

PubMed

Juel, N G; Brox, J I; Hellund, J C; Holte, K B; Berg, T J

2017-12-14

This study compares the prevalence of radiological osteoarthritis (OA) in patients with type 1 diabetes mellitus (DM1) for > 45 years and controls, and explores the association with shoulder pain and glycaemic burden in patients with DM1. The Dialong study is a cross-sectional, observational study with 30 years of historical data on long-term glycaemic control. We included 102 patients with DM1 and 73 diabetes-free controls. Demographic data, worst shoulder pain last week [numeric rating scale (NRS) 0-10], pain on abduction at examination (NRS 0-10), and current and historical glycosylated haemoglobin (HbA 1c ) levels were collected. Standardized shoulder X-rays were taken and interpreted for OA applying the Kellgren-Lawrence classification. In the diabetes group (49% women), the mean ± sd duration of DM1 was 50.6 ± 4.8 years, mean 30 year HbA 1c 7.4%, and age 61.9 ± 7.1 years. The mean age of controls (57% women) was 62.6 ± 7.0 years. Radiological glenohumeral OA was found in 36 diabetes patients (35%) and 10 controls (14%) [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.6 to 7.5; p = 0.002]. Few persons had moderate and severe OA [6.9% vs 1.3%, OR 5.3 (95% Cl 0.6 to 44.1); p = 0.1]. Fifteen diabetes patients had painful OA versus two controls (adjusted OR 5.4, 95% CI 0.6 to 47.9; p = 0.13). There was no association between OA and long-term glycaemic burden (mean 30 year HbA 1c ) in the diabetes group (p > 0.2). Radiological glenohumeral OA was more common in patients with DM1 than in controls for mild, but not moderate and severe OA. The radiological findings were not associated with shoulder pain or long-term glycaemic burden.

Externally Acquired Radiological Data for the Clinical Routine - A Review of the Reimbursement Situation in Germany.

PubMed

Schreyer, Andreas G; Steinhäuser, René T; Rosenberg, Britta

2018-02-07

 Interdisciplinary radiological conferences and boards can improve therapeutic pathways. Because of the reinterpretation and presentation of external image data, which already was read, an additional workload is created which is currently not considered by health care providers. In this review we discuss the ongoing basics and possibilities in health economy for a radiological second opinion for the outpatient and inpatient sector in Germany.  Based on up-to-date literature and jurisdiction, we discuss the most important questions for the reimbursement for second opinions and conference presentations of external image data in an FAQ format. Additionally, we focus on the recently introduced E-Health law accordingly.  Radiological services considering second opinion or board presentation of externally acquired image data are currently not adequately covered by health care providers. In particular, there is no reimbursement possibility for the inpatient sector. Only patients with private insurance or privately paid second opinions can be charged when these patients visit the radiologist directly.  Currently there is no adequate reimbursement possibility for a radiological second opinion or image demonstrations in clinical conferences. It will be essential to integrate adequate reimbursement by health care providers in the near future because of the importance of radiology as an essential diagnostic and therapeutic medical partner.   · Currently there is no reimbursement for image interpretation and presentation in boards.. · Second opinions can only be reimbursed for patients with private insurance or privately recompensed.. · The E-Health law allows reimbursement for tele-counsel in very complex situations.. · It will be crucial to integrate radiological second opinion in future reimbursement policies by health care providers.. · Schreyer AG, Steinhäuser RT, Rosenberg B. Externally Acquired Radiological Data for the Clinical Routine - A Review of the Reimbursement Situation in Germany. Fortschr Röntgenstr 2018; DOI: 10.1055/s-0044-101552. © Georg Thieme Verlag KG Stuttgart · New York.

Design and implementation of GRID-based PACS in a hospital with multiple imaging departments

NASA Astrophysics Data System (ADS)

Yang, Yuanyuan; Jin, Jin; Sun, Jianyong; Zhang, Jianguo

2008-03-01

Usually, there were multiple clinical departments providing imaging-enabled healthcare services in enterprise healthcare environment, such as radiology, oncology, pathology, and cardiology, the picture archiving and communication system (PACS) is now required to support not only radiology-based image display, workflow and data flow management, but also to have more specific expertise imaging processing and management tools for other departments providing imaging-guided diagnosis and therapy, and there were urgent demand to integrate the multiple PACSs together to provide patient-oriented imaging services for enterprise collaborative healthcare. In this paper, we give the design method and implementation strategy of developing grid-based PACS (Grid-PACS) for a hospital with multiple imaging departments or centers. The Grid-PACS functions as a middleware between the traditional PACS archiving servers and workstations or image viewing clients and provide DICOM image communication and WADO services to the end users. The images can be stored in distributed multiple archiving servers, but can be managed with central mode. The grid-based PACS has auto image backup and disaster recovery services and can provide best image retrieval path to the image requesters based on the optimal algorithms. The designed grid-based PACS has been implemented in Shanghai Huadong Hospital and been running for two years smoothly.

Flattening the organization: implementing self-directed work groups.

PubMed

Brandon, G M

1996-01-01

In response to tremendous growth of managed care and threats to financial stability and job security, the Greater Baltimore Medical Center (GBMC) restructured itself into independent business units. The radiology department at GBMC resolved to reduce cost per unit-of-service, improve service, determine optimal staffing levels and reduce the number of layers of organization. It was decided to achieve those goals by implementing self-directed work groups. Staff buy-in was critical to success of the project. To begin, the staff was educated intensively about current trends in healthcare, managed care and potential changes in the job market. The radiology department was allowed to reduce the size of its staff through attrition and worked hard to focus staff concern on the impact each individual could have on the bottom line and the resultant effect on job security. Self-directed work groups were designed on a matrix that used small "service teams" in combinations to form larger "work groups." Actual work and daily activities occur at the service team level; information exchange and major decisions occue at the work group level. Seventeen months after beginning the project and 10 months after implementation, the organization has flattened, staff members have adjusted well to new roles, there have been no lay-offs, and the matrix system of small and large groups have proved particularly valuable.

Excerpts from Managing CQI in Radiology and Diagnostic Imaging Services: A CQI Handbook.

PubMed

Joseph, E D; Lesher, C; Zage, R

1994-01-01

Continuous quality improvement (CQI) is currently the most popular and influential quality management program used in healthcare organizations. It is an effective methodology for identifying and acting on opportunities to improve the efficiency, effectiveness and value of services provided to customers. CQI implementation can be broken down into four components: (1) achievement objectives and goal identification, (2) system process analysis, (3) action planning and implementation, and (4) performance measurement and follow-up. As the project team establishes goals, it should consider customer and staff needs, what constitutes "quality," existing guidelines and regulations, and how results will be measured. Many techniques can be used to analyze the procedure or function targeted for improvement, including charts and diagrams, formal monitoring, data collection and statistical analysis. After the project team has identified potential service improvements, they develop an action plan, which may include education, recruitment, reassignment or equipment acquisition. The team must consider the impact of proposed changes and the financial and logistical feasibility of various proposals. The dynamic challenges of radiology and diagnostic imaging cannot be addressed through single, isolated actions; efforts to improve quality should be continuous. Accordingly, the project team should measure and analyze results of the action plan, reappraise goals and look for opportunities to further improve service.

Work plan for the radiological survey for the David Witherspoon, Incorporated, Landfill-1630 site, Knoxville, Tennessee

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1996-07-01

This work plan establishes the methods and requirements for performing a radiological survey at the David Witherspoon, Incorporated, Landfill-1630 Site, Knoxville, Tennessee (DWI 1630 Site) in accordance with requirements under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). The radiological survey will identify the radiological contamination level of the equipment and debris stored at the DWI 1630 Site. The data generated from the survey activities will support the decisions for characterization of the equipment/debris and aid in subsequent disposition and waste handling. The survey activities to be performed under this work plan include an equipment radiological survey,more » a walkover survey, and an immunoassay testing for polychlorinated biphenyls (PCBs). This work plan includes a quality assurance (QA)/quality control (QC) project plan, a health and safety (H&S) plan, and a waste management plan.« less

Manpower Needs in Environmental Engineering

ERIC Educational Resources Information Center

Middlebrooks, E. J.; And Others

1974-01-01

Outlines manpower needs in both the public and private sectors in the areas of air pollution control, solid waste management, radiological hazard control, pesticide hazard control, and water pollution control. (GS)

21 CFR 812.20 - Application.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES..., where appropriate, installation of the device, in sufficient detail so that a person generally familiar... Center for Devices and Radiological Health, the Center for Biologics Evaluation and Research, or the...

75 FR 43178 - Medicare Program; Solicitation for Proposals for the Medicare Imaging Demonstration

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

..., medical specialty societies, physician groups, integrated health care delivery systems, independent practice associations, radiology benefit managers, health plans, information technology vendors, and... societies. The Centers for Medicare & Medicaid Services (CMS) worked with medical specialty societies and...

An Integrated Interactive-Spaced Education Radiology Curriculum for Preclinical Students.

PubMed

Tshibwabwa, Eli; Mallin, Robert; Fraser, Madeleine; Tshibwabwa, Martin; Sanii, Reza; Rice, James; Cannon, Jenifer

2017-01-01

The objective of this study is to determine whether a radiology module, together with online spaced education, helps students of an integrated problem-based learning (PBL) curriculum increase their radiology knowledge and long-term retention. Second-year students at the American University of Antigua College of Medicine participated in small groups of ten students each into two 2 h of radiology laboratories. The study comprised two cohorts: winter and fall 2013 students (control group) and 2014 students (experimental group). Both groups used face-to-face PBL. The students of the experimental group received additional online-spaced education. The skills were assessed for both groups before the beginning of laboratories and 4 weeks and 7 months after laboratories. There was no significant difference on pretest between the control and experimental groups. On completion of the radiology laboratories, comparison of test results before and after training showed net improvement for both groups. The corresponding difference for the experimental group was higher compared to the one for the control group (7.83 vs. 6.21, P < 0.001). The difference between the scores on delayed test and pretest showed that the students of both groups demonstrated average knowledge improvement even though their level of performance was slightly below the posttest. The corresponding difference for the experimental group did not differ much from the posttest ( P > 0.05), and no significant difference of scores was observed 7 months later for either group. Further, a higher percentage of the students in the experimental group strongly agreed that their learning objectives were met (92% vs. 71%, P > 0.001), and this trend persisted throughout the study. Online spaced education combined to a face-to-face PBL enhances not only the student's knowledge of basic radiology along with his/her self-assessment skills but also the long-term retention of radiology material and satisfaction with the integrated interactive system-based module. Future research is needed to see if medical students in need of additional education support may benefit from spaced education in the field of remediation.

An indicator device for monitoring of room illuminance level in the radiological image viewing environment.

PubMed

Azlan, C A; Ng, K H; Anandan, S; Nizam, M S

2006-09-01

Illuminance level in the softcopy image viewing room is a very important factor to optimize productivity in radiological diagnosis. In today's radiological environment, the illuminance measurements are normally done during the quality control procedure and performed annually. Although the room is equipped with dimmer switches, radiologists are not able to decide the level of illuminance according to the standards. The aim of this study is to develop a simple real-time illuminance detector system to assist the radiologists in deciding an adequate illuminance level during radiological image viewing. The system indicates illuminance in a very simple visual form by using light emitting diodes. By employing the device in the viewing room, illuminance level can be monitored and adjusted effectively.

Is excision biopsy of fibroadenomas based solely on size criteria warranted?

PubMed

Neville, Grace; Neill, Cathleen O'; Murphy, Rosemary; Corrigan, Mark; Redmond, Paul H; Feeley, Linda; Bennett, Michael W; O'Connell, Fionnuala; Browne, Tara Jane

2018-05-25

Fibroadenomas (FA) are the most common benign tumor in the female breast. Most are managed conservatively provided there is clinical, radiologic, and pathologic concordance. However, surgical excision is typically recommended for cellular fibroepithelial lesions or those lesions with clinical, radiologic, or pathologic features concerning for phyllodes tumor (PT). Some studies have suggested surgical excision in all FA >30 mm to reduce core needle biopsy (CNB) sampling errors. The aim of our study was to evaluate, in the absence of any other concerning clinicopathologic features, whether surgical excision of FA was warranted based on size criteria alone. Cork University Hospital is a large academic center in Southern Ireland. Its breast cancer center provides both a screening and symptomatic service and diagnoses approximately 600 cancers per year. The breast histopathological data base was reviewed for all CNBs from January 1, 2010, to June 30, 2015, with a diagnosis of FA that went on to have excision at our institution. We excluded all cellular fibroepithelial lesions and those cases with co-existent lobular neoplasia, ductal carcinoma in situ, invasive carcinoma, atypical ductal hyperplasia, or lesions which would require excision in their own right. Cases in which the radiologic targeted mass was discordant with a diagnosis of FA were also excluded. Patient demographics and preoperative radiologic size and the radiologic target were recorded in each case. All radiology was reviewed by a breast radiologist prior to inclusion in the study, and there was histologic radiologic concordance with a diagnosis of FA in all cases. A total of 12,109 consecutive radiologically guided CNB were performed January 2010-June 2015; 3438 with a diagnosis of FA were identified of which 290 cases went on to have surgical excision. Of those 290 cases; 98.28% (n = 285) were confirmed as FA on excision. The remaining 1.72% (n = 5) had atypical features-FA with LCIS (n = 1), benign PT (n = 3), and invasive ductal carcinoma (n = 1). Our study suggests that, excision based solely on size is not warranted in clinical and radiologically concordant cases with a diagnosis of FA on CNB. © 2018 Wiley Periodicals, Inc.

Value management program: performance, quantification, and presentation of imaging value-added actions.

PubMed

Patel, Samir

2015-03-01

Health care is in a state of transition, shifting from volume-based success to value-based success. Hospital executives and referring physicians often do not understand the total value a radiology group provides. A template for easy, cost-effective implementation in clinical practice for most radiology groups to demonstrate the value they provide to their clients (patients, physicians, health care executives) has not been well described. A value management program was developed to document all of the value-added activities performed by on-site radiologists, quantify them in terms of time spent on each activity (investment), and present the benefits to internal and external stakeholders (outcomes). The radiology value-added matrix is the platform from which value-added activities are categorized and synthesized into a template for defining investments and outcomes. The value management program was first implemented systemwide in 2013. Across all serviced locations, 9,931.75 hours were invested. An annual executive summary report template demonstrating outcomes is given to clients. The mean and median individual value-added hours per radiologist were 134.52 and 113.33, respectively. If this program were extrapolated to the entire field of radiology, approximately 30,000 radiologists, this would have resulted in 10,641,161 uncompensated value-added hours documented in 2013, with an estimated economic value of $2.21 billion. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Comparison of delayed complications of central venous catheters placed surgically or radiologically in pediatric oncology patients.

PubMed

Basford, Tavis J; Poenaru, Dan; Silva, Mariana

2003-05-01

Pediatric central venous catheters (CVCs) traditionally have been placed surgically, guided by anatomic landmarks. Increasingly, interventional radiology services are inserting CVCs using ultrasound image guidance. This study compares the frequency of delayed complications in CVCs placed surgically or radiologically in a pediatric oncology population. Data on CVCs placed in one academic institution over 10 years were collected and analyzed retrospectively. Main outcomes assessed were infectious complications, mechanical complications, and premature catheter removal. Ninety-eight CVCs-comprising 52 external tunneled catheters (ETCs) and 46 subcutaneous ports-were assessed in 67 patients. Median patient age was 6.1 years for children with external catheters and 7.8 years for those with ports. Both infectious and mechanical complications were significantly more common among surgically placed ETCs than those placed radiologically (P <.05). Complications per 1,000 catheter days and premature removal showed a trend toward greater frequency among surgical ETCs, although this did not reach statistical significance. No consistent trends were seen in complications among ports. Pediatric patients with CVCs, especially those with external catheters, experience frequent delayed complications. Patients with radiologically inserted ETCs may encounter fewer complications than those with surgically placed ones. This corroborates previous reports in the literature suggesting image-guided CVC placement as a preferable alternative to traditional techniques. Copyright 2003 Elsevier Inc. All rights reserved.

Strategic planning and radiology practice management in the new health care environment.

PubMed

Sharpe, Richard E; Mehta, Tejas S; Eisenberg, Ronald L; Kruskal, Jonathan B

2015-01-01

Current comprehensive health care reform in the United States demands that policy makers, insurers, providers, and patients work in reshaping the health care system to deliver care that is both more affordable and of higher quality. A tectonic shift is under way that runs contrary to the traditional goal of radiology groups to perform and interpret large numbers of imaging examinations. In fact, radiology service requisitions now must be evaluated for their appropriateness, possibly resulting in a reduction in the number of imaging studies performed. To be successful, radiology groups will have to restructure their business practices and strategies to align with the emerging health care paradigm. This article outlines a four-stage strategic framework that has aided corporations in achieving their goals and that can be readily adapted and applied by radiologists. The four stages are (a) definition and articulation of a purpose, (b) clear definition of strategic goals, (c) prioritization of specific strategic enablers, and (d) implementation of processes for tracking progress and enabling continuous adaptation. The authors provide practical guidance for applying specific tools such as analyses of strengths, weaknesses, opportunities, and threats (so-called SWOT analyses), prioritization matrices, and balanced scorecards to accomplish each stage. By adopting and applying these tools within the strategic framework outlined, radiology groups can position themselves to succeed in the evolving health care environment. RSNA, 2015

Effect of direct neuroradiologist participation in physician marketing on imaging volumes in outpatient radiology.

PubMed

Grignon, L; Keiper, M; Vavricek, J; Horsley, W; Murphy, R; Grignon, A; Yu, F

2014-08-01

Over the past several years, decreased demand for and increased supply of imaging services has increased competition among outpatient imaging centers in the United States. This study hypothesizes that using a radiology sales representative and neuroradiologist as a team in marketing and sales will increase imaging referrals in outpatient imaging. From January to December 2009, baseline monthly physician referral data of CT and MR scans of 19 referring clinicians (neurologists, neurosurgeons, and anesthesiologists) to an outpatient radiology group were collected. During that time, a nonphysician radiology sales representative visited the referring clinicians' offices every 2 weeks. From January to June 2010, the same radiology sales representative visited the referring clinicians' offices every 2 weeks but was accompanied by a neuroradiologist once a month. From July 2010 to June 2011, the same radiology sales representative visited the referring clinicians' offices twice a month without a neuroradiologist. Cross-sectional imaging referral volumes were approximately 2.5 times greater during the 6-month period using the neuroradiologist for direct physician-to-physician marketing when compared with the volumes achieved with the sales representative alone, and continued neuroradiologist involvement in marketing and sales is required to maintain referral volumes over time. The impact on imaging referral volumes during the 6-month use of the neuroradiologist for direct physician-to-physician marketing in this study supports the assertion that neuroradiologist visits are an important element in establishing and maintaining a relationship with the referring clinician's office and thereby maximizing imaging referrals. © 2014 by American Journal of Neuroradiology.

The Radiologist Is in, but Was it Worth the Wait? Radiology Resident Note Quality in an Outpatient Interventional Radiology Clinic.

PubMed

Abboud, Salim E; Soriano, Stephanie; Abboud, Rayan; Patel, Indravadan; Davidson, Jon; Azar, Nami R; Nakamoto, Dean A

Preprocedural evaluation of patients in an interventional radiology (IR) clinic is a complex synthesis of physical examination and imaging findings, and as IR transitions to an independent clinical specialty, such evaluations will become an increasingly critical component of a successful IR practice and quality patient care. Prior research suggests that preprocedural evaluations increased patient's perceived quality of care and may improve procedural technical success rates. Appropriate documentation of a preprocedural evaluation in the medical record is also paramount for an interventional radiologist to add value and function as an effective member of a larger IR service and multidisciplinary health care team. The purpose of this study is to examine the quality of radiology resident notes for patients seen in an outpatient IR clinic at a single academic medical center before and after the adoption of clinic note template with reminders to include platelet count, international normalized ratio, glomerular filtration rate, and plan for periprocedural coagulation status. Before adoption of the template, platelet count, international normalized ratio, glomerular filtration rate and an appropriate plan for periprocedural coagulation status were documented in 72%, 82%, 42%, and 33% of patients, respectively. After adoption of the template, appropriate documentation of platelet count, international normalized ratio, and glomerular filtration rate increased to 96%, and appropriate plan for periprocedural coagulation status was documented in 83% of patients. Patient evaluation and clinical documentation skills may not be adequately practiced during radiology residency, and tools such as templates may help increase documentation quality by radiology residents. Copyright © 2017 Elsevier Inc. All rights reserved.

21 CFR 1002.13 - Annual reports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Required Manufacturers' Reports for Listed Electronic Products § 1002.13... § 1002.1 shall submit an annual report summarizing the contents of the records required to be maintained...

21 CFR 892.1820 - Pneumoencephalographic chair.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pneumoencephalographic chair. 892.1820 Section 892.1820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1820 Pneumoencephalographic chair. (a...

Changing concepts in long-term central venous access: catheter selection and cost savings.

PubMed

Horattas, M C; Trupiano, J; Hopkins, S; Pasini, D; Martino, C; Murty, A

2001-02-01

Long-term central venous access is becoming an increasingly important component of health care today. Long-term central venous access is important therapeutically for a multitude of reasons, including the administration of chemotherapy, antibiotics, and total parenteral nutrition. Central venous access can be established in a variety of ways varying from catheters inserted at the bedside to surgically placed ports. Furthermore, in an effort to control costs, many traditionally inpatient therapies have moved to an outpatient setting. This raises many questions regarding catheter selection. Which catheter will result in the best outcome at the least cost? It has become apparent in our hospital that traditionally placed surgical catheters (ie, Hickmans and central venous ports) may no longer be the only options. The objective of this study was to explore the various modalities for establishing central venous access comparing indications, costs, and complications to guide the clinician in choosing the appropriate catheter with the best outcome at the least cost. We evaluated our institution's central venous catheter use during a 3-year period from 1995 through 1997. Data was obtained retrospectively through chart review. In addition to demographic data, specific information regarding catheter type, placement technique, indications, complications, and catheter history were recorded. Cost data were obtained from several departments including surgery, radiology, nursing, anesthesia, pharmacy, and the hospital purchasing department. During a 30-month period, 684 attempted central venous catheter insertions were identified, including 126 surgically placed central venous catheters, 264 peripherally inserted central catheters by the nursing service, and 294 radiologically inserted peripheral ports. Overall complications were rare but tended to be more severe in the surgical group. Relative cost differences between the groups were significant. Charges for peripherally inserted central catheters were $401 per procedure, compared with $3870 for radiologically placed peripheral ports and $3532 to $4296 for surgically placed catheters. Traditional surgically placed central catheters are increasingly being replaced by peripherally inserted central venous access devices. Significant cost savings and fewer severe complications can be realized by preferential use of peripherally inserted central catheters when clinically indicated. Cost savings may not be as significant when comparing radiologically placed versus surgically placed catheters. However, significant cost savings and fewer severe complications are associated with peripheral central venous access versus the surgical or radiologic approach.

Effects of Hospital Workers' Friendship Networks on Job Stress.

PubMed

Shin, Sung Yae; Lee, Sang Gyu

2016-01-01

This study attempted to identify the sources of job stress according to job position and investigate how friendship networks affect job stress. Questionnaires based on The Health Professions Stress Inventory (HPSI) developed by Wolfgang experienced by healthcare providers were collected from 420 nurses, doctors and radiological technologists in two general hospitals in Korea by a multistage cluster sampling method. Multiple regression analysis was used to examine the effects of friendship networks on job stress after controlling for other factors. The severity of job stress differed according to level of job demands (p = .006); radiologic technologists experienced the least stress (45.4), nurses experienced moderate stress (52.4), and doctors experienced the most stress (53.6). Those with long-term friendships characterized by strong connections reported lower levels of stress than did those with weak ties to friends among nurses (1.3, p < .05) and radiological technologists (11.4, p < .01). The degree of cohesion among friends had a positive impact on the level of job stress experienced by nurses (8.2, p < .001) and radiological technologists (14.6, p < .1). Doctors who participated in workplace alumni meetings scored higher than those who did not. However, those who participated in alumni meetings outside the workplace showed the opposite tendency, scoring 9.4 (p < .05) lower than those who did not. The resources from their friendship network include both information and instrumental support. As most radiological technologists were male, their instrumental support positively affected their job stress (9.2, p < .05). Life information support was the primary positive contributor to control of nurses' (4.1, p < .05), radiological technologists' (8.0, p < .05) job stress. The strength and density of such friendship networks were related to job stress. Life information support from their friendship network was the primary positive contributor to control of job stress.

Effects of Hospital Workers’ Friendship Networks on Job Stress

PubMed Central

Shin, Sung Yae; Lee, Sang Gyu

2016-01-01

Background This study attempted to identify the sources of job stress according to job position and investigate how friendship networks affect job stress. Methods Questionnaires based on The Health Professions Stress Inventory (HPSI) developed by Wolfgang experienced by healthcare providers were collected from 420 nurses, doctors and radiological technologists in two general hospitals in Korea by a multistage cluster sampling method. Multiple regression analysis was used to examine the effects of friendship networks on job stress after controlling for other factors. Results The severity of job stress differed according to level of job demands (p = .006); radiologic technologists experienced the least stress (45.4), nurses experienced moderate stress (52.4), and doctors experienced the most stress (53.6). Those with long-term friendships characterized by strong connections reported lower levels of stress than did those with weak ties to friends among nurses (1.3, p < .05) and radiological technologists (11.4, p < .01). The degree of cohesion among friends had a positive impact on the level of job stress experienced by nurses (8.2, p < .001) and radiological technologists (14.6, p < .1). Doctors who participated in workplace alumni meetings scored higher than those who did not. However, those who participated in alumni meetings outside the workplace showed the opposite tendency, scoring 9.4 (p < .05) lower than those who did not. The resources from their friendship network include both information and instrumental support. As most radiological technologists were male, their instrumental support positively affected their job stress (9.2, p < .05). Life information support was the primary positive contributor to control of nurses’ (4.1, p < .05), radiological technologists’ (8.0, p < .05) job stress. Conclusion The strength and density of such friendship networks were related to job stress. Life information support from their friendship network was the primary positive contributor to control of job stress. PMID:26900945

Patient-centered outcomes research in radiology: trends in funding and methodology.

PubMed

Lee, Christoph I; Jarvik, Jeffrey G

2014-09-01

The creation of the Patient-Centered Outcomes Research Trust Fund and the Patient-Centered Outcomes Research Institute (PCORI) through the Patient Protection and Affordable Care Act of 2010 presents new opportunities for funding patient-centered comparative effectiveness research (CER) in radiology. We provide an overview of the evolution of federal funding and priorities for CER with a focus on radiology-related priority topics over the last two decades, and discuss the funding processes and methodological standards outlined by PCORI. We introduce key paradigm shifts in research methodology that will be required on the part of radiology health services researchers to obtain competitive federal grant funding in patient-centered outcomes research. These paradigm shifts include direct engagement of patients and other stakeholders at every stage of the research process, from initial conception to dissemination of results. We will also discuss the increasing use of mixed methods and novel trial designs. One of these trial designs, the pragmatic trial, has the potential to be readily applied to evaluating the effectiveness of diagnostic imaging procedures and imaging-based interventions among diverse patient populations in real-world settings. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Offshore teleradiology.

PubMed

Bradley, William G

2004-04-01

Radiologists are responsible for providing prompt emergency radiology interpretations 24 hours a day, every day of the year. As a result of the increasing use of multidetector computed tomography, emergency radiology has increased significantly in volume over the past 5 years. Simultaneously, radiologists are working harder during the day because of the workforce shortage. Although teleradiology services located in the continental United States have been providing efficient coverage until recently, they are now having increasing difficulty recruiting radiologists who are willing to work at night. Addressing this problem is "offshore teleradiology." With the increasing use of several enabling technologies--Digital Imaging and Communication in Medicine, the picture archiving and communication system, and the Internet-it is now possible to cover a domestic radiology practice at night from any location in the world where it is daytime. Setting up such a practice is nontrivial, however. The radiologists must all be American trained and certified by the American Board of Radiology. They must have medical licenses in every state and privileges at every hospital they cover. This article describes some of the details involved in setting up an offshore teleradiology practice. It also attempts to make a financial case for using such a practice, particularly in the current economic environment.

Informatics in radiology: automated Web-based graphical dashboard for radiology operational business intelligence.

PubMed

Nagy, Paul G; Warnock, Max J; Daly, Mark; Toland, Christopher; Meenan, Christopher D; Mezrich, Reuben S

2009-11-01

Radiology departments today are faced with many challenges to improve operational efficiency, performance, and quality. Many organizations rely on antiquated, paper-based methods to review their historical performance and understand their operations. With increased workloads, geographically dispersed image acquisition and reading sites, and rapidly changing technologies, this approach is increasingly untenable. A Web-based dashboard was constructed to automate the extraction, processing, and display of indicators and thereby provide useful and current data for twice-monthly departmental operational meetings. The feasibility of extracting specific metrics from clinical information systems was evaluated as part of a longer-term effort to build a radiology business intelligence architecture. Operational data were extracted from clinical information systems and stored in a centralized data warehouse. Higher-level analytics were performed on the centralized data, a process that generated indicators in a dynamic Web-based graphical environment that proved valuable in discussion and root cause analysis. Results aggregated over a 24-month period since implementation suggest that this operational business intelligence reporting system has provided significant data for driving more effective management decisions to improve productivity, performance, and quality of service in the department.

Volume Changes After Stereotactic LINAC Radiotherapy in Vestibular Schwannoma: Control Rate and Growth Patterns

DOE Office of Scientific and Technical Information (OSTI.GOV)

Langenberg, Rick van de, E-mail: rickvandelangenberg@hotmail.com; Dohmen, Amy J.C.; Bondt, Bert J. de

2012-10-01

Purpose: The purpose of this study was to evaluate the control rate of vestibular schwannomas (VS) after treatment with linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) or radiotherapy (SRT) by using a validated volumetric measuring tool. Volume-based studies on prognosis after LINAC-based SRS or SRT for VS are reported scarcely. In addition, growth patterns and risk factors predicting treatment failure were analyzed. Materials and Methods: Retrospectively, 37 VS patients treated with LINAC based SRS or SRT were analyzed. Baseline and follow-up magnetic resonance imaging scans were analyzed with volume measurements on contrast enhanced T1-weighted magnetic resonance imaging. Absence of intervention aftermore » radiotherapy was defined as 'no additional intervention group, ' absence of radiological growth was defined as 'radiological control group. ' Significant growth was defined as a volume change of 19.7% or more, as calculated in a previous study. Results: The cumulative 4-year probability of no additional intervention was 96.4% {+-} 0.03; the 4-year radiological control probability was 85.4% {+-} 0.1). The median follow-up was 40 months. Overall, shrinkage was seen in 65%, stable VS in 22%, and growth in 13%. In 54% of all patients, transient swelling was observed. No prognostic factors were found regarding VS growth. Previous treatment and SRS were associated with transient swelling significantly. Conclusions: Good control rates are reported for LINAC based SRS or SRT in VS, in which the lower rate of radiological growth control is attributed to the use of the more sensitive volume measurements. Transient swelling after radiosurgery is a common phenomenon and should not be mistaken for treatment failure. Previous treatment and SRS were significantly associated with transient swelling.« less

Uniformed Services University of the Health Sciences Journal, 2001 Edition

DTIC Science & Technology

2002-05-15

rehabilitation system developed by Movement and Sports Specialists, Inc., which improves physical rehabilitation of mine amputees through the use of new...unique challenges created by the use of biologic, chemical and radiologic weapons, we were especially pleased to note that DoD’s University of the...improving the quality of life for our service members, retirees, and families. All of us in the Office of the Secretary of Defense place great emphasis

[Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital: measurable changes in academic quality indicators?].

PubMed

Lorenzen, J; Habermann, C; Utler, C; Grzyska, U; Weber, C; Adam, G; Koops, A

2009-10-01

To evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. After implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. The evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. The evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological University Hospital after implementation of a QM system according to DIN ISO 9001:2000. Georg Thieme Verlag KG Stuttgart-New York.

DOC/WSNSO (Department of Commerce/Weather Service Nuclear Support Office) operational support to Federal Radiological Monitoring and Assessment Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mueller, P.

1989-01-01

The National Weather Service (NWS) is an agency of the Department of Commerce. The NWS has hundreds of weather offices throughout the United States. The Weather Service Nuclear Support Office (WSNSO) is a highly specialized unit of NWS that provides direct support to the U.S. Department of Energy's (DOE's) underground nuclear testing program. The WSNSO has been associated with the DOE for >33 yr. As a result of the unique relationship with the DOE, all WSNSO emergency response meteorologists and meteorological technicians are allowed access to classified material. Meteorological phenomena play a significant role during a Federal Radiological Monitoring andmore » Assessment Center (FRMAC) event, and WSNSO meteorologists provide direct support to ARAC. The marriage of state-of-the-art computer systems together with proven technology provides the on-scene WSNSO meteorologist with essentially a portable fully equipped, fully functional, advanced NWS weather station. The WSNSO's emergency response personnel and hardware are at the ready and can be mobilized within 2 h. WSNSO can provide on-scene weather forecasts and critical weather data collection whenever and wherever necessary.« less

RCT: Module 2.03, Counting Errors and Statistics, Course 8768

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hillmer, Kurt T.

2017-04-01

Radiological sample analysis involves the observation of a random process that may or may not occur and an estimation of the amount of radioactive material present based on that observation. Across the country, radiological control personnel are using the activity measurements to make decisions that may affect the health and safety of workers at those facilities and their surrounding environments. This course will present an overview of measurement processes, a statistical evaluation of both measurements and equipment performance, and some actions to take to minimize the sources of error in count room operations. This course will prepare the student withmore » the skills necessary for radiological control technician (RCT) qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and by providing in the field skills.« less

The information security needs in radiological information systems-an insight on state hospitals of Iran, 2012.

PubMed

Farhadi, Akram; Ahmadi, Maryam

2013-12-01

Picture Archiving and Communications System (PACS) was originally developed for radiology services over 20 years ago to capture medical images electronically. Medical diagnosis methods are based on images such as clinical radiographs, ultrasounds, CT scans, MRIs, or other imaging modalities. Information obtained from these images is correlated with patient information. So with regards to the important role of PACS in hospitals, we aimed to evaluate the PACS and survey the information security needed in the Radiological Information system. First, we surveyed the different aspects of PACS that should be in any health organizations based on Department of Health standards and prepared checklists for assessing the PACS in different hospitals. Second, we surveyed the security controls that should be implemented in PACS. Checklists reliability is affirmed by professors of Tehran Science University. Then, the final data are inputted in SPSS software and analyzed. The results indicate that PACS in hospitals can transfer patient demographic information but they do not show route of information. These systems are not open source. They don't use XML-based standard and HL7 standard for exchanging the data. They do not use DS digital signature. They use passwords and the user can correct or change the medical information. PACS can detect alternation rendered. The survey of results demonstrates that PACS in all hospitals has the same features. These systems have the patient demographic data but they do not have suitable flexibility to interface network or taking reports. For the privacy of PACS in all hospitals, there were passwords for users and the system could show the changes that have been made; but there was no water making or digital signature for the users.

21 CFR 814.100 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... public health and safety and with ethical standards, to encourage the discovery and use of devices...), Center for Devices and Radiological Health (CDRH), the Center for Biologics Evaluation and Research (CBER...

44 CFR 351.28 - The Department of Commerce.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Assignments § 351.28 The Department of Commerce. (a) Assist State and local governments in determining their requirements for meteorological and hydrological services for radiological emergencies and assist State and local governments in preparing to meet these requirements within the limits of available resources. (b...

44 CFR 351.28 - The Department of Commerce.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Assignments § 351.28 The Department of Commerce. (a) Assist State and local governments in determining their requirements for meteorological and hydrological services for radiological emergencies and assist State and local governments in preparing to meet these requirements within the limits of available resources. (b...

21 CFR 892.1870 - Radiographic film/cassette changer programmer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic film/cassette changer programmer. 892... SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1870 Radiographic film/cassette changer programmer. (a) Identification. A radiographic film/cassette changer programmer is a...

21 CFR 892.1870 - Radiographic film/cassette changer programmer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic film/cassette changer programmer. 892... SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1870 Radiographic film/cassette changer programmer. (a) Identification. A radiographic film/cassette changer programmer is a...

21 CFR 892.1870 - Radiographic film/cassette changer programmer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic film/cassette changer programmer. 892... SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1870 Radiographic film/cassette changer programmer. (a) Identification. A radiographic film/cassette changer programmer is a...

21 CFR 892.1870 - Radiographic film/cassette changer programmer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic film/cassette changer programmer. 892... SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1870 Radiographic film/cassette changer programmer. (a) Identification. A radiographic film/cassette changer programmer is a...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

21 CFR 1002.12 - Abbreviated reports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Abbreviated reports. 1002.12 Section 1002.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Required Manufacturers' Reports for Listed Electronic Products § 1002...

40. Perimeter acquisition radar building room #510B, chemical, biological, and ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

40. Perimeter acquisition radar building room #510B, chemical, biological, and radiological (CBR) air filter room no. 1 - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

21 CFR 892.1870 - Radiographic film/cassette changer programmer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic film/cassette changer programmer. 892... SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1870 Radiographic film/cassette changer programmer. (a) Identification. A radiographic film/cassette changer programmer is a...

21 CFR 1002.20 - Reporting of accidental radiation occurrences.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Reporting of accidental radiation occurrences... SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Manufacturers' Reports on Accidental Radiation Occurrences § 1002.20 Reporting of accidental radiation occurrences. (a) Manufacturers of electronic products...

21 CFR 1002.20 - Reporting of accidental radiation occurrences.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Reporting of accidental radiation occurrences... SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Manufacturers' Reports on Accidental Radiation Occurrences § 1002.20 Reporting of accidental radiation occurrences. (a) Manufacturers of electronic products...

21 CFR 1002.20 - Reporting of accidental radiation occurrences.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Reporting of accidental radiation occurrences... SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Manufacturers' Reports on Accidental Radiation Occurrences § 1002.20 Reporting of accidental radiation occurrences. (a) Manufacturers of electronic products...

21 CFR 892.1960 - Radiographic intensifying screen.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic intensifying screen. 892.1960 Section 892.1960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying screen...

21 CFR 892.5740 - Radionuclide teletherapy source.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radionuclide teletherapy source. 892.5740 Section 892.5740 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5740 Radionuclide teletherapy source...

21 CFR 892.1570 - Diagnostic ultrasonic transducer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic ultrasonic transducer. 892.1570 Section 892.1570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1570 Diagnostic ultrasonic transducer...

21 CFR 892.5730 - Radionuclide brachytherapy source.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radionuclide brachytherapy source. 892.5730 Section 892.5730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5730 Radionuclide brachytherapy...

21 CFR 892.1910 - Radiographic grid.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic grid. 892.1910 Section 892.1910 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1910 Radiographic grid. (a) Identification. A...

Educating medical staff about responding to a radiological or nuclear emergency.

PubMed

McCurley, M Carol; Miller, Charles W; Tucker, Florie E; Guinn, Amy; Donnelly, Elizabeth; Ansari, Armin; Holcombe, Maire; Nemhauser, Jeffrey B; Whitcomb, Robert C

2009-05-01

A growing body of audience research reveals medical personnel in hospitals are unprepared for a large-scale radiological emergency such as a terrorist event involving radioactive or nuclear materials. Also, medical personnel in hospitals lack a basic understanding of radiation principles, as well as diagnostic and treatment guidelines for radiation exposure. Clinicians have indicated that they lack sufficient training on radiological emergency preparedness; they are potentially unwilling to treat patients if those patients are perceived to be radiologically contaminated; and they have major concerns about public panic and overloading of clinical systems. In response to these findings, the Centers for Disease Control and Prevention (CDC) has developed a tool kit for use by hospital medical personnel who may be called on to respond to unintentional or intentional mass-casualty radiological and nuclear events. This tool kit includes clinician fact sheets, a clinician pocket guide, a digital video disc (DVD) of just-in-time basic skills training, a CD-ROM training on mass-casualty management, and a satellite broadcast dealing with medical management of radiological events. CDC training information emphasizes the key role that medical health physicists can play in the education and support of emergency department activities following a radiological or nuclear mass-casualty event.

Understanding patient satisfaction ratings for radiology services.

PubMed

Lang, Elvira V; Yuh, William T C; Ajam, Amna; Kelly, Ronda; Macadam, Luke; Potts, Richard; Mayr, Nina A

2013-12-01

Under the Hospital Value-Based Purchasing Program of the Centers for Medicare & Medicaid Services, patient satisfaction accounts for 30% of the measures of and payments for quality of care. Understanding what drives patient satisfaction data and how the data are obtained, converted into scores, and formulated into rankings is increasingly critical for imaging departments. The objectives of this article are to describe the potential impact of patient satisfaction ratings on institutions and individuals, explain how patient satisfaction is rated and ranked, identify drivers that affect the ratings and rankings, and probe the resulting challenges unique to radiology departments. Research results indicate that training providers to make simple modifications in their language and behavior during patient care can significantly impact patient satisfaction, which, in turn, can impact both quality-of-care ratings and the bottom line of hospitals. Training providers is a simple and cost-effective way to potentiate the clinical expression of compassion into improvement of patient satisfaction and financial reward, a national trend that no one in the game can afford to ignore.

2008 Mississippi Curriculum Framework: Postsecondary Radiologic Technology. (Program CIP: 51.0911 - Radiologic Technology/Science - Radiographer)

ERIC Educational Resources Information Center

Armstrong, David; Cochran, Timothy; Compton, Steve; Davis, Jennifer; Edgerton, Seena Shazowee; Kisner, Christie; Lewis, Judy; Sartin, Billie Faye; Shell, Deborah

2008-01-01

As the world economy continues to evolve, businesses and industries must adopt new practices and processes in order to survive. Quality and cost control, work teams and participatory management, and an infusion of technology are transforming the way people work and do business. Employees are now expected to read, write, and communicate…

What is found positive in healthcare information and communication technology implementation?-the results of a nationwide survey in Finland.

PubMed

Winblad, Ilkka; Hämäläinen, Päivi; Reponen, Jarmo

2011-03-01

Considerable expectations have been placed on information and communication technology (ICT) in improving the processes and quality of healthcare. Our purpose was to find out which element is found positive in healthcare ICT implementation. An online questionnaire on e-Health implementation submitted to all Finnish public health service providers and a sample from the private sector included an open question about which the electronic working methods, systems, or applications have most positively influenced the fluency or quality of service processes. The electronic health record was mentioned as an item that has positive influence by 52% of the respondents from the hospital districts, 27% of those from the primary healthcare centers, and 38% of those from the private providers. Digital radiology systems (including teleradiology) were mentioned by 52% of the hospital districts and 27% of the primary healthcare centers. The figures for digital laboratory systems (including telelaboratory) were 5% and 11%, respectively. The figures for teleradiology itself were 5% for the hospital districts and 15% for the primary healthcare centers; the figures for telelaboratory systems were 5% and 9%, respectively. The specialized healthcare seem to experience intraorganizational electronic services integrated to the electronic health record, such as digital radiology and laboratory services as exerting a positive influence, whereas the primary healthcare find such influence from different functions such as interorganizational data exchange and telemedicine services. These might indicate where the efforts should be focused when implementing ICT in healthcare.

Nevada National Security Site Radiological Control Manual

DOE Office of Scientific and Technical Information (OSTI.GOV)

Radiological Control Managers’ Council

2012-03-26

This document supersedes DOE/NV/25946--801, 'Nevada Test Site Radiological Control Manual,' Revision 1 issued in February 2010. Brief Description of Revision: A complete revision to reflect a recent change in name for the NTS; changes in name for some tenant organizations; and to update references to current DOE policies, orders, and guidance documents. Article 237.2 was deleted. Appendix 3B was updated. Article 411.2 was modified. Article 422 was re-written to reflect the wording of DOE O 458.1. Article 431.6.d was modified. The glossary was updated. This manual contains the radiological control requirements to be used for all radiological activities conducted bymore » programs under the purview of the U.S. Department of Energy (DOE) and the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO). Compliance with these requirements will ensure compliance with Title 10 Code of Federal Regulations (CFR) Part 835, 'Occupational Radiation Protection.' Programs covered by this manual are located at the Nevada National Security Site (NNSS); Nellis Air Force Base and North Las Vegas, Nevada; Santa Barbara and Livermore, California; and Andrews Air Force Base, Maryland. In addition, fieldwork by NNSA/NSO at other locations is covered by this manual. Current activities at NNSS include operating low-level radioactive and mixed waste disposal facilities for United States defense-generated waste, assembly and execution of subcritical experiments, assembly/disassembly of special experiments, the storage and use of special nuclear materials, performing criticality experiments, emergency responder training, surface cleanup and site characterization of contaminated land areas, environmental activity by the University system, and nonnuclear test operations, such as controlled spills of hazardous materials at the Hazardous Materials Spill Center. Currently, the major potential for occupational radiation exposure is associated with the burial of low-level radioactive waste and the handling of radioactive sources. Remediation of contaminated land areas may also result in radiological exposures.« less

A new ambulatory classification and funding model for radiation oncology: non-admitted patients in Victorian hospitals.

PubMed

Antioch, K M; Walsh, M K; Anderson, D; Wilson, R; Chambers, C; Willmer, P

1998-01-01

The Victorian Department of Human Services has developed a classification and funding model for non-admitted radiation oncology patients. Agencies were previously funded on an historical cost input basis. For 1996-97, payments were made according to the new Non-admitted Radiation Oncology Classification System and include four key components. Fixed grants are based on Weighted Radiation Therapy Services targets for megavoltage courses, planning procedures (dosimetry and simulation) and consultations. The additional throughput pool covers additional Weighted Radiation Therapy Services once targets are reached, with access conditional on the utilisation of a minimum number of megavoltage fields by each hospital. Block grants cover specialised treatments, such as brachytherapy, allied health payments and other support services. Compensation grants were available to bring payments up to the level of the previous year. There is potential to provide incentives to promote best practice in Australia through linking appropriate practice to funding models. Key Australian and international developments should be monitored, including economic evaluation studies, classification and funding models, and the deliberations of the American College of Radiology, the American Society for Therapeutic Radiology and Oncology, the Trans-Tasman Radiation Oncology Group and the Council of Oncology Societies of Australia. National impact on clinical practice guidelines in Australia can be achieved through the Quality of Care and Health Outcomes Committee of the National Health and Medical Research Council.

Decentralization in Indonesia: lessons from cost recovery rate of district hospitals.

PubMed

Maharani, Asri; Femina, Devi; Tampubolon, Gindo

2015-07-01

In 1991, Indonesia began a process of decentralization in the health sector which had implications for the country's public hospitals. The public hospitals were given greater authority to manage their own personnel, finance and procurement, with which they were allowed to operate commercial sections in addition to offering public services. These public services are subsidized by the government, although patients still pay certain proportion of fees. The main objectives of health sector decentralization are to increase the ability of public hospitals to cover their costs and to reduce government subsidies. This study investigates the consequences of decentralization on cost recovery rate of public hospitals at district level. We examine five service units (inpatient, outpatient, operating room, laboratory and radiology) in three public hospitals. We find that after 20 years of decentralization, district hospitals still depend on government subsidies, demonstrated by the fact that the cost recovery rate of most service units is less than one. The commercial sections fail to play their role as revenue generator as they are still subsidized by the government. We also find that the bulk of costs are made up of staff salaries and incentives in all units except radiology. As this study constitutes exploratory research, further investigation is needed to find out the reasons behind these results. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Informatics in radiology: evaluation of an e-learning platform for teaching medical students competency in ordering radiologic examinations.

PubMed

Marshall, Nina L; Spooner, Muirne; Galvin, P Leo; Ti, Joanna P; McElvaney, N Gerald; Lee, Michael J

2011-01-01

A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P < .0001). In general, medical students lack the core knowledge that is needed for good-quality ordering of radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.

78 FR 10174 - Agency Information Collection Activities; Proposed Collection; Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... specialties (internal medicine, radiology, cardiology, ophthalmology, and orthopedics) to gather information... Schedule, payments are based in part on the relative amount of physician work associated with each service... values are updated to reflect changes in medical practice, technology and physician productivity, some...

21 CFR 1010.13 - Special test procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Special test procedures. 1010.13 Section 1010.13 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR ELECTRONIC PRODUCTS: GENERAL Alternate Test Procedures § 1010.13...

42 CFR 413.1 - Introduction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... such as radiology. (F) Section 1834(c)(1)(C) of the Act establishes the method for determining Medicare... interns and residents in approved teaching programs on the basis of a “per resident” amount. (2) Scope....170 establishes a prospective payment method for outpatient maintenance dialysis services that applies...

42 CFR 413.1 - Introduction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... such as radiology. (F) Section 1834(c)(1)(C) of the Act establishes the method for determining Medicare... interns and residents in approved teaching programs on the basis of a “per resident” amount. (2) Scope....170 establishes a prospective payment method for outpatient maintenance dialysis services that applies...

21 CFR 892.2020 - Medical image communications device.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical image communications device. 892.2020 Section 892.2020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.2020 Medical image communications...

44 CFR 351.22 - The Environmental Protection Agency.

Code of Federal Regulations, 2014 CFR

2014-10-01

... animal feed will be done in coordination with the Department of Health and Human Services (HHS)/Food and Drug Administration.) (c) Assist FEMA in developing and promulgating guidance to State and local... State and local governments may select for use in testing and exercising radiological emergency plans...

44 CFR 351.22 - The Environmental Protection Agency.

Code of Federal Regulations, 2013 CFR

2013-10-01

... animal feed will be done in coordination with the Department of Health and Human Services (HHS)/Food and Drug Administration.) (c) Assist FEMA in developing and promulgating guidance to State and local... State and local governments may select for use in testing and exercising radiological emergency plans...

44 CFR 351.22 - The Environmental Protection Agency.

Code of Federal Regulations, 2012 CFR

2012-10-01

... animal feed will be done in coordination with the Department of Health and Human Services (HHS)/Food and Drug Administration.) (c) Assist FEMA in developing and promulgating guidance to State and local... State and local governments may select for use in testing and exercising radiological emergency plans...

44 CFR 351.22 - The Environmental Protection Agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... animal feed will be done in coordination with the Department of Health and Human Services (HHS)/Food and Drug Administration.) (c) Assist FEMA in developing and promulgating guidance to State and local... State and local governments may select for use in testing and exercising radiological emergency plans...

44 CFR 351.22 - The Environmental Protection Agency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... animal feed will be done in coordination with the Department of Health and Human Services (HHS)/Food and Drug Administration.) (c) Assist FEMA in developing and promulgating guidance to State and local... State and local governments may select for use in testing and exercising radiological emergency plans...

21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic ECG/respirator synchronizer. 892.1970 Section 892.1970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic ECG/respirator...

21 CFR 892.1360 - Radionuclide dose calibrator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radionuclide dose calibrator. 892.1360 Section 892.1360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1360 Radionuclide dose calibrator. (a...

21 CFR 892.1920 - Radiographic head holder.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic head holder. 892.1920 Section 892.1920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1920 Radiographic head holder. (a...

21 CFR 892.6500 - Personnel protective shield.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Personnel protective shield. 892.6500 Section 892.6500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Miscellaneous Devices § 892.6500 Personnel protective shield. (a...

A School-Based Clinic for Elementary Schools in Phoenix, Arizona.

ERIC Educational Resources Information Center

Wenzel, Mark

1996-01-01

A hospital, school district, and pediatrician collaboration ensured all elementary students access to health care. School nurses referred students without health insurance needing health care to hospital-provided nurse practitioners for primary care. The hospital provided pharmacy, radiology, laboratory, and emergency services. The pediatrician…

Radiology as the Point of Cancer Patient and Care Team Engagement: Applying the 4R Model at a Patient's Breast Cancer Care Initiation.

PubMed

Weldon, Christine B; Friedewald, Sarah M; Kulkarni, Swati A; Simon, Melissa A; Carlos, Ruth C; Strauss, Jonathan B; Bunce, Mikele M; Small, Art; Trosman, Julia R

2016-12-01

Radiologists aspire to improve patient experience and engagement, as part of the Triple Aim of health reform. Patient engagement requires active partnerships among health providers and patients, and rigorous teamwork provides a mechanism for this. Patient and care team engagement are crucial at the time of cancer diagnosis and care initiation but are complicated by the necessity to orchestrate many interdependent consultations and care events in a short time. Radiology often serves as the patient entry point into the cancer care system, especially for breast cancer. It is uniquely positioned to play the value-adding role of facilitating patient and team engagement during cancer care initiation. The 4R approach (Right Information and Right Care to the Right Patient at the Right Time), previously proposed for optimizing teamwork and care delivery during cancer treatment, could be applied at the time of diagnosis. The 4R approach considers care for every patient with cancer as a project, using project management to plan and manage care interdependencies, assign clear responsibilities, and designate a quarterback function. The authors propose that radiology assume the quarterback function during breast cancer care initiation, developing the care initiation sequence, as a project care plan for newly diagnosed patients, and engaging patients and their care teams in timely, coordinated activities. After initial consultations and treatment plan development, the quarterback function is transitioned to surgery or medical oncology. This model provides radiologists with opportunities to offer value-added services and solidifies radiology's relevance in the evolving health care environment. To implement 4R at cancer care initiation, it will be necessary to change the radiology practice model to incorporate patient interaction and teamwork, develop 4R content and local adaption approaches, and enrich radiology training with relevant clinical knowledge, patient interaction competence, and teamwork skill set. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Medico-legal issues in radiological consultation.

PubMed

Mozumdar, Biswita C; Jones, Gary

2003-01-01

Providers increasingly use radiological services for diagnosis and treatment. Both the referring physician and the radiological consultant can contribute to efficient and effective consultation, and direct interaction may facilitate the process further. Furthermore, inadequate communication can influence poor patient outcome. We examine the roles and responsibilities of referring physicians and consultant radiologists, and present a malpractice case, Townsend v. Turk 218 Cal. App. 3d 278 (1990), to identify medico-legal issues in radiological consultation. Important issues are implied by the Townsend case. First, it is the clinician's responsibility to include clinical information that is appropriate and adequate. Further, the radiologist is a valuable resource in the selection of the optimal procedure, provided that he or she is aware of the patient's history. The second issue discussed by the court represents a possibly more pervasive problem. The interaction between a consulting radiologist--indeed any specialist--and a treating physician is subject to difficulties caused by different conceptions of professional boundaries. The position taken by the court in the Townsend case is consistent with the traditional view that a consulting radiologist has an attenuated duty to the patient. It also would seem to receive at least some support from the language contained in the current revision of the ACR Standard for Communication: Diagnostic Radiology, effective Jan. 1, 2002: ...The referring physician or healthcare provider also shares in the responsibility of obtaining results of imaging studies they have ordered. Despite the result of the Townsend case and the current formulation of the ACR Standards, however, radiologists face risks of litigation. Indeed, the emerging trend in radiological consultation is the direct communication of results to the patient. It is clear that improved communication between radiologists and referring physicians is both desirable and imperative. Clinico-radiological encounters yield additional clinical information and guide the decision-making process. In the Townsend case, direct interaction would have resolved ambiguity.

Lack of security of networked medical equipment in radiology.

PubMed

Moses, Vinu; Korah, Ipeson

2015-02-01

OBJECTIVE. There are few articles in the literature describing the security and safety aspects of networked medical equipment in radiology departments. Most radiologists are unaware of the security issues. We review the security of the networked medical equipment of a typical radiology department. MATERIALS AND METHODS. All networked medical equipment in a radiology department was scanned for vulnerabilities with a port scanner and a network vulnerability scanner, and the vulnerabilities were classified using the Common Vulnerability Scoring System. A network sniffer was used to capture and analyze traffic on the radiology network for exposure of confidential patient data. We reviewed the use of antivirus software and firewalls on the networked medical equipment. USB ports and CD and DVD drives in the networked medical equipment were tested to see whether they allowed unauthorized access. Implementation of the virtual private network (VPN) that vendors use to access the radiology network was reviewed. RESULTS. Most of the networked medical equipment in our radiology department used vulnerable software with open ports and services. Of the 144 items scanned, 64 (44%) had at least one critical vulnerability, and 119 (83%) had at least one high-risk vulnerability. Most equipment did not encrypt traffic and allowed capture of confidential patient data. Of the 144 items scanned, two (1%) used antivirus software and three (2%) had a firewall enabled. The USB ports were not secure on 49 of the 58 (84%) items with USB ports, and the CD or DVD drive was not secure on 17 of the 31 (55%) items with a CD or DVD drive. One of three vendors had an insecure implementation of VPN access. CONCLUSION. Radiologists and the medical industry need to urgently review and rectify the security issues in existing networked medical equipment. We hope that the results of our study and this article also raise awareness among radiologists about the security issues of networked medical equipment.

When the Reading Room Meets the Team Room: Resident Perspectives From Radiology and Internal Medicine on the Effect of Personal Communication After Implementing a Resident-Led Radiology Rounds.

PubMed

Klobuka, Andrew J; Lee, John; Buranosky, Raquel; Heller, Matthew

2018-02-13

Current radiology and internal medicine (IM) residents have trained to varying degrees depending on program in the post picture archiving and communication systems implementation era and thus have largely missed out on the benefits of in-person, 2-way communication between radiologists and consulting clinicians. The purpose of this study is to broadly explore resident perspectives from these groups on the desire for personal contact between radiologists and referring physicians and the effect of improved contact on clinical practice. A radiology rounds was implemented in which radiology residents travel to the IM teaching service teams to discuss their inpatients and review ordered imaging biweekly. Surveys were given to both cohorts following 9 months of implementation. A total of 23/49 diagnostic radiology (DR) and 72/197 IM residents responded. In all, 83% of DR and 96% of IM residents desired more personal contact between radiologists and clinicians. Of all, 92% of DR residents agree that contact with referring clinicians changes their approach to a study, 96% of IM residents agree that personal contact with a radiologist has changed patient management in a way that they otherwise would not have done having simply read a report, 85% of DR residents report that more clinician contact will improve resource use, and 96% report that it will improve care quality. Furthermore, 99% of IM residents report that increased access to a radiologist would make selecting the most appropriate imaging study easier in various clinical scenarios. A majority of IM residents prefer radiology reports that provide specific next-step recommendations and that include arrows/key-image series. We conclude that the newest generation of physicians is already attuned to the value of a radiologist who plays an active, in-person role in the clinical decision-making process. Copyright © 2018 Elsevier Inc. All rights reserved.

Estimation of the herd protection of Haemophilus influenzae type b conjugate vaccine against radiologically confirmed pneumonia in children under 2 years old in Dhaka, Bangladesh.

PubMed

Chen, Wei-Ju; Moulton, Lawrence H; Saha, Samir K; Mahmud, Abdullah Al; Arifeen, Shams El; Baqui, Abdullah H

2014-02-12

Herd protection of Haemophilus influenzae type b (Hib) conjugate vaccine has been associated with excessive decrease of invasive Hib diseases, i.e., pneumonia and meningitis, with increased national or regional Hib vaccine coverage. Only a few studies have examined herd protection at the individual level and even less evidence is available from Asia. We examined Hib vaccine herd protection against radiologically confirmed pneumonia among children less than 2 years old. We incorporated data from a matched case-control study and a vaccine coverage survey in Dhaka, Bangladesh. Pneumonia cases (n=343) were confirmed by radiology. For each case, two controls with conditions other than pneumonia or meningitis were selected from the same hospital. Hib vaccine coverage was calculated as percentages of children who received at least 2 doses of Hib vaccine from a survey in the neighborhood centered on each case and control. Conditional logistic regression was fit to examine the association between vaccine coverage and risk of radiologically confirmed pneumonia. Neighborhood Hib vaccine coverage varied from 0% to 63.5% for cases and from 8.7% to 61.5% for controls, respectively. Cases were less likely to have neighborhood coverage higher than 20% (OR=0.49, 0.52, 0.55, and 0.69 for coverage 20-29%, 30-39%, 40-49%, and ≥50%, respectively) than coverage <20%, compared to controls, although the estimates for coverage 40-49% and ≥50% were not statistically significant. The study indicates that Hib vaccine may provide herd protection, even when the coverage is as low as 20-39%, in a low-income country. Asian countries should consider herd protection in implementing effective vaccine policy with limited resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

Music during interventional radiological procedures, effect on sedation, pain and anxiety: a randomised controlled trial

PubMed Central

Kulkarni, S; Johnson, P C D; Kettles, S; Kasthuri, R S

2012-01-01

Objective : To assess the effects of playing patient-selected music during interventional procedures on (1) the doses of sedation and analgesia and (2) anxiety levels. Methods : Patients undergoing interventional radiological procedures were randomised to either the intervention (music) or the control (no music) group. Patients in the intervention group had music of their choice played via headphones during the procedure. The primary outcomes were reductions in the doses of drugs for sedation (midazolam) and analgesia (fentanyl). Anxiety levels were assessed both before and after the procedure using the validated State Anxiety Inventory. Mean pulse rate and average of mean blood pressures were also recorded before and during the procedures as surrogate indicators of anxiety levels. Results : 100 patients were randomised in a 1:1 ratio. There were 58 males and 42 females, with a mean age of 58 years. Sedation was required in 21 (42%) patients in the music group compared with 30 (60%) patients in the control group (p=0.046). The mean [standard deviation (SD)] midazolam dose was 2.1 mg (2.3 mg) in the control group and 1.3 mg (2.2 mg) in the music group (p=0.027). The mean (SD) fentanyl dose was 29 mg (40 mg) in the control group and 18 mg (34 mg) in the music group (p=0.055). There was no significant effect of music on the change from baseline in anxiety levels (p=0.74), pulse rate (p=0.56) or blood pressure (p=0.34). Conclusion : Sedation requirements are significantly reduced by playing self-selected music to the patient during interventional radiology procedures. By lowering sedation during interventional radiology, music makes the procedure safer. It also contributes favourably to the overall patient experience. PMID:22422386

Architecture of next-generation information management systems for digital radiology enterprises

NASA Astrophysics Data System (ADS)

Wong, Stephen T. C.; Wang, Huili; Shen, Weimin; Schmidt, Joachim; Chen, George; Dolan, Tom

2000-05-01

Few information systems today offer a clear and flexible means to define and manage the automated part of radiology processes. None of them provide a coherent and scalable architecture that can easily cope with heterogeneity and inevitable local adaptation of applications. Most importantly, they often lack a model that can integrate clinical and administrative information to aid better decisions in managing resources, optimizing operations, and improving productivity. Digital radiology enterprises require cost-effective solutions to deliver information to the right person in the right place and at the right time. We propose a new architecture of image information management systems for digital radiology enterprises. Such a system is based on the emerging technologies in workflow management, distributed object computing, and Java and Web techniques, as well as Philips' domain knowledge in radiology operations. Our design adapts the approach of '4+1' architectural view. In this new architecture, PACS and RIS will become one while the user interaction can be automated by customized workflow process. Clinical service applications are implemented as active components. They can be reasonably substituted by applications of local adaptations and can be multiplied for fault tolerance and load balancing. Furthermore, it will provide powerful query and statistical functions for managing resources and improving productivity in real time. This work will lead to a new direction of image information management in the next millennium. We will illustrate the innovative design with implemented examples of a working prototype.

National Alliance for Radiation Readiness: Leveraging Partnerships to Increase Preparedness.

PubMed

Blumenstock, James S; Allen, Meredith

2016-02-01

The National Alliance for Radiation Readiness (NARR) is an alliance of 16 national member organizations that have banded together to serve as the collective "voice of health" in radiological preparedness through: • participation in national dialogues on radiological emergency issues; • provision of thoughtful feedback on documents, policies, and guidelines; and • convening of partners to raise awareness of and resolve radiological emergency issues. NARR benefits from the intersection and interaction of public health, radiation control, healthcare, and emergency management professionals--all with an interest in bolstering the nation's preparedness for a radiological or nuclear incident. NARR is able to provide a unique perspective on radiological and nuclear preparedness by creating multi-disciplinary workgroups to develop guidance, recommendations, and provide subject matter feedback. NARR aims to build response and recovery capacity and capabilities by supporting the sharing of resources and tools, including technical methods and information through the development of an online clearinghouse. NARR also aims to identify and disseminate best practices, as well as define and educate on the roles and responsibilities of local, state, and federal government and the numerous agencies involved with the response to a radiological emergency.

Criteria for radiologic diagnosis of hypochondroplasia in neonates.

PubMed

Saito, Tomoko; Nagasaki, Keisuke; Nishimura, Gen; Wada, Masaki; Nyuzuki, Hiromi; Takagi, Masaki; Hasegawa, Tomonobu; Amano, Naoko; Murotsuki, Jun; Sawai, Hideaki; Yamada, Takahiro; Sato, Shuhei; Saitoh, Akihiko

2016-04-01

A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period. To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia. This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora. Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6. Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates.

[Endovascular interventions for multiple trauma].

PubMed

Kinstner, C; Funovics, M

2014-09-01

In recent years interventional radiology has significantly changed the management of injured patients with multiple trauma. Currently nearly all vessels can be reached within a reasonably short time with the help of specially preshaped catheters and guide wires to achieve bleeding control of arterial und venous bleeding. Whereas bleeding control formerly required extensive open surgery, current interventional methods allow temporary vessel occlusion (occlusion balloons), permanent embolization and stenting. In injured patients with multiple trauma preinterventional procedural planning is performed with the help of multidetector computed tomography whenever possible. Interventional radiology not only allows minimization of therapeutic trauma but also a considerably shorter treatment time. Interventional bleeding control has developed into a standard method in the management of vascular trauma of the chest and abdomen as well as in vascular injuries of the upper and lower extremities when open surgical access is associated with increased risk. Additionally, pelvic trauma, vascular trauma of the superior thoracic aperture and parenchymal arterial lacerations of organs that can be at least partially preserved are primarily managed by interventional methods. In an interdisciplinary setting interventional radiology provides a safe and efficient means of rapid bleeding control in nearly all vascular territories in addition to open surgical access.

Daily Readiness Huddles in Radiology-Improving Communication, Coordination, and Problem-Solving Reliability.

PubMed

Donnelly, Lane F

Deploying an intentional daily management process is a key part to create high-reliability culture. Key components described in the literature for a successfully daily management process include leadership standard work, visual controls, daily accountability processes, and the discipline to stick to the process over the long term. We believe that the institution of a daily readiness huddle has helped us better coordinate and communicate as a department and improved our ability to deliver imaging services on a daily basis. The daily readiness huddle has enabled us to more rapidly identify issues and has brought accountability to seeing solutions to those issues brought to fruition. In addition, it has helped with team building, including between the radiologists and the nonphysician staff. Copyright © 2017 Elsevier Inc. All rights reserved.

Lean Management Systems in Radiology: Elements for Success.

PubMed

Schultz, Stacy R; Ruter, Royce L; Tibor, Laura C

2016-01-01

This article is a review of the literature on Lean and Lean Management Systems and how they have been implemented in healthcare organizations and particularly in radiology departments. The review focuses on the elements required for a successful implementation of Lean by applying the principles of a Lean Management System instead of a Lean tools-only approach. This review shares the successes and failures from healthcare organizations' efforts to improve the quality and safety of the services they provide. There are a limited number of healthcare organizations in the literature who have shared their experiences and additional research is necessary to determine whether a Lean Management System is a viable alternative to the current management structure in healthcare.

Rural health care in New Zealand: the case of Coast to Coast Health Centre, Wellsford, an early Integrated Family Health Centre.

PubMed

Raymont, Antony; Boyd, Mary-Anne; Malloy, Timothy; Malloy, Nancy

2015-12-01

Primary health care is critical, particularly in rural areas distant from secondary care services. To describe the development of Coast to Coast Health Centre (CTCHC) at Wellsford, north of Auckland, New Zealand and reflect on its achievements and ongoing challenges. Interviews were conducted with staff and management of CTCHC and with other health service providers. Surveys of staff and a sample of enrolled patients were undertaken. Numerical data on service utilisation were obtained from the practice and from national datasets. The CTCHC provides a wide range of services, including after-hours care, maternity and radiology, across a network of electronically connected sites, as well as interdisciplinary training for a range of health students. General practitioner (GP) recruitment is problematic and nursing roles have been expanded. Staff report positively on the work environment. Consultation rates are higher than in comparable practices, especially consultations with nurses. Rates of hospital admission are relatively low. The development of the CTCHC was assisted by formation of a local primary health organisation (PHO) and by recognition by the local district health board (DHB). Issues with poor coordination of local services, and less service provision than is characteristic in urban areas, remain. Contracting processes with the DHB were complex and time-consuming. The merging of the local PHO into a larger PHO within the Waitemata DHB catchment inhibited progression towards more complete locality planning. A dedicated and locally controlled provider was able to generate a more than usually complete community health service for Wellsford and area.

21 CFR 1005.10 - Notice of sampling.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Notice of sampling. 1005.10 Section 1005.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH IMPORTATION OF ELECTRONIC PRODUCTS Inspection and Testing § 1005.10 Notice of sampling...

21 CFR 1002.31 - Preservation and inspection of records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Preservation and inspection of records. 1002.31 Section 1002.31 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Manufacturers' Records § 1002.31 Preservation and...

21 CFR 1003.21 - Notification by the manufacturer to affected persons.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH NOTIFICATION OF DEFECTS OR FAILURE TO COMPLY Notification... nontechnical terms of the hazards reasonably related to any defect or failure to comply; and (3) The following... the above statement. (b) The envelope containing the notice shall not contain advertising or other...

76 FR 9832 - In the Matter of Superior Well Services, Ltd. Indiana, PA; Confirmatory Order Modifying License...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... of this event to its radiological training contractors, Applied Health Physics (AHP), for inclusion... North American Transportation Management Institute publication, and the Applied Health Physics (AHP... Institute publication, and the Applied Health Physics newsletter; and c. Provide the details of this event...

78 FR 37723 - Laser Products; Proposed Amendment to Performance Standard

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Parts 1002, 1010, and... promote the public health. DATES: Submit either electronic or written comments on the proposed rule by... Radiation Programs, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New...

78 FR 13348 - Science Board to the Food and Drug Administration Advisory Committee; Amendment of Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001... for Devices and Radiological Health Research Review subcommittee and the Global Health subcommittee. Progress updates will be presented regarding the Global Health subcommittee and the recently established...

75 FR 34451 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... Response Network (LRN) was established by the Department of Health and Human Services, Centers for Disease... LRN's mission is to maintain an integrated national and international network of laboratories that can respond to acts of biological, chemical, or radiological terrorism and other public health emergencies...

21 CFR 1020.30 - Diagnostic x-ray systems and their major components.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Diagnostic x-ray system means an x-ray system designed for irradiation of any part of the human body for the... HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR IONIZING RADIATION EMITTING... for the radiographic visualization and measurement of the dimensions of the human head. Coefficient of...

21 CFR 1020.30 - Diagnostic x-ray systems and their major components.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Diagnostic x-ray system means an x-ray system designed for irradiation of any part of the human body for the... HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR IONIZING RADIATION EMITTING... for the radiographic visualization and measurement of the dimensions of the human head. Coefficient of...

21 CFR 1000.1 - General.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false General. 1000.1 Section 1000.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH GENERAL General Provisions § 1000.1 General. References in this subchapter J to regulatory sections of the...

76 FR 36989 - Medical Devices; Exception From General Requirements for Informed Consent

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 50 [Docket No...: Claudia M. Gaffey, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New... consumer groups, and one each from a health professional, a health professional group, and a local...

21 CFR 892.5710 - Radiation therapy beam-shaping block.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiation therapy beam-shaping block. 892.5710 Section 892.5710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5710 Radiation therapy beam-shaping...

21 CFR 892.1420 - Radionuclide test pattern phantom.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radionuclide test pattern phantom. 892.1420 Section 892.1420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1420 Radionuclide test pattern phantom...

21 CFR 892.1880 - Wall-mounted radiographic cassette holder.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wall-mounted radiographic cassette holder. 892.1880 Section 892.1880 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1880 Wall-mounted...

21 CFR 892.5780 - Light beam patient position indicator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Light beam patient position indicator. 892.5780 Section 892.5780 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5780 Light beam patient position...

21 CFR 892.5770 - Powered radiation therapy patient support assembly.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered radiation therapy patient support assembly. 892.5770 Section 892.5770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5770 Powered radiation...

RADIOPROTECTION CAMPAIGN AND CARD: EDUCATIONAL STRATEGIES THAT REDUCE CHILDREN'S EXCESSIVE EXPOSURE TO RADIOLOGICAL EXAMS.

PubMed

Bernardo, Mônica Oliveira; Almeida, Fernando Antonio de; Morgado, Flavio

2017-01-01

To analyze the results of an initiative aimed at improving the reasonable use of radiological examinations, ensuring their technical quality, implementing a radioprotection campaign that includes training of the professional team, and introducing the radioprotection card for children under 12 years old as a tool for parents and doctors to control children's exposure to radiation. The study was held in a health care insurance system covering 140,000 people. A radioprotection campaign was implemented according to Image Gently • protocols, ensuring the lowest dose of radiation and the quality of examinations, and the radioprotection card was implemented. To assess the effectiveness of these actions, the number of radiological examinations performed at the pediatric emergency room in a period of one year preceding the campaign was compared with the number of radiological examinations performed one year after the campaign. The campaign was well accepted by all professionals, families, and patients involved. In the year following the implementation of radioprotection strategies, there was a 22% reduction of radiological examinations performed at the pediatric emergency room. There was also a 29% reduction in the request of two or more radiological examinations for the same child or examinations with two or more incidences. The campaign and the radioprotection card for children under 12 years old proved to be feasible strategies and correlated with a reduction in radiological examinations requested and performed at the pediatric emergency room.

Model for collaboration: a rural medicine and academic health center teleradiology project

NASA Astrophysics Data System (ADS)

Van Slyke, Mark A.; Eggli, Douglas F.; Prior, Fred W.; Salmon, William; Pappas, Gregory; Vanatta, Fred; Goldfetter, Warren; Hashem, Said

1996-05-01

A pilot project was developed to explore the role of subspecialty radiology support to rural medicine sites over a long-distance network. A collaborative relationship between 2 rural radiology practices and an academic health was established. Project objectives included: (1) Does the subspecialty consultation significantly change diagnosis patterns at the rural site? (2) Is there value added as measured by improved clinical care or an overall decreased cost of care? (3) Can a collaborative model be economically self-supportive? (4) Does the collaborative model encourage and support education and collegial relationships? Two rural hospitals were selected based on the level of imaging technology and willingness to cooperate. Image capture and network technology was chosen to make the network process transparent to the users. DICOM standard interfaces were incorporated into existing CT and MRI scanners and a film digitizer. Nuclear medicine images were transferred and viewed using a proprietary vendor protocol. Relevant clinical data was managed by a custom designed PC based Lotus Notes application (Patient Study Tracking System: PaSTS) (Pennsylvania Blue Shield Institute). All data was transferred over a Frame Relay network and managed by the Pennsylvania Commonwealth sponsored PA Health Net. Images, other than nuclear medicine, were viewed on a GE Advantage viewing station using a pair of 2 X 2.5 K gray scale monitors. Patient text data was managed by the PaSTS PC and displayed on a separate 15' color monitor. A total of 476 radiology studies were networked into the AHC. Randomly chosen research studies comprised 82% of the case work. Consultative and primary read cases comprised 17% and 1% respectively. The exercise was judged effective by both rural sites. Significant findings and diagnoses were confirmed in 73% of cases with discrepant findings in only 4%. One site benefited by adopting more advanced imaging techniques increasing the sophistication of radiology services. The primary value for the referring sites was the added confidence provided by the subspecialty overreads. An educational value was recognized by all. In conclusion, the networking of rural health care sites to an AHC subspecialty radiology practice was successful primarily in increasing the diagnostic confidence at the rural site. Other benefits included: education; increased rural imaging and an opportunity to provide primary interpretation when the rural radiologist is not available. However, the rate of rural generated consultation was low (17%) and is unlikely to support the costs of a high speed network. To support, rather than replace, rural radiology requires a lower cost network and a mechanism for payment for these services.

Image management within a PACS

NASA Astrophysics Data System (ADS)

Glicksman, Robert A.; Prior, Fred W.; Wilson, Dennis L.

1993-09-01

The full benefits of a PACS system cannot be achieved by a departmental system, as films must still be made to service referring physicians and clinics. Therefore, a full hospital PACS must provide workstations throughout the hospital which are connected to the central file server and database, but which present `clinical' views of radiological data. In contrast to the radiologist, the clinician needs to select examinations from a `patient list' which presents the results of his/her radiology referrals. The most important data for the clinician is the radiology report, which must be immediately available upon selection of the examination. The images themselves, perhaps with annotations provided by the reading radiologist, must also be available in a few seconds from selection. Furthermore, the ability to display radiologist selected relevant historical images along with the new examination is necessary in those instances where the radiologist felt that certain historical images were important in the interpretation and diagnosis of the patient. Therefore, views of the new and historical data along clinical lines, conference preparation features, and modality and body part specific selections are also required to successfully implement a full hospital PACS. This paper describes the concepts for image selection and presentation at PACS workstations, both `diagnostic' workstations within the radiology department and `clinical' workstations which support the rest of the hospital and outpatient clinics.

Multidisciplinary HIS DICOM interfaces at the Department of Veterans Affairs

NASA Astrophysics Data System (ADS)

Kuzmak, Peter M.; Dayhoff, Ruth E.

2000-05-01

The U.S. Department of Veterans Affairs (VA) is using the Digital Imaging and Communications in Medicine (DICOM) standard to integrate image data objects from multiple systems for use across the healthcare enterprise. DICOM uses a structured representation of image data and a communication mechanism that allows the VA to easily acquire images from multiple sources and store them directly into the online patient record. The VA can obtain both radiology and non- radiology images using DICOM, and can display them on low-cost clinician's color workstations throughout the medical center. High-resolution gray-scale diagnostic quality multi-monitor workstations with specialized viewing software can be used for reading radiology images. The VA's DICOM capabilities can interface six different commercial Picture Archiving and Communication Systems (PACS) and over twenty different image acquisition modalities. The VA is advancing its use of DICOM beyond radiology. New color imaging applications for Gastrointestinal Endoscopy and Ophthalmology using DICOM are under development. These are the first DICOM offerings for the vendors, who are planning to support the recently passed DICOM Visible Light and Structured Reporting service classes. Implementing these in VistA is a challenge because of the different workflow and software support for these disciplines within the VA HIS environment.

Application of failure mode and effect analysis in a radiology department.

PubMed

Thornton, Eavan; Brook, Olga R; Mendiratta-Lala, Mishal; Hallett, Donna T; Kruskal, Jonathan B

2011-01-01

With increasing deployment, complexity, and sophistication of equipment and related processes within the clinical imaging environment, system failures are more likely to occur. These failures may have varying effects on the patient, ranging from no harm to devastating harm. Failure mode and effect analysis (FMEA) is a tool that permits the proactive identification of possible failures in complex processes and provides a basis for continuous improvement. This overview of the basic principles and methodology of FMEA provides an explanation of how FMEA can be applied to clinical operations in a radiology department to reduce, predict, or prevent errors. The six sequential steps in the FMEA process are explained, and clinical magnetic resonance imaging services are used as an example for which FMEA is particularly applicable. A modified version of traditional FMEA called Healthcare Failure Mode and Effect Analysis, which was introduced by the U.S. Department of Veterans Affairs National Center for Patient Safety, is briefly reviewed. In conclusion, FMEA is an effective and reliable method to proactively examine complex processes in the radiology department. FMEA can be used to highlight the high-risk subprocesses and allows these to be targeted to minimize the future occurrence of failures, thus improving patient safety and streamlining the efficiency of the radiology department. RSNA, 2010

The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

PubMed

Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

2014-12-01

We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.

Quality initiatives: lean approach to improving performance and efficiency in a radiology department.

PubMed

Kruskal, Jonathan B; Reedy, Allen; Pascal, Laurie; Rosen, Max P; Boiselle, Phillip M

2012-01-01

Many hospital radiology departments are adopting "lean" methods developed in automobile manufacturing to improve operational efficiency, eliminate waste, and optimize the value of their services. The lean approach, which emphasizes process analysis, has particular relevance to radiology departments, which depend on a smooth flow of patients and uninterrupted equipment function for efficient operation. However, the application of lean methods to isolated problems is not likely to improve overall efficiency or to produce a sustained improvement. Instead, the authors recommend a gradual but continuous and comprehensive "lean transformation" of work philosophy and workplace culture. Fundamental principles that must consistently be put into action to achieve such a transformation include equal involvement of and equal respect for all staff members, elimination of waste, standardization of work processes, improvement of flow in all processes, use of visual cues to communicate and inform, and use of specific tools to perform targeted data collection and analysis and to implement and guide change. Many categories of lean tools are available to facilitate these tasks: value stream mapping for visualizing the current state of a process and identifying activities that add no value; root cause analysis for determining the fundamental cause of a problem; team charters for planning, guiding, and communicating about change in a specific process; management dashboards for monitoring real-time developments; and a balanced scorecard for strategic oversight and planning in the areas of finance, customer service, internal operations, and staff development. © RSNA, 2012.

Value of trainees in a radiology department. A retrospective semi-quantitative analysis.

PubMed

Vardhanabhuti, V; Bhatnagar, G; Brown, S; James, J; Shuen, V; Sidhu, H; Thomas, R; Fox, B

2011-07-01

To examine the productivity (both economic and otherwise) of trainees within a radiology department at our institution. Productivity was measured in three ways: (1) independent workload contribution, (2) impact on on-call services, and (3) impact on day-to-day practice as perceived by consultant radiologists. Data were collected using retrospective searches on computerized radiology information system (CRIS), analysis of trainees and consultant rotas, and a questionnaire to consultants and trainees. Where possible, productivity was quantified in terms of number of programmed activities (PAs). The contribution of independent work by trainees in a single week was 52.75 PAs (or 1.45 PAs per trainee per week). In addition, the on-call contribution was 23.1 PAs per week (or 0.93 PAs per trainee per week). When both trainees and consultants report independently, productivity in a single list in most cases increased and can be as much as 197%. On calculating the economic impact, this amounts to significant savings of around £1.2million per year at our institution. Based upon objectively measurable areas of service provision, the employment of trainees yields considerable economic benefit. Furthermore, based upon qualitative methods we have shown that trainees contribute positively in those areas, which are much harder to quantifiably evaluate. These are benefits in addition to fundamental requirement to train future competent radiologists. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

ACR Imaging IT Reference Guide: Image Sharing: Evolving Solutions in the Age of Interoperability

PubMed Central

Erickson, Bradley J.; Choy, Garry

2014-01-01

Interoperability is a major focus of the quickly evolving world of Health Information Technology. Easy, yet secure and confidential exchange of imaging exams and the associated reports must be a part of the solutions that are implemented. The availability of historical exams is essential in providing a quality interpretation and reducing inappropriate utilization of imaging services. Today exchange of imaging exams is most often achieved via a CD. We describe the virtues of this solution as well as challenges that have surfaced. Internet and cloud based technologies employed for many consumer services can provide a better solution. Vendors are making these solutions available. Standards for internet based exchange are emerging. Just as Radiology converged on DICOM as a standard to store and view images we need a common exchange standard. We will review the existing standards, and how they are organized into useful workflows through Integrating the Healthcare Enterprise (IHE) profiles. IHE and standards development processes are discussed. Healthcare and the domain of Radiology must stay current with quickly evolving internet standards. The successful use of the “cloud” will depend upon both the technologies we discuss and the policies put into place around these technologies. We discuss both aspects. The Radiology community must lead the way and provide a solution that works for radiologists and clinicians in the Electronic Medical Record (EMR). Lastly we describe the features we believe radiologists should consider when considering adding internet based exchange solutions to their practice. PMID:25467903

Quality initiatives: planning, setting up, and carrying out radiology process improvement projects.

PubMed

Tamm, Eric P; Szklaruk, Janio; Puthooran, Leejo; Stone, Danna; Stevens, Brian L; Modaro, Cathy

2012-01-01

In the coming decades, those who provide radiologic imaging services will be increasingly challenged by the economic, demographic, and political forces affecting healthcare to improve their efficiency, enhance the value of their services, and achieve greater customer satisfaction. It is essential that radiologists master and consistently apply basic process improvement skills that have allowed professionals in many other fields to thrive in a competitive environment. The authors provide a step-by-step overview of process improvement from the perspective of a radiologic imaging practice by describing their experience in conducting a process improvement project: to increase the daily volume of body magnetic resonance imaging examinations performed at their institution. The first step in any process improvement project is to identify and prioritize opportunities for improvement in the work process. Next, an effective project team must be formed that includes representatives of all participants in the process. An achievable aim must be formulated, appropriate measures selected, and baseline data collected to determine the effects of subsequent efforts to achieve the aim. Each aspect of the process in question is then analyzed by using appropriate tools (eg, flowcharts, fishbone diagrams, Pareto diagrams) to identify opportunities for beneficial change. Plans for change are then established and implemented with regular measurements and review followed by necessary adjustments in course. These so-called PDSA (planning, doing, studying, and acting) cycles are repeated until the aim is achieved or modified and the project closed.

Optimized delivery radiological reports: applying Six Sigma methodology to a radiology department.

PubMed

Cavagna, Enrico; Berletti, Riccardo; Schiavon, Francesco; Scarsi, Barbara; Barbato, Giuseppe

2003-03-01

To optimise the process of reporting and delivering radiological examinations with a view to achieving 100% service delivery within 72 hours to outpatients and 36 hours to inpatients. To this end, we used the Six Sigma method which adopts a systematic approach and rigorous statistical analysis to analyse and improve processes, by reducing variability and minimising errors. More specifically, our study focused on the process of radiological report creation, from the end of the examination to the time when the report is made available to the patient, to examine the bottlenecks and identify the measures to be taken to improve the process. Six Sigma uses a five-step problem-solving process called DMAIC, an acronym for Define, Measure, Analyze, Improve and Control. The first step is to define the problem and the elements crucial to quality, in terms of Total Quality Control. Next, the situation is analysed to identify the root causes of the problem and determine which of these is most influential. The situation is then improved by implementing change. Finally, to make sure that the change is long-lasting, measures are taken to sustain the improvements and obtain long-term control. In our case we analysed all of the phases the report passes through before reaching the user, and studied the impact of voice-recognition reporting on the speed of the report creation process. Analysis of the information collected showed that the tools available for report creation (dictaphone, voice-recognition system) and the transport of films and reports were the two critical elements on which to focus our efforts. Of all the phases making up the process, reporting (from end of examination to end of reporting) and distribution (from the report available to administrative staff to report available to the patient) account for 90% of process variability (73% and 17%, respectively). We further found that the reports dictated into a voice-recognition reporting system are delivered in 45 hours (median), whereas those dictated using a dictaphone take 96 hours: voice-recognition reporting systems therefore improve performance by 50 hours. Unfortunately, 38% of our reports are delivered within longer timeframes than the 72h for outpatients and 36h for inpatients agreed with the service users. Reports for inpatients have much faster delivery times and lower variability, as 95% of these examinations are reported using voice-recognition reporting (as a result of the greater sensitivity of physicians to the problem of inpatient waiting times). For conventional radiology examinations, numerically greater than CT or MRI, there is a stronger tendency to use the dictaphone which allows for faster dictation as it is unburdened by administrative tasks such as entering examination codes, correcting errors, etc. Freelance status has no impact on report delivery times, service delivery being the same as in the institutional setting. The subprocess of reporting is strongly affected by the choice of reporting method (voice-recognition system or dictaphone), whereas report delivery is affected by the individual's behaviour patterns and ultimately by habits generated by the lack of a clearly charted process (lack of synchronisation among the various phases), and therefore potentially avoidable. The analytical study of the various phases of examination reporting, from writing to delivery, allowed us to identify the process bottlenecks and take corrective measures. Regardless of imaging modality and individual physician, examination reporting consistently takes longer when a dictaphone is used instead of a voice-recognition reporting system, as this makes the process more complex. To improve the two critical subprocesses whilst maintaining constant resources, a first step is to abandon the dictaphone in favour of the voice-recognition system. In addition, we are experimenting other measures to improve the collection and sorting of examinations and the delivery of reports: the technical staff take the films from the examination rooms to the reporting rooms three times a day; the radiologists collect their examinations and prepare the reports, possibly on the same day; the radiologists leave their signed reports on the table in the central reporting room; the administrative staff collect the signed reports three times a day in the morning and afternoon to be able to deliver them on the same day. This project has allowed us to become familiar with the principles of total quality, to better understand our internal processes and to take effective measures to optimise them. This has resulted in enhanced satisfaction of all the department staff and has laid the grounds for further measures in the future.

Use of a simulation laboratory to train radiology residents in the management of acute radiologic emergencies.

PubMed

Sarwani, Nabeel; Tappouni, Rafel; Flemming, Donald

2012-08-01

Simulation laboratories use realistic clinical scenarios to train physicians in a controlled environment, especially in potentially life-threatening complications that require prompt management. The objective of our study was to develop a comprehensive program using the simulation laboratory to train radiology residents in the management of acute radiologic emergencies. All radiology residents attended a dedicated simulation laboratory course lasting 3 hours, divided over two sessions. Training included basic patient management skills, management of a tension pneumothorax, massive hemorrhage, and contrast agent reactions. Participants were presented with 20 multiple-choice questions before and after the course. Pre- and posttest results were analyzed, and the McNemar test was used to compare correct responses by individual question. Twenty-six radiology residents attended the class. The average pre- and posttest scores and the average difference between the scores for all residents were 13.8, 17.1, and 3.3, respectively (p < 0.0001). Incorrect answers on the pretest examination that were subsequently answered correctly concerned administration of epinephrine for severe reactions, management of a tension pneumothorax, oxygen therapy, ECG placement, cardiopulmonary resuscitation technique, and where to stand during a code situation. Persistent incorrect answers concerned vasovagal reactions and emergency telephone numbers at an off-site imaging center. Simulation laboratories can be used to teach crisis management and crisis resource management for radiology residents and should be part of the education toolbox. Defined objectives lead to a comprehensive course dealing with the management of acute radiologic emergencies. Such programs can improve the role of radiologists as members of the health care team.

Automatic film processors' quality control test in Greek military hospitals.

PubMed

Lymberis, C; Efstathopoulos, E P; Manetou, A; Poudridis, G

1993-04-01

The two major military radiology installations (Athens, Greece) using a total of 15 automatic film processors were assessed using the 21-step-wedge method. The results of quality control in all these processors are presented. The parameters measured under actual working conditions were base and fog, contrast and speed. Base and fog as well as speed displayed large variations with average values generally higher than acceptable, whilst contrast displayed greater stability. Developer temperature was measured daily during the test and was found to be outside the film manufacturers' recommended limits in nine of the 15 processors. In only one processor did film passing time vary on an every day basis and this was due to maloperation. Developer pH test was not part of the daily monitoring service being performed every 5 days for each film processor and found to be in the range 9-12; 10 of the 15 processors presented pH values outside the limits specified by the film manufacturers.

Can Patients Comprehend the Educational Materials that Hospitals Provide about Common IR Procedures?

PubMed

Sadigh, Gelareh; Hawkins, C Matthew; O'Keefe, John J; Khan, Ramsha; Duszak, Richard

2015-08-01

To assess the readability of online education materials offered by hospitals describing commonly performed interventional radiology (IR) procedures. Online patient education materials from 402 hospitals selected from the Medicare Hospital Compare database were assessed. The presence of an IR service was determined by representation in the Society of Interventional Radiology physician finder directory. Patient online education materials about (i) uterine artery embolization for fibroid tumors, (ii) liver cancer embolization, (iii) varicose vein treatment, (iv) central venous access, (v) inferior vena cava (IVC) filter placement, (vi) nephrostomy tube insertion, (vii) gastrostomy tube placement, and (viii) vertebral augmentation were targeted and assessed by using six validated readability scoring systems. Of 402 hospitals sampled, 156 (39%) were presumed to offer IR services. Of these, 119 (76%) offered online patient education material for one or more of the eight service lines. The average readability scores corresponding to grade varied between the ninth- and 12th-grade levels. All were higher than the recommended seventh-grade level (P < .05) except for nephrostomy and gastrostomy tube placement. Average Flesch-Kincaid Reading Ease scores ranged from 42 to 69, corresponding with fairly difficult to difficult readability for all service lines except IVC filter and gastrostomy tube placement, which corresponded with standard readability. A majority of hospitals offering IR services provide at least some online patient education material. Most, however, are written significantly above the reading comprehension level of most Americans. More attention to health literacy by hospitals and IR physicians is warranted. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Dutch guideline for clinical foetal-neonatal and paediatric post-mortem radiology, including a review of literature.

PubMed

Sonnemans, L J P; Vester, M E M; Kolsteren, E E M; Erwich, J J H M; Nikkels, P G J; Kint, P A M; van Rijn, R R; Klein, W M

2018-06-01

Clinical post-mortem radiology is a relatively new field of expertise and not common practice in most hospitals yet. With the declining numbers of autopsies and increasing demand for quality control of clinical care, post-mortem radiology can offer a solution, or at least be complementary. A working group consisting of radiologists, pathologists and other clinical medical specialists reviewed and evaluated the literature on the diagnostic value of post-mortem conventional radiography (CR), ultrasonography, computed tomography (PMCT), magnetic resonance imaging (PMMRI), and minimally invasive autopsy (MIA). Evidence tables were built and subsequently a Dutch national evidence-based guideline for post-mortem radiology was developed. We present this evaluation of the radiological modalities in a clinical post-mortem setting, including MIA, as well as the recently published Dutch guidelines for post-mortem radiology in foetuses, neonates, and children. In general, for post-mortem radiology modalities, PMMRI is the modality of choice in foetuses, neonates, and infants, whereas PMCT is advised in older children. There is a limited role for post-mortem CR and ultrasonography. In most cases, conventional autopsy will remain the diagnostic method of choice. Based on a literature review and clinical expertise, an evidence-based guideline was developed for post-mortem radiology of foetal, neonatal, and paediatric patients. What is Known: • Post-mortem investigations serve as a quality check for the provided health care and are important for reliable epidemiological registration. • Post-mortem radiology, sometimes combined with minimally invasive techniques, is considered as an adjunct or alternative to autopsy. What is New: • We present the Dutch guidelines for post-mortem radiology in foetuses, neonates and children. • Autopsy remains the reference standard, however minimal invasive autopsy with a skeletal survey, post-mortem computed tomography, or post-mortem magnetic resonance imaging can be complementary thereof.

Mobile Versus Fixed Facility: Latinas' Attitudes and Preferences for Obtaining a Mammogram.

PubMed

Scheel, John R; Tillack, Allison A; Mercer, Lauren; Coronado, Gloria D; Beresford, Shirley A A; Molina, Yamile; Thompson, Beti

2018-01-01

Mobile mammographic services have been proposed as a way to reduce Latinas' disproportionate late-stage presentation compared with white women by increasing their access to mammography. The aims of this study were to assess why Latinas may not use mobile mammographic services and to explore their preferences after using these services. Using a mixed-methods approach, a secondary analysis was conducted of baseline survey data (n = 538) from a randomized controlled trial to improve screening mammography rates among Latinas in Washington. Descriptive statistics and bivariate regression were used to characterize mammography location preferences and to test for associations with sociodemographic indices, health care access, and perceived breast cancer risk and beliefs. On the basis of these findings, a qualitative study (n = 18) was used to explore changes in perceptions after using mobile mammographic services. More Latinas preferred obtaining a mammogram at a fixed facility (52.3% [n = 276]) compared with having no preference (46.3% [n = 249]) and preferring mobile mammographic services (1.7% [n = 9]). Concerns about privacy and comfort (15.6% [n = 84]) and about general quality (10.6% [n = 57]) were common reasons for preferring a fixed facility. Those with no history of mammography preferred a fixed facility (P < .05). In the qualitative study, Latinas expressed similar initial concerns but became positive toward the mobile mammographic services after obtaining a mammogram. Although most Latinas preferred obtaining a mammogram at a fixed facility, positive experiences with mobile mammography services changed their attitudes toward them. These findings highlight the need to include community education when using mobile mammographic service to increase screening mammography rates in underserved communities. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Diagnosis-related Groups and Hospital Inpatient Federal Reimbursement.

PubMed

Rimler, Simcha B; Gale, Brian D; Reede, Deborah L

2015-10-01

To understand the complex system of reimbursement for health care services, it is helpful to have a working knowledge of the historic context of diagnosis-related groups (DRGs), as well as their utility and increasing relevance. Congress implemented the DRG system in 1983 in response to rapidly increasing health care costs. The DRG system was designed to control hospital reimbursements by replacing retrospective payments with prospective payments for hospital charges. This article explains how these payments are calculated. Every inpatient admission is classified into one of several hundred DRGs that are based on the diagnosis, complications, and comorbidities. The Centers for Medicare & Medicaid Services (CMS) assigns each DRG a weight that the CMS uses in conjunction with hospital-specific data to determine reimbursement. A population's DRGs represent the resources needed to treat the medical disorders of that population. Hospital administrators use this information to budget and plan for the future. The Affordable Care Act and other recent legislation affect medical reimbursement by altering the DRG system. Radiologic procedures in particular are affected. This legislation will give DRGs an even larger role in determining reimbursements in the coming years. © RSNA, 2015.

PACS: implementation in the U.S. Department of Defense

NASA Astrophysics Data System (ADS)

Chacko, Anna K.; Wider, Ronald; Romlein, John R.; Cawthon, Michael A.; Richardson, Ronald R., Jr.; Lollar, H. William; Cook, Jay F.; Timboe, Harold L.; Johnson, Thomas G.; Fellows, Douglas W.

2000-05-01

The Department of Defense has been a leader in Radiology re- engineering for the past decade. Efforts have included the development of two landmark PACS specifications (MDIS and DIN- PACS), respective vendor selection and implementation programs. A Tri-Service (Army, Navy and Air Force) Radiology re-engineering program was initiated which identified transitioning to digital imaging, PACS and teleradiology as key enabling technologies in a changing business scenario. Subsequently, the systematic adjustment of procurement process for radiological imaging equipment included a focus on specifying PACS-capable-digital imaging modalities and mini- PACS as stepping stones to make the hospitals and health clinics PACS-ready. The success of the PACS and teleradiology program in the DOD is evidenced by the near filmless operation of most Army and Air Force Medical Centers, several community hospitals and several operational teleradiology constellations. Additionally, the MDIS PACSystem has become the commercial PACS product for General Electric Medical Systems. The DOD continues to forge ahead in the PACS arena by implementing advanced configurations and operational concepts such as the VRE (Virtual Radiology Environment), the negotiation of Regional Archiving and Regional PACS Maintenance Programs. Newer regulations (HIPAA, the FDA approval of digital mammography) have been promulgated impacting the culture and conduct of our business. Incorporating their requirements at the very outset will enable us to streamline the delivery of radiology. The DOD community has embraced the information age at multiple levels. The Healthcare portion of this community with these initiatives is integrating itself into DOD's future. The future holds great possibilities, promises and challenges for the DOD PACS programs.

Research Challenges and Opportunities for Clinically Oriented Academic Radiology Departments.

PubMed

Decker, Summer J; Grajo, Joseph R; Hazelton, Todd R; Hoang, Kimberly N; McDonald, Jennifer S; Otero, Hansel J; Patel, Midhir J; Prober, Allen S; Retrouvey, Michele; Rosenkrantz, Andrew B; Roth, Christopher G; Ward, Robert J

2016-01-01

Between 2004 and 2012, US funding for the biomedical sciences decreased to historic lows. Health-related research was crippled by receiving only 1/20th of overall federal scientific funding. Despite the current funding climate, there is increased pressure on academic radiology programs to establish productive research programs. Whereas larger programs have resources that can be utilized at their institutions, small to medium-sized programs often struggle with lack of infrastructure and support. To address these concerns, the Association of University Radiologists' Radiology Research Alliance developed a task force to explore any untapped research productivity potential in these smaller radiology departments. We conducted an online survey of faculty at smaller clinically funded programs and found that while they were interested in doing research and felt it was important to the success of the field, barriers such as lack of resources and time were proving difficult to overcome. One potential solution proposed by this task force is a collaborative structured research model in which multiple participants from multiple institutions come together in well-defined roles that allow for an equitable distribution of research tasks and pooling of resources and expertise. Under this model, smaller programs will have an opportunity to share their unique perspective on how to address research topics and make a measureable impact on the field of radiology as a whole. Through a health services focus, projects are more likely to succeed in the context of limited funding and infrastructure while simultaneously providing value to the field. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Academic musculoskeletal radiology: influences for gender disparity.

PubMed

Qamar, Sadia R; Khurshid, Kiran; Jalal, Sabeena; Bancroft, Laura; Munk, Peter L; Nicolaou, Savvas; Khosa, Faisal

2018-03-01

Research productivity is one of the few quintessential gauges that North American academic radiology departments implement to determine career progression. The rationale of this study is to quantify the relationship of gender, research productivity, and academic advancements in the musculoskeletal (MSK) radiology to account for emerging trends in workforce diversity. Radiology residency programs enlisted in the Fellowship and Residency Electronic Interactive Database (FREIDA), Canadian Resident Matching Service (CaRMS) and International Skeletal Society (ISS) were searched for academic faculty to generate the database for gender and academic profiles of MSK radiologists. Bibliometric data was collected using Elsevier's SCOPUS archives, and analyzed using Stata version 14.2. Among 274 MSK radiologists in North America, 190 (69.34%) were men and 84 (30.66%) were women, indicating a statistically significant difference (χ2 = 6.34; p value = 0.042). The available number of female assistant professors (n = 50) was more than half of the male assistant professors (n = 88), this ratio however, plummeted at higher academic ranks, with only one-fourth of women (n = 11) professors compared to men (n = 45). The male MSK radiologist had 1.31 times the odds of having a higher h-index, keeping all other variables constant. The trend of gender disparity exists in MSK radiology with significant underrepresentation of women in top tiers of academic hierarchy. Even with comparable h-indices, at the lower academic ranks, a lesser number of women are promoted relative to their male colleagues. Further studies are needed to investigate the degree of influence research productivity has, in determining academic advancement of MSK radiologists.

Limitations Influencing Interventional Radiology in Canada: Results of a National Survey by the Canadian Interventional Radiology Association (CIRA)

DOE Office of Scientific and Technical Information (OSTI.GOV)

O'Brien, Jeremy; Baerlocher, Mark Otto; Asch, Murray R.

2007-09-15

Purpose. To describe the current state and limitations to interventional radiology (IR) in Canada through a large, national survey of Canadian interventional radiologists. Methods. An anonymous online survey was offered to members of the Canadian Interventional Radiology Association (CIRA). Only staff radiologists were invited to participate. Results. Seventy-five (75) responses were received from a total of 247, giving a response rate of 30%. Respondents were split approximately equally between academic centers (47%) and community practice (53%), and the majority of interventional radiologists worked in hospitals with either 200-500 (49%) or 500-1,000 (39%) beds. Procedures listed by respondents as most commonlymore » performed in their practice included PICC line insertion (83%), angiography and stenting (65%), and percutaneous biopsy (37%). Procedures listed as not currently performed but which interventional radiologists believed would benefit their patient population included radiofrequency ablation (36%), carotid stenting (34%), and aortic stenting (21%); the majority of respondents noted that a lack of support from referring services was the main reason for not performing these procedures (56%). Impediments to increasing scope and volume of practice in Canadian IR were most commonly related to room or equipment shortage (35%), radiologist shortage (33%), and a lack of funding or administrative support (28%). Conclusion. Interventional radiology in Canada is limited by a number of factors including funding, manpower, and referral support. A concerted effort should be undertaken by individual interventional radiologists and IR organizations to increase training capacity, funding, remuneration, and public exposure to IR in order to help advance the subspecialty.« less

[Mobile IT: Possibilities and barriers of mHealth].

PubMed

Böckmann, B

2016-04-01

The increasing availability of mobile devices and corresponding applications, both for providers and patients, often leads to speculation that mHealth, as the combination of mobile devices and health services is often called, would revolutionize the use of information technology (IT) in healthcare. On the other hand users, providers and operators providing such solutions are often confronted with completely new challenges. This article assesses the options and potential of mHealth and also takes a critical look at potential obstacles. As this field is very broad this critical analysis is illustrated by means of three exemplary application areas: mHealth in radiology, the influence of mHealth on research and mHealth as an enabler of new services, always with examples from other countries.The use of mHealth in radiology currently often develops empirically from existing applications in a relatively unstructured way and benefiting from the dynamic development of mobile technology. The possibilities range from viewing images at the bedside via mobile accessibility of radiologists up to teleradiology. In research there is a huge potential in solutions that actively involve patients with their own mobile devices but the field of data protection is still perceived in Germany as problematic so that only a few research institutions are actively addressing these options. The concept of mHealth allows physicians, hospitals and other service providers to invent entirely new services and a start-up scene is beginning to be established with business models becoming successful particularly with exchanges at the interface with established suppliers.

78 FR 50422 - Medical Devices; Availability of Safety and Effectiveness Summaries for Premarket Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket Nos. FDA-2013-M-0462... Wolanski, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave..... ABI 7500 Fast DX Real-Time PCR Instrument. P060028, FDA-2013-M-0738..... Mentor Worldwide LLC...

42 CFR 410.34 - Mammography services: Conditions for and limitations on coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... mammography means a radiologic procedure furnished to a man or woman with signs or symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease... purpose of early detection of breast cancer, and includes a physician's interpretation of the results of...

WORK SAFETY CONDITIONS WITH CLOSED RADIATION SOURCES (in Polish)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brosziewicz, R.

1963-01-01

A discussion is presented of principles of radiological protection observed in the Radiation Chemistry Dept. of the Nuclear Research Inst., during operation of large sources of ionizing radiation. It has been revealed that a properly designed servicing system of these sources ensures full protection of personnel even with not fully protected sources. (auth)

42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Bone mass measurement: Conditions for coverage and... Medical and Other Health Services § 410.31 Bone mass measurement: Conditions for coverage and frequency... applies: Bone mass measurement means a radiologic, radioisotopic, or other procedure that meets the...

42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Bone mass measurement: Conditions for coverage and... Medical and Other Health Services § 410.31 Bone mass measurement: Conditions for coverage and frequency... applies: Bone mass measurement means a radiologic, radioisotopic, or other procedure that meets the...

42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Bone mass measurement: Conditions for coverage and... Medical and Other Health Services § 410.31 Bone mass measurement: Conditions for coverage and frequency... applies: Bone mass measurement means a radiologic, radioisotopic, or other procedure that meets the...

42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Bone mass measurement: Conditions for coverage and... Medical and Other Health Services § 410.31 Bone mass measurement: Conditions for coverage and frequency... applies: Bone mass measurement means a radiologic, radioisotopic, or other procedure that meets the...

42 CFR 410.31 - Bone mass measurement: Conditions for coverage and frequency standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Bone mass measurement: Conditions for coverage and... Medical and Other Health Services § 410.31 Bone mass measurement: Conditions for coverage and frequency... applies: Bone mass measurement means a radiologic, radioisotopic, or other procedure that meets the...

42 CFR Appendix A to Part 75 - Standards for Accreditation of Educational Programs for Radiographers

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Standards for Accreditation of Educational Programs for Radiographers A Appendix A to Part 75 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH... film evaluation; (k) Methods of patient care; (l) Pathology; (m) Radiologic physics; and (n) Radiation...

21 CFR 1002.40 - Records to be obtained by dealers and distributors.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Dealer and Distributor Records § 1002.40 Records to be obtained by dealers and distributors. (a) Dealers and distributors of electronic products... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Records to be obtained by dealers and distributors...

21 CFR 1002.51 - Exemptions for manufacturers of products intended for the U.S. Government.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Exemptions From Records and Reports Requirements § 1002.51 Exemptions for manufacturers of products intended for the U.S... Health, may exempt from the provisions of this part a manufacturer of any electronic product intended for...

21 CFR 1030.10 - Microwave ovens.

Code of Federal Regulations, 2011 CFR

2011-04-01

... interlock on a fully assembled microwave oven shall not be operable by any part of the human body, or any... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Microwave ovens. 1030.10 Section 1030.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL...

21 CFR 1030.10 - Microwave ovens.

Code of Federal Regulations, 2010 CFR

2010-04-01

... interlock on a fully assembled microwave oven shall not be operable by any part of the human body, or any... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Microwave ovens. 1030.10 Section 1030.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL...

75 FR 55803 - Neurological Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001... Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, or FDA... the treatment of depression. FDA intends to make background material available to the public no later...

21 CFR 1003.22 - Copies of communications sent to purchasers, dealers or distributors.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Copies of communications sent to purchasers... OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH NOTIFICATION OF DEFECTS OR FAILURE TO COMPLY Notification § 1003.22 Copies of communications sent to purchasers, dealers or distributors. (a...

21 CFR 892.3 - Effective dates of requirement for premarket approval.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Effective dates of requirement for premarket approval. 892.3 Section 892.3 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES General Provisions § 892.3 Effective dates of...

Effect of low-intensity pulsed ultrasound on bone regeneration: biochemical and radiologic analyses.

PubMed

Pomini, Karina T; Andreo, Jesus C; Rodrigues, Antonio de C; de O Gonçalves, Jéssica B; Daré, Letícia R; German, Iris J S; Rosa, Geraldo M; Buchaim, Rogerio L

2014-04-01

The purpose of this study was to evaluate the effects of low-intensity pulsed ultrasound at 1.0 MHz on the healing process of fractures with bone loss in the rat fibula by alkaline phosphate level measurement and radiologic analyses. Thirty 70-day-old male Wistar rats underwent a bone resection of 2.5 to 3.0 mm between the proximal and middle third of the right fibular diaphysis. The animals were randomly divided into 3 experimental groups: reference (uninjured), control (injured only), and treated (injured and treated with 5 applications of ultrasound, interspersed by 2 days of rest, beginning 24 hours after the osteotomy). Euthanasia was performed at experimental periods of 7 and 14 days. The right hind limb was removed for radiologic analysis. The blood was collected via cardiac puncture to determine the serum alkaline phosphatase activity. The bone fractures had not been completely consolidated in the treated and control group when analysis of the bone took place. At day 7, the serum alkaline phosphatase activity was higher in the treated group (mean ± SD, 72.17 ± 7.02 U/L) compared to the control (65.26 ± 8.41 U/L) and reference (67.21 ± 7.86 U/L) groups. At day 14, higher alkaline phosphatase activity was seen in the control group (68.96 ± 8.12 U/L) compared to the treated (66.09 ± 8.46 U/L) and reference (67.14 ± 7.96 U/L) groups. The biochemical and radiologic results suggest that low-intensity pulsed ultrasound can be used as an auxiliary method to consolidate fractures and probably reduces the bone healing time, offering clinical benefits.

Developing Navy Capability to Recover Forces in Chemical, Biological, and Radiological Hazard Environments

DTIC Science & Technology

2013-01-01

damage control; LHD flight deck and well deck operations; fleet surgical team; Afloat Training Group; Assault Craft Unit; Naval Surface Warfare Center ...Biological, Radiological and Nuclear School, and U.S. Army Edgewood Chemical Biological Center , Guidelines for Mass Casualty Decontamination During a HAZMAT...Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by OSD, the Joint Staff

A telecommunications journey rural health network.

PubMed

Moore, Joe

2012-01-01

Utilizing a multi-gigabit statewide fiber healthcare network, Radiology Consultants of Iowa (RCI) set out to provide instantaneous service to their rural, critical access, hospital partners. RCIs idea was to assemble a collection of technologies and services that would even out workflow, reduce time on the road, and provide superior service. These technologies included PACS, voice recognition enabled dictation, HL7 interface technology, an imaging system for digitizing paper and prior films, and modern communication networks. The Iowa Rural Health Telecommunication Project was undertaken to form a system that all critical access hospitals would participate in, allowing RCI radiologists the efficiency of "any image, anywhere, anytime".

Interventional Radiologic Treatment for Idiopathic Portal Hypertension

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hirota, Shozo; Ichikawa, Satoshi; Matsumoto, Shinichi

1999-07-15

Purpose: To evaluate the usefulness of interventional radiological treatment for idiopathic portal hypertension. Methods: Between 1995 and 1998, we performed an interventional radiological treatment in five patients with idiopathic portal hypertension, four of whom had refused surgery and one of whom had undergone surgery. Three patients with gastroesophageal varices (GEV) were treated by partial splenic embolization (PSE), one patient with esophageal varices (EV) and massive ascites by transjugular intrahepatic portosytemic shunt (TIPS) and PSE, and one patient with GEV by percutaneous transhepatic obliteration (PTO). Midterm results were analyzed in terms of the effect on esophageal and/or gastric varices. Results: Inmore » one woman with severe GEV who underwent three sessions of PSE, there was endoscopic confirmation that the GEV had disappeared. In one man his EV shrunk markedly after two sessions of PSE. In two patients slight reduction of the EV was obtained with one application of PSE combined with endoscopic variceal ligation therapy. PTO for GV in one patient resulted in good control of the varices. All patients have survived for 16-42 months since the first interventional treatment, and varices are well controlled. Conclusion: Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone surgery.« less

RADIOLOGICAL SEALED SOURCE LIBRARY: A NUCLEAR FORENSICS TOOL

DOE Office of Scientific and Technical Information (OSTI.GOV)

Canaday, Jodi; Chamberlain, David; Finck, Martha

If a terrorist were to obtain and possibly detonate a device that contained radiological material, radiological forensic analysis of the material and source capsule could provide law enforcement with valuable clues about the origin of the radiological material; this information could then provide further leads on where the material and sealed source was obtained, and the loss of control point. This information could potentially be utilized for attribution and prosecution. Analyses of nuclear forensic signatures for radiological materials are generally understood to include isotopic ratios, trace element concentrations, the time since irradiation or purification, and morphology. Radiological forensic signatures formore » sealed sources provide additional information that leverages information on the physical design and chemical composition of the source capsule and containers, physical markings indicative of an owner or manufacturer. Argonne National Laboratory (Argonne), in collaboration with Idaho National Laboratory (INL), has been working since 2003 to understand signatures that could be used to identify specific source manufacturers. These signatures include the materials from which the capsule is constructed, dimensions, weld details, elemental composition, and isotopic abundances of the radioactive material. These signatures have been compiled in a library known as the Argonne/INL Radiological Sealed Source Library. Data collected for the library has included open-source information from vendor catalogs and web pages; discussions with source manufacturers and touring of production facilities (both protected through non-disclosure agreements); technical publications; and government registries such as the U.S. Nuclear Regulatory Commission’s Sealed Source and Device Registry.« less

Characteristics and quality of published animal research in the field of radiology.

PubMed

Yoon, Soo Jeong; Yoon, Dae Young; Cho, Young Kwon; Baek, Sora; Lim, Kyoung Ja; Seo, Young Lan; Yun, Eun Joo

2017-06-01

Background Animal research has played an important role in the field of radiology. Purpose To evaluate the characteristics and quality of published radiological animal research. Material and Methods A PubMed search was performed for radiological animal research articles (defined as studies using animal models with a radiologist as the first author) published in 1994, 2004, and 2014. The following information was extracted from each article: journal name, radiological subspecialty, imaging technique, animal species, number of animals used, number of authors, declared funding, country of origin, methodological quality, and ethical quality. Methodological and ethical quality of studies were assessed with seven-item (sample size calculation, animal age, animal sex, animal weight, inclusion and exclusion criteria, randomization, and blinded outcome assessment) and four-item (ethical review committee approval, anesthesia, pain control, and euthanasia) scales, respectively. Results The numbers of radiological animal studies markedly increased, from 91 in 1994 to 163 in 2004 and to 305 in 2014. One hundred and sixty-two (29.0%) articles focused on the neuroradiology/head and neck subspecialty, 233 (41.7%) used magnetic resonance imaging (MRI), 190 (34.0%) used mice, 254 (45.4%) used 10-30 animals, 297 (53.1%) had 4-7 authors, 392 (70.1%) were funded, and 222 (39.7%) were from the USA. Six of 7 methodological and 3/4 ethical quality items significantly improved over time. Conclusion The quantity and quality of radiological animal research has increased over the last two decades; however, methodological and ethical quality remains suboptimal.

Idiopathic pulmonary fibrosis in a Christmas Island nuclear test veteran

PubMed Central

Parfrey, H; Babar, J; Fiddler, CA; Chilvers, ER

2010-01-01

We describe the case of a 71-year-old man with idiopathic pulmonary fibrosis (usual interstitial pneumonia (UIP) pattern) diagnosed on clinical, radiological and lung function criteria, in accordance with the American Thoracic Society/European Respiratory Society consensus criteria (2000), who had been in close proximity to three atmospheric nuclear bomb blasts during military service in 1957. He does not have clubbing and clinically and radiologically his lung disease is stable. He also has bladder carcinoma and carotid arteriosclerosis, both recognised consequences of radiation injury. This is the first reported case of UIP in a nuclear test veteran. Awareness of this potential association is important given the current attempts of the British Nuclear Test Veterans Association to gain compensation for claimed injuries. PMID:22797205

Integrating radiology information systems with healthcare delivery environments using DICOM and HL7 standards.

PubMed

Blazona, Bojan; Koncar, Miroslav

2006-01-01

Integration based on open standards, in order to achieve communication and information interoperability, is one of the key aspects of modern health care information systems. Interoperability presents data and communication layer interchange. In this context we identified the HL7 standard as the world's leading medical Information and communication technology (ICT) standard for the business layer in healthcare information systems and we tried to explore the ability to exchange clinical documents with minimal integrated healthcare information systems (IHCIS) change. We explored HL7 Clinical Document Architecture (CDA) abilities to achieve radiology information system integration (DICOM) to IHCIS (HL7). We introduced the use of WADO service interconnection to IHCIS and finally CDA rendering in widely used Internet explorers.

Radiation exposure levels within timber industries in Calabar, Nigeria

PubMed Central

Inyang, S. O.; Inyang, I. S.; Egbe, N. O.

2009-01-01

The UNSCEAR (2000) observed that there could be some exposure at work which would require regulatory control but is not really considered. This study was, therefore, set up to evaluate the effective dose in timber industries in Calabar, Nigeria to determine if the evaluated dose levels could lead to any radiological health effect in the workers, and also determine if the industries require regulatory control. The gamma ray exposure at four timber industries measured using an exposure meter were converted to effective dose and compared with the public and occupational values. The evaluated effective dose values in the timber industries were below public and occupational exposure limits and may not necessarily result in any radiological health hazard. Therefore, they may not require regulatory control. PMID:20098544

Is there a gender gap in Italian radiology? A cross-sectional study.

PubMed

Magnavita, Nicola

2013-09-01

Although the number of women entering the medical profession has increased, this has not led to an even distribution in all branches of medicine. In countries where the health service is mainly private, there are still fewer female radiologists, especially at managerial level. The aim of this paper is to make a comparison of work-related stress, satisfaction and perceived organizational justice in male and female radiologists in Italy. Italian radiologists were asked to answer an anonymous questionnaire during two successive national radiology Congresses. Women reported a psychophysical workload that was the same as that of their male colleagues, but claimed that they had less control over their work, made a greater effort to fulfill job requirements, were more over-committed in their work and received fewer rewards for the work performed than their male colleagues. On account of the lack of procedural, distributive and informative justice, women radiologists perceived the work environment as significantly less fair compared to their male colleagues. Moreover, they derived less satisfaction from their job. They suffered from anxiety, depression and minor psychiatric disorders to a greater extent than their male counterparts. Despite the significant number of women radiologists in Italy, the gender gap still exists and can be witnessed in horizontal and vertical segregation. Policies should be introduced to contrast gender bias. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A composite CBRN surveillance and testing service

NASA Astrophysics Data System (ADS)

Niemeyer, Debra M.

2004-08-01

The terrorist threat coupled with a global military mission necessitates quick and accurate identification of environmental hazards, and CBRN early warning. The Air Force Institute for Operational Health (AFIOH) provides fundamental support to protect personnel from and mitigate the effects of untoward hazards exposures. Sustaining healthy communities since 1955, the organizational charter is to enhance warfighter mission effectiveness, protect health, improve readiness and reduce costs, assess and manage risks to human heath and safety, operational performance and the environment. The AFIOH Surveillance Directorate provides forward deployed and reach-back surveillance, agent identification, and environ-mental regulatory compliance testing. Three unique laboratories process and analyze over two million environmental samples and clinical specimens per year, providing analytical chemistry, radiological assessment, and infectious disease testing, in addition to supporting Air Force and Department of Defense (DoD) clinical reference laboratory and force health protection testing. Each laboratory has an applied or investigational testing section where new technologies and techniques are evaluated, and expert consultative support to assist in technology assessments and test analyses. The Epidemiology Surveillance Laboratory and Analytical Chemistry Laboratory are critical assets of the Centers for Disease Control and Prevention (CDC) National Laboratory Response Network. Deployable assets provide direct support to the Combatant Commander and include the Air Force Radiological Assessment Team, and the Biological Augmentation Team. A diverse directorate, the synergistic CBRN response capabilities are a commander"s force protection tool, critical to maintaining combat power.

Proton beam radiosurgery for vestibular schwannoma: tumor control and cranial nerve toxicity.

PubMed

Weber, Damien C; Chan, Annie W; Bussiere, Marc R; Harsh, Griffith R; Ancukiewicz, Marek; Barker, Fred G; Thornton, Allan T; Martuza, Robert L; Nadol, Joseph B; Chapman, Paul H; Loeffler, Jay S

2003-09-01

We sought to determine the tumor control rate and cranial nerve function outcomes in patients with vestibular schwannomas who were treated with proton beam stereotactic radiosurgery. Between November 1992 and August 2000, 88 patients with vestibular schwannomas were treated at the Harvard Cyclotron Laboratory with proton beam stereotactic radiosurgery in which two to four convergent fixed beams of 160-MeV protons were applied. The median transverse diameter was 16 mm (range, 2.5-35 mm), and the median tumor volume was 1.4 cm(3) (range, 0.1-15.9 cm(3)). Surgical resection had been performed previously in 15 patients (17%). Facial nerve function (House-Brackmann Grade 1) and trigeminal nerve function were normal in 79 patients (89.8%). Eight patients (9%) had good or excellent hearing (Gardner-Robertson [GR] Grade 1), and 13 patients (15%) had serviceable hearing (GR Grade 2). A median dose of 12 cobalt Gray equivalents (range, 10-18 cobalt Gray equivalents) was prescribed to the 70 to 108% isodose lines (median, 70%). The median follow-up period was 38.7 months (range, 12-102.6 mo). The actuarial 2- and 5-year tumor control rates were 95.3% (95% confidence interval [CI], 90.9-99.9%) and 93.6% (95% CI, 88.3-99.3%). Salvage radiosurgery was performed in one patient 32.5 months after treatment, and a craniotomy was required 19.1 months after treatment in another patient with hemorrhage in the vicinity of a stable tumor. Three patients (3.4%) underwent shunting for hydrocephalus, and a subsequent partial resection was performed in one of these patients. The actuarial 5-year cumulative radiological reduction rate was 94.7% (95% CI, 81.2-98.3%). Of the 21 patients (24%) with functional hearing (GR Grade 1 or 2), 7 (33.3%) retained serviceable hearing ability (GR Grade 2). Actuarial 5-year normal facial and trigeminal nerve function preservation rates were 91.1% (95% CI, 85-97.6%) and 89.4% (95% CI, 82-96.7%). Univariate analysis revealed that prescribed dose (P = 0.005), maximum dose (P = 0.006), and the inhomogeneity coefficient (P = 0.03) were associated with a significant risk of long-term facial neuropathy. No other cranial nerve deficits or cancer relapses were observed. Proton beam stereotactic radiosurgery has been shown to be an effective means of tumor control. A high radiological response rate was observed. Excellent facial and trigeminal nerve function preservation rates were achieved. A reduced prescribed dose is associated with a significant decrease in facial neuropathy.

Impact of a major hurricane on surgical services in a university hospital.

PubMed

Norcross, E D; Elliott, B M; Adams, D B; Crawford, F A

1993-01-01

Hurricane Hugo struck Charleston, South Carolina, on September 21, 1989. This report analyzes the impact this storm had upon surgical care at a university medical center. Although disaster planning began on September 17, hurricane damage by high winds and an 8.7-foot tidal surge led to loss of emergency power and water. Consequently, system failures occurred in air conditioning, vacuum suction, steam and ethylene oxide sterilization, plumbing, central paging, lighting, and refrigeration. The following surgical support services were affected. In the blood bank, lack of refrigeration meant no platelet packs for 2 days. In radiology, loss of electrical power damaged CT/MRI scanners and flooding ruined patient files, resulting in lost information. In the intensive care unit, loss of electricity meant no monitors and hand ventilation was used for 4 hours. In the operating room, lack of temperature and humidity control (steam, water, and suction supply) halted elective surgery until October 2. Ground and air transportation were limited by unsafe landing sites, impassable roads, and personnel exhaustion. Surgical planning for a major hurricane should include: 1) a fail-safe source of electrical power, 2) evacuation of as many critically ill patients as possible before the storm, 3) cancellation of all elective surgery, and 4) augmented ancillary service staffing with some, although limited, physician support.

Chart-stimulated Recall as a Learning Tool for Improving Radiology Residents' Reports.

PubMed

Nadeem, Naila; Zafar, Abdul Mueed; Haider, Sonia; Zuberi, Rukhsana W; Ahmad, Muhammad Nadeem; Ojili, Vijayanadh

2017-08-01

Workplace-based assessments gauge the highest tier of clinical competence. Chart-stimulated recall (CSR) is a workplace-based assessment method that complements chart audit with an interview based on the residents' notes. It allows evaluation of the residents' knowledge and heuristics while providing opportunities for feedback and self-reflection. We evaluated the utility of CSR for improving the radiology residents' reporting skills. Residents in each year of training were randomly assigned to an intervention group (n = 12) or a control group (n = 13). Five pre-intervention and five post-intervention reports of each resident were independently evaluated by three blinded reviewers using a modified Bristol Radiology Report Assessment Tool. The study intervention comprised a CSR interview tailored to each individual resident's learning needs based on the pre-intervention assessment. The CSR process focused on the clinical relevance of the radiology reports. Student's t test (P < .05) was used to compare pre- and post-intervention scores of each group. A total of 125 pre-intervention and 125 post-intervention reports were evaluated (total 750 assessments). The Cronbach's alpha for the study tool was 0.865. A significant improvement was seen in the cumulative 19-item score (66% versus 73%, P < .001) and the global rating score (59% versus 72%, P < .001) of the intervention group after the CSR. The reports of the control group did not demonstrate any significant improvement. CSR is a feasible workplace-based assessment method for improving reporting skills of the radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The common cold in patients with a history of recurrent sinusitis: increased symptoms and radiologic sinusitislike findings.

PubMed

Alho, O P; Ylitalo, K; Jokinen, K; Laitinen, J; Suramo, I; Tuokko, H; Koskela, M; Uhari, M

2001-01-01

We evaluated whether the symptoms and signs and radiologic findings during a common cold are similar in patients who have and have not suffered from recurrent sinusitis. We recruited 2 series of volunteer cases from February 1, 1996, to December 31, 1996. Twenty-three adults who claimed to have suffered from recurrent sinusitis and 25 who had never had sinusitis were examined during the period of a self-diagnosed cold of 48 to 96 hours' duration and again after 21 days. Symptom scores were recorded, nasoendoscopy and computed tomography scans were performed, and viral and bacterial specimens were taken. The patients with a history of sinusitis had significantly higher symptom scores than the control patients (P=.04) and had radiologic sinusitislike changes more often (65% [15] vs 36% [9]; difference 29% [95% confidence interval, 2%-56%]; P=.04). The viral etiology of the common cold (verified in 67% of the episodes) was similar in both groups. Pathogenic bacteria were isolated from the middle meatus in 24% (6) of the control patients and only 9% (2) of the sinusitis-prone patients (P=.15). On the basis of the symptomatology, radiologic findings, and bacterial cultures only 2 patients in the sinusitis-prone group should have been treated with antimicrobials. Some patients are susceptible to both sinusitislike symptoms and radiologic findings during viral common colds. This may cause them to consult their physicians earlier and more often during viral colds, which may result in unnecessary antibiotic treatments. Nasopharyngeal bacteriological cultures may prove to be useful in ruling out bacterial sinusitis.

Communication interventions to improve adherence to infection control precautions: a randomised crossover trial.

PubMed

Ong, Mei-Sing; Magrabi, Farah; Post, Jeffrey; Morris, Sarah; Westbrook, Johanna; Wobcke, Wayne; Calcroft, Ross; Coiera, Enrico

2013-02-06

Ineffective communication of infection control requirements during transitions of care is a potential cause of non-compliance with infection control precautions by healthcare personnel. In this study, interventions to enhance communication during inpatient transfers between wards and radiology were implemented, in the attempt to improve adherence to precautions during transfers. Two interventions were implemented, comprising (i) a pre-transfer checklist used by radiology porters to confirm a patient's infectious status; (ii) a coloured cue to highlight written infectious status information in the transfer form. The effectiveness of the interventions in promoting adherence to standard precautions by radiology porters when transporting infectious patients was evaluated using a randomised crossover trial at a teaching hospital in Australia. 300 transfers were observed over a period of 4 months. Compliance with infection control precautions in the intervention groups was significantly improved relative to the control group (p < 0.01). Adherence rate in the control group was 38%. Applying the coloured cue resulted in a compliance rate of 73%. The pre-transfer checklist intervention achieved a comparable compliance rate of 71%. When both interventions were applied, a compliance rate of 74% was attained. Acceptability of the coloured cue was high, but adherence to the checklist was low (40%). Simple measures to enhance communication through the provision of a checklist and the use a coloured cue brought about significant improvement in compliance with infection control precautions by transport personnel during inpatient transfers. The study underscores the importance of effective communication in ensuring compliance with infection control precautions during transitions of care.

[Development of clinical radiology in the Military field therapy Department of the Military Medical Academy (the 90th anniversary of the birth of G. I. Alekseyev)].

PubMed

Khalimov, Iu Sh; Vlasenko, A N; Matveev, S Iu

2012-08-01

On August 18, 2012, 90 years have passed since the birth of the former head of the Military field therapy Department of The Military-Medical Academy named after S. M. Kirov--the main radiologist of the Ministry of Defence of Russian Federation, the corresponding member of the Soviet Union Academy of Medical Science and the Russian Academy of Medical Science, the major- general of a medical service G. I. Alekseyev, who had been working in the department since its foundation till the last day of his life. Being the head of the department for twelve years, G. I. Alekseyev made a considerable contribution to the formation and development of native military radiology, training of medical and scientific skilled specialists. Professor G. I. Alekseyev's scientific ideas and views in the sphere of radiology were realized and developed in further educational, research and medical work of the department. Nowadays the staff of the Military field therapy Department remembers G. I. Alekseyev with special gratitude and appreciation and successfully realizes his ideas and plans in work.

Teaching Communication Skills to Radiology Residents.

PubMed

Itri, Jason N; Yacob, Sammy; Mithqal, Ayman

The transition of health care in the United States from volume to value requires a systems-based approach aligning clinical services across the continuum of care. The ability to communicate effectively and resolve conflict is a critical skill within the systems-based model. Recognizing the essential role of communication in medicine, the Accreditation Council of Graduate Medical Education has designated interpersonal and communication skills a core competency for all residents regardless of specialty. Yet, communication skills are often developed through on-the-job training or not at all. Traditional educational curricula use a predominantly didactic approach without opportunities for trainees to observe, actively experiment, or reflect on what is learned as a part of the learning process. In this article, we describe a 1-day experiential communication skills workshop customized for radiology residents that consists of Myers-Briggs Type Indicator and conflict management sessions designed to develop interpersonal, communication, and conflict management skills through group discussion, role-play, and simulation. The purpose of this educational initiative was to determine the perceived value of an experiential communication skills workshop designed for radiology trainees. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality measures and pediatric radiology: suggestions for the transition to value-based payment.

PubMed

Heller, Richard E; Coley, Brian D; Simoneaux, Stephen F; Podberesky, Daniel J; Hernanz-Schulman, Marta; Robertson, Richard L; Donnelly, Lane F

2017-06-01

Recent political and economic factors have contributed to a meaningful change in the way that quality in health care, and by extension value, are viewed. While quality is often evaluated on the basis of subjective criteria, pay-for-performance programs that link reimbursement to various measures of quality require use of objective and quantifiable measures. This evolution to value-based payment was accelerated by the 2015 passage of the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA). While many of the drivers of these changes are rooted in federal policy and programs such as Medicare and aimed at adult patients, the practice of pediatrics and pediatric radiology will be increasingly impacted. This article addresses issues related to the use of quantitative measures to evaluate the quality of services provided by the pediatric radiology department or sub-specialty section, particularly as seen from the viewpoint of a payer that may be considering ways to link payment to performance. The paper concludes by suggesting a metric categorization strategy to frame future work on the subject.

Using Standardized Lexicons for Report Template Validation with LexMap, a Web-based Application.

PubMed

Hostetter, Jason; Wang, Kenneth; Siegel, Eliot; Durack, Jeremy; Morrison, James J

2015-06-01

An enormous amount of data exists in unstructured diagnostic and interventional radiology reports. Free text or non-standardized terminologies limit the ability to parse, extract, and analyze these report data elements. Medical lexicons and ontologies contain standardized terms for relevant concepts including disease entities, radiographic technique, and findings. The use of standardized terms offers the potential to improve reporting consistency and facilitate computer analysis. The purpose of this project was to implement an interface to aid in the creation of standards-compliant reporting templates for use in interventional radiology. Non-standardized procedure report text was analyzed and referenced to RadLex, SNOMED-CT, and LOINC. Using JavaScript, a web application was developed which determined whether exact terms or synonyms in reports existed within these three reference resources. The NCBO BioPortal Annotator web service was used to map terms, and output from this application was used to create an interactive annotated version of the original report. The application was successfully used to analyze and modify five distinct reports for the Society of Interventional Radiology's standardized reporting project.