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      A Web-Based Flexible Communication System in Radiology

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          Abstract

          A web-based system for rapid multidirectional communication has been created in the Radiology department at San Francisco General Hospital. The system allows messaging among radiology attendings, residents, and technologists, as well as other members of the hospital community, such as Emergency Department physicians and nurses. Instead of being tied to a particular workflow, this system provides a flexible communication infrastructure which can be easily adapted for different functions and user roles. The system has so far been configured to successfully support the standard “wet reading” workflow, to support marking and tracking of critical results, as well as multiple educational and quality improvement workflows. In the 19 months of operation, the system has gained over 1,800 users (virtually all providers at our institution), it has been accessed by radiologists over 39,000 times and by non-radiologists over 34,000 times. It has become an integral part of the radiology department operations and non-radiology clinical workflows. Unlike most existing softwares, our system is not a task-specific application, but a multipurpose communication system. It is able to effectively accommodate multiple workflows and user roles through configuration (without additional programming). This flexibility has helped this system to be rapidly and widely adopted within our enterprise. The extended reach of the system enables improved monitoring and documentation of workflows, helping with management decision making, and quality assurance. We report a successful radiology communication system based on the principles of flexibility and inclusiveness of users inside and outside the radiology department.

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          Most cited references8

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          Informatics in radiology: A prototype Web-based reporting system for onsite-offsite clinician communication.

          The communication of imaging findings to a referring physician is an important role of the radiologist. However, communication between onsite and offsite physicians is a time-consuming process that can obstruct work flow and frequently involves no exchange of visual information, which is especially problematic given the importance of radiologic images for diagnosis and treatment. A prototype World Wide Web-based image documentation and reporting system was developed for use in supporting a "communication loop" that is based on the concept of a classic "wet-read" system. The proposed system represents an attempt to address many of the problems seen in current communication work flows by implementing a well-documented and easily accessible communication loop that is adaptable to different types of imaging study evaluation. Images are displayed in a native (DICOM) Digital Imaging and Communications in Medicine format with a Java applet, which allows accurate presentation along with use of various image manipulation tools. The Web-based infrastructure consists of a server that stores imaging studies and reports, with Web browsers that download and install necessary client software on demand. Application logic consists of a set of PHP (hypertext preprocessor) modules that are accessible with an application programming interface. The system may be adapted to any clinician-specialist communication loop, and, because it integrates radiologic standards with Web-based technologies, can more effectively communicate and document imaging data. RSNA, 2007
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            A web-based interface for communication of data between the clinical and research environments without revealing identifying information.

            Recent health care policies and regulations have affected the manner in which patient data--especially protected health information (PHI)--are handled in both the clinical and research settings. Specifically, it is now more challenging to obtain de-identified PHI from the clinic for use in research while adhering to the requirements of this new environment. To meet this challenge, we have devised a novel web-based interface that facilitates the communication of data (eg, biopsy results) between the clinic and research environments without revealing PHI to the research team or associated research identifiers to the clinical collaborators. At the heart of the scheme is a web application that coordinates message passing between the researchers (in general, the requesters of de-identified PHI) and clinical collaborators (who have access to PHI) by use of a protocol that protects confidentiality. We describe the design requirements of this communication scheme and present implementation details of the web application and its associated database. We conclude that this scheme provides a useful communication mechanism that facilitates clinical research while maintaining confidentiality of patient data.
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              Internet-based radiology order-entry, reporting, and workflow management system for coordinating urgent study requests during off-hours.

              Our aim was to develop a simple, low-cost, Internet-based application for radiology order-entry, reporting, and workflow management during off-hours. The system was quickly accepted by users both within and outside the radiology department, and it required very modest resources to develop, deploy, and support. In a busy on-call setting at a high-volume academic institution, the system described was effective in obtaining more thorough patient histories from referring physicians, reducing the number of telephone calls required, and documenting more rigorously the communication between radiologists and clinical services. These benefits allow the generation of more informative and timely radiology reports.
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                Author and article information

                Contributors
                +1-415-2068024 , +1-415-2064004 , manxray@yahoo.com
                Journal
                J Digit Imaging
                Journal of Digital Imaging
                Springer-Verlag (New York )
                0897-1889
                1618-727X
                9 December 2010
                9 December 2010
                October 2011
                : 24
                : 5
                : 890-896
                Affiliations
                Department of Radiology and Biomedical Imaging, San Francisco General Hospital, University of California, San Francisco, 1001 Potrero Ave Rm 1x57, San Francisco, CA 94110 USA
                Article
                9351
                10.1007/s10278-010-9351-0
                3180535
                21152949
                a13da624-4d76-4165-bb2e-9c4bb43b3b5f
                © The Author(s) 2010
                History
                Categories
                Article
                Custom metadata
                © Society for Imaging Informatics in Medicine 2011

                Radiology & Imaging
                clinical information systems,communication,electronic medical record (emr),hospital information systems (his),administration,computerized,workflow,radiology workflow,computerized method,auditing,quality assurance,critical results reporting,computer communication networks,medical records system,clinical workflow,efficiency

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