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Ferret G, Cremades M, Cornejo L, Guillem-López F, Farrés R, Parés D, Julian JF. Economic impact of outpatient follow-up using telemedicine vs in-person visits for patients in general surgery: A secondary analysis of a randomized clinical trial. Cir Esp 2024; 102:314-321. [PMID: 38604567 DOI: 10.1016/j.cireng.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/26/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Innovation in internet connectivity and the Covid 19 pandemic have caused a dramatic change in the management of patients in the medical field, boosting the use of telemedicine. A comparison of clinical outcomes and satisfaction between conventional face-to-face and telemedicine follow-up in general surgery, an economic evaluation is mandatory. The aim of the present study was to compare the differences in economic costs between these two outpatient approaches in a designed randomized controlled trial (RCT). METHODS A RCT was conducted enrolling 200 patients to compare conventional in-person vs. digital health follow-up using telemedicine in the outpatient clinics in patients of General Surgery Department after their planned discharge. After a demonstration that no differences were found in clinical outcomes and patient satisfaction, we analyzed the medical costs, including staff wages, initial investment, patent's transportation and impact on social costs. RESULTS After an initial investment of 7527.53€, the costs for the Medical institution of in-person conventional follow-up were higher (8180.4€) than those using telemedicine (4630.06€). In relation to social costs, loss of productivity was also increased in the conventional follow-up. CONCLUSION The use of digital Health telemedicine is a cost-effective approach compared to conventional face-to-face follow-up in patients of General Surgery after hospital discharge.
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Affiliation(s)
- Georgina Ferret
- Department of General Surgery, Hospital Universitari Doctor Josep Trueta, Avda. França s/n, 17007 Girona, Spain
| | - Manel Cremades
- Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut de Recerca Germans Trias i Pujol-IGTP, Carretera de Canyet s/n, 08916 Barcelona, Spain
| | - Lídia Cornejo
- Department of General Surgery, Hospital Universitari Doctor Josep Trueta, Avda. França s/n, 17007 Girona, Spain
| | - Francesc Guillem-López
- Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut de Recerca Germans Trias i Pujol-IGTP, Carretera de Canyet s/n, 08916 Barcelona, Spain
| | - Ramon Farrés
- Department of General Surgery, Hospital Universitari Doctor Josep Trueta, Avda. França s/n, 17007 Girona, Spain
| | - David Parés
- Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut de Recerca Germans Trias i Pujol-IGTP, Carretera de Canyet s/n, 08916 Barcelona, Spain.
| | - Joan-Francesc Julian
- Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut de Recerca Germans Trias i Pujol-IGTP, Carretera de Canyet s/n, 08916 Barcelona, Spain
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Agrawal A. Emergency Teleradiology-Past, Present, and, Is There a Future? FRONTIERS IN RADIOLOGY 2022; 2:866643. [PMID: 37492686 PMCID: PMC10365018 DOI: 10.3389/fradi.2022.866643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/16/2022] [Indexed: 07/27/2023]
Abstract
Emergency radiology has evolved into a distinct radiology subspecialty requiring a specialized skillset to make a timely and accurate diagnosis of acutely and critically ill or traumatized patients. The need for emergency and odd hour radiology coverage fuelled the growth of internal and external teleradiology and the "nighthawk" services to meet the increasing demands from all stakeholders and support the changing trends in emergency medicine and trauma surgery inclined toward increased reliance on imaging. However, the basic issues of increased imaging workload, radiologist demand-supply mismatch, complex imaging protocols are only partially addressed by teleradiology with the promise of workload balancing by operations to scale. Incorporation of artificially intelligent tools helps scale manifold by the promise of streamlining the workflow, improved detection and quantification as well as prediction. The future of emergency teleradiologists and teleradiology groups is entwined with their ability to incorporate such tools at scale and adapt to newer workflows and different roles. This agility to adopt and adapt would determine their future.
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Abstract
OBJECTIVE. In recent decades, teleradiology has expanded considerably, and many radiology practices now engage in intraorganizational or extraorganizational teleradiology. In this era of patient primacy, optimizing patient care and care delivery is paramount. This article provides an update on recent changes, current challenges, and future opportunities centered around the ability of teleradiology to improve temporal and geographic imaging access. We review licensing and regulations and discuss teleradiology in providing services to rural areas and assisting with disaster response, including the response to the coronavirus disease (COVID-19) pandemic. CONCLUSION. Teleradiology can help increase imaging efficiency and mitigate both geographic and temporal discrepancies in imaging care. Technologic limitations and regulatory hurdles hinder the optimal practice of teleradiology, and future attention to these issues may help ensure broader patient access to high-quality imaging across the United States.
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Kalyanpur A. Teleradiology and Artificial Intelligence - Birds of the Same Feather. Acad Radiol 2020; 27:123-126. [PMID: 31147240 DOI: 10.1016/j.acra.2019.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 04/21/2019] [Indexed: 11/25/2022]
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Wang TT, Li JM, Zhu CR, Hong Z, An DM, Yang HY, Ren JC, Zou XM, Huang C, Chi XS, Chen JN, Hong Z, Wang WZ, Xu CG, He L, Li WM, Zhou D. Assessment of Utilization and Cost-Effectiveness of Telemedicine Program in Western Regions of China: A 12-Year Study of 249 Hospitals Across 112 Cities. Telemed J E Health 2016; 22:909-920. [PMID: 27314300 DOI: 10.1089/tmj.2015.0213] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The imbalance in healthcare between urban and rural areas is still a problem in China. In recent decades, China has aimed to develop telemedicine. We assessed the implementation, utilization, and cost-effectiveness of a large telemedicine program across western China. MATERIALS AND METHODS In 2002-2013, a government-sponsored major telemedicine program was established by West China Hospital of Sichuan University (hub), covering 249 spoke hospitals in 112 cities throughout western China and in 40 medical expertise areas. We analyzed the cross-sectional data from 11,987 consultations conducted at West China Hospital using the telemedicine network over a 12-year period. The types of diseases as well as the diagnosis and treatment changes were assessed. We also performed a cost-savings analysis and a one-way sensitivity analysis. RESULTS Of the 11,987 teleconsultations, we noted that neoplasms (19.4%), injuries (13.9%), and circulatory diseases (10.3%) were the three most common diagnoses. Teleconsultations resulted in a change of diagnosis in 4,772 (39.8%) patients, and 3,707 (77.7%) of them underwent major diagnosis changes. Moreover, it led to a change of treatment in 6,591 (55.0%) patients, including 3,677 (55.8%) changes not linked to diagnosis changes. The telemedicine network resulted in an estimated net saving of $2,364,525 (if the patients traveled to the hub) or $3,759,014 (if the specialists traveled to the spoke hospitals). CONCLUSIONS The introduction of telemedicine in China, linking highly specialized major hospitals (hub) with hundreds of small rural hospitals (spoke), can greatly improve the quality, efficiency, and cost-effectiveness of healthcare delivery and utilization. This new Internet-based healthcare model should be utilized more widely in developing countries.
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Affiliation(s)
- Ting-Ting Wang
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Jin-Mei Li
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Cai-Rong Zhu
- 2 Department of Health Statistics, West China School of Public Health, Sichuan University , Chengdu, Sichuan, China
| | - Zhen Hong
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Dong-Mei An
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Hong-Yu Yang
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Jie-Chuan Ren
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Xue-Mei Zou
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Cheng Huang
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Xiao-Sa Chi
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Jia-Ni Chen
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Zhen Hong
- 3 Department of Neurology, Huashan Hospital, Fudan University , Shanghai, China
| | - Wen-Zhi Wang
- 4 Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University , Beijing, China
| | - Cai-Gang Xu
- 5 Department of Hematology and Research Laboratory of Hematology, West China Hospital, Sichuan University , Chengdu, Sichuan, China .,6 Department of Public Affairs Development, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Li He
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Wei-Min Li
- 7 Department of Respiratory Medicine, West China Hospital, Sichuan University , Chengdu, Sichuan, China
| | - Dong Zhou
- 1 Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan, China
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Clark JR, Huckman RS, Staats BR. Learning from Customers: Individual and Organizational Effects in Outsourced Radiological Services. ORGANIZATION SCIENCE 2013. [DOI: 10.1287/orsc.1120.0796] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kshetri N. The healthcare off-shoring industry in developing economies--institutional and economic foundations: an Indian case. Int J Health Care Qual Assur 2011; 24:453-70. [PMID: 21916147 DOI: 10.1108/09526861111150716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Industrialized world-based healthcare providers are increasingly off-shoring low-end healthcare services such as medical transcription, billing and insurance claims. High-skill medical jobs such as tele-imaging and tele-pathology are also being sub-contracted to developing countries. Despite its importance, little theory or research exists to explain what factors affect industry growth. The article's goals, therefore, are to examine economic processes associated with developing economies' shift from low- to high-value information technology enabled healthcare services, and to investigate how these differ in terms of legitimacy from regulative, normative and cognitive institutions in the sending country and how healthcare services differ from other services. DESIGN/METHODOLOGY/APPROACH This research is conceptual and theory-building. Broadly, its approach can be described as a positivistic epistemology. FINDINGS Anti off-shoring regulative, normative and cognitive pressures in the sending country are likely to be stronger in healthcare than in most business process outsourcing. Moreover, such pressures are likely to be stronger in high-value rather than in low-value healthcare off-shoring. The findings also indicate that off-shoring low-value healthcare services and emergent healthcare industries in a developing economy help accumulate implicit and tacit knowledge required for off-shoring high-value healthcare services. RESEARCH LIMITATIONS/IMPLICATIONS The approach lacks primary data and empirical documentation. PRACTICAL IMPLICATIONS The article helps in understanding industry drivers and its possible future direction. The findings help in understanding the lens through which various institutional actors in a sending country view healthcare service off-shoring. ORIGINALITY/VALUE The article's value stems from its analytical context, mechanisms and processes associated with developing economies' shift to high-value healthcare off-shoring services.
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Affiliation(s)
- Nir Kshetri
- Bryan School of Business and Economics, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA.
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Kaewlai R, Greene RE, Asrani AV, Abujudeh HH. The impact of an early-morning radiologist work shift on the timeliness of communicating urgent imaging findings on portable chest radiography. J Am Coll Radiol 2011; 7:715-21. [PMID: 20816634 DOI: 10.1016/j.jacr.2010.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Accepted: 02/11/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to assess the potential impact of staggered radiologist work shifts on the timeliness of communicating urgent imaging findings that are detected on portable overnight chest radiography of hospitalized patients. METHODS The authors conducted a retrospective study that compared the interval between the acquisition and communication of urgent findings on portable overnight critical care chest radiography detected by an early-morning shift for radiologists (3 am to 11 am) with historical experience with a standard daytime shift (8 am to 5 pm) in the detection and communication of urgent findings in a similar patient population a year earlier. RESULTS During a 4-month period, 6,448 portable chest radiographic studies were interpreted on the early-morning radiologist shift. Urgent findings requiring immediate communication were detected in 308 (4.8%) studies. The early-morning shift of radiologists, on average, communicated these findings 2 hours earlier compared with the historical control group (P < .001). CONCLUSION Staggered radiologist work shifts that include an early-morning shift can improve the timeliness of reporting urgent findings on overnight portable chest radiography of hospitalized patients.
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Affiliation(s)
- Rathachai Kaewlai
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruiit Street, Boston, MA 02114, USA.
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9
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Ethical and legal challenges for health telematics in a global world: telehealth and the technological imperative. Int J Med Inform 2010; 80:e1-5. [PMID: 21067967 DOI: 10.1016/j.ijmedinf.2010.10.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 10/02/2010] [Indexed: 11/23/2022]
Abstract
Telehealth is one of the more recent applications of ICT to health care. It promises to be both cost-effective and efficient. However, there lies a danger that focusing mainly on pragmatic considerations will ignore fundamental ethical issues with legal implications that could undermine its success. Implicated here are, among others, changes in the nature of the health care professional patient relationship and informed consent, etc. The position of health informatics professionals as well as hard- and software providers is also affected. A further complicating factor is outsourcing. This paper identifies relevant issues and outlines some of their implications.
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Adler J, Yu C, Datta M. The changing face of radiology: from local practice to global network. Med J Aust 2009; 190:20-3. [PMID: 19120003 DOI: 10.5694/j.1326-5377.2009.tb02256.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Accepted: 09/08/2008] [Indexed: 11/17/2022]
Abstract
Rapid advances in communications and computing technology have opened up new opportunities for clinical teleradiology. The quality of teleradiology reporting, when carried out properly, is on par with onsite reporting, and offers the potential for increased accuracy and improved patient outcomes. Local and international industry organisations and professional bodies are creating standards, policies and protocols for every aspect of teleradiology in response to concerns about the use of this technology. The key factor for the long-term success of teleradiology has been identified as a commitment to ensuring duty of care to patients (encompassing high-quality service and patient safety) is the first priority. Evidence indicates that increased use of teleradiology will be a step forward if managed well, but requires a commitment to excellence, patience and perseverance.
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Affiliation(s)
- Julian Adler
- Imaging Partners Online, Sydney, NSW, Australia.
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11
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Di Paolo M, Guidi B, Picano E, Caramella D. Emergency radiology without the radiologist: the forensic perspective. Radiol Med 2009; 114:475-83. [PMID: 19322633 DOI: 10.1007/s11547-009-0373-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 05/09/2008] [Indexed: 01/13/2023]
Abstract
PURPOSE The aim of this paper is to describe two cases from the authors' forensic archive database in which teleradiology was related to unfavourable outcomes. MATERIAL AND METHODS Two patients underwent autopsy after unexpected death following road accidents. In one case, death was caused by multiple cervical fractures following minor neck injury in the presence of diffuse idiopathic skeletal hyperostosis. In the other case, death was due to delayed isthmic aortic rupture occurring after thoracic blunt trauma in a young adult. Both conditions were diagnosed at autopsy only. RESULTS In both cases, the lethal outcome was due to the failure to obtain radiological reports of the X-rays performed in the emergency department. Radiological diagnoses could have been established by activating the teleradiology service which, according to the hospitals' teleradiology protocols, is available on demand in cases of emergency only, as selected by the physician requesting the service. CONCLUSIONS These cases suggest the high risk of excluding the radiologist from the management of patients whose images are transmitted via a teleradiology system.
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Affiliation(s)
- M Di Paolo
- Section of Legal Medicine, University of Pisa, Pisa, Italy.
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12
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Shieh YY, Tsai FY, Shieh M. The impact of globalisation on teleradiology practice. ACTA ACUST UNITED AC 2009; 4:290-8. [PMID: 19174364 DOI: 10.1504/ijeh.2008.022666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Some advocates of globalisation argue that a free market with little regulation is the best approach for achieving cost-effective healthcare. Healthcare, however, is different from other business activities in that it is typically less profit-driven; instead, it often involves the goal of providing equitable care to the underprivileged. Traditionally, the government has subsidised the expenses of delivering affordable healthcare to underserved communities. Because of the many recent advances in telecommunications technology, telemedicine has gained increasing attention. Teleradiology, in particular, is by far the maturest of all telemedicine disciplines and, thus, it may serve as a pivotal indicator of whether telemedicine on a global scale is feasible or not. In this paper, a prediction of the future landscape of globalised teleradiology operations is attempted based on the extrapolation of the historical trends in teleradiology practice as well as the growing pressure on federal and local governments to reduce their regulatory power under the General Agreement on Trade in Services (GATS).
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Affiliation(s)
- Yao Y Shieh
- Department of Radiological Sciences, School of Medicine, UCIrvine Medical Center, Orange CA 92868, USA
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14
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Adang EMM, Wensing M. Economic barriers to implementation of innovations in health care: is the long run-short run efficiency discrepancy a paradox? Health Policy 2008; 88:236-42. [PMID: 18471924 DOI: 10.1016/j.healthpol.2008.03.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Revised: 03/17/2008] [Accepted: 03/30/2008] [Indexed: 11/25/2022]
Abstract
Favourable cost-effectiveness of innovative technologies is more and more a necessary condition for implementation in clinical practice. But proven cost-effectiveness itself does not guarantee successful implementation. The reason for this is a potential discrepancy between long run efficiency, on which cost-effectiveness is based, and short run efficiency. Long run and short run efficiency is dependent upon economies of scale. This paper addresses the potential discrepancy between long run and short run efficiency of innovative technologies in healthcare, explores diseconomies of scale in Dutch hospitals and suggests what strategies might help to overcome hurdles to implement innovations due to that discrepancy.
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Affiliation(s)
- Eddy M M Adang
- Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Center, HP138, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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The pros and cons of outsourcing information technology. J Oncol Pract 2008; 4:126-7. [PMID: 20856615 DOI: 10.1200/jop.0833002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Affiliation(s)
- Sanjiv N Singh
- University of California, San Francisco, School of Medicine, San Francisco, USA
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17
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Kenny LM, Lau LS. Clinical teleradiology — the purpose of principles. Med J Aust 2008; 188:197-8. [DOI: 10.5694/j.1326-5377.2008.tb01582.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2007] [Accepted: 01/20/2008] [Indexed: 11/17/2022]
Affiliation(s)
- Lizbeth M Kenny
- Royal Australian and New Zealand College of Radiologists, Sydney, NSW
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD
| | - Lawrence S Lau
- Royal Australian and New Zealand College of Radiologists, Sydney, NSW
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Puech PA, Boussel L, Belfkih S, Lemaitre L, Douek P, Beuscart R. DicomWorks: software for reviewing DICOM studies and promoting low-cost teleradiology. J Digit Imaging 2007; 20:122-30. [PMID: 17333414 PMCID: PMC3043902 DOI: 10.1007/s10278-007-9018-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
DicomWorks is freeware software for reading and working on medical images [digital imaging and communication in medicine (DICOM)]. It was jointly developed by two research laboratories, with the feedback of more than 35,000 registered users throughout the world who provided information to guide its development. We detail their occupations (50% radiologists, 20% engineers, 9% medical physicists, 7% cardiologists, 6% neurologists, and 8% others), geographic origins, and main interests in the software. The viewer's interface is similar to that of a picture archiving and communication system viewing station. It provides basic but efficient tools for opening DICOM images and reviewing and exporting them to teaching files or digital presentations. E-mail, FTP, or DICOM protocols are supported for transmitting images through a local network or the Internet. Thanks to its wide compatibility, a localized (15 languages) and user-friendly interface, and its opened architecture, DicomWorks helps quick development of non proprietary, low-cost image review or teleradiology solutions in developed and emerging countries.
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Affiliation(s)
- Philippe A Puech
- Department of Medical Informatics and Biostatistics, CERIM, Faculte de Medecine, 1 Place de Verdun, 59045 Lille Cedex, France.
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Lau L. Leadership and management in quality radiology. Biomed Imaging Interv J 2007; 3:e21. [PMID: 21614284 PMCID: PMC3097676 DOI: 10.2349/biij.3.3.e21] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Accepted: 05/17/2007] [Indexed: 12/25/2022] Open
Abstract
The practice of medical imaging and interventional radiology are undergoing rapid change in recent years due to technological advances, workload escalation, workforce shortage, globalisation, corporatisation, commercialisation and commoditisation of healthcare. These professional and economical changes are challenging the established norm but may bring new opportunities. There is an increasing awareness of and interest in the quality of care and patient safety in medical imaging and interventional radiology. Among the professional organisations, a range of quality systems are available to address individual, facility and system needs. To manage the limited resources successfully, radiologists and professional organisations must be leaders and champion for the cause of quality care and patient safety. Close collaboration with other stakeholders towards the development and management of proactive, long-term, system-based strategies and infrastructures will underpin a sustainable future in quality radiology. The International Radiology Quality Network can play a useful facilitating role in this worthwhile but challenging endeavour.
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Affiliation(s)
- Ls Lau
- International Radiology Quality Network, Canterbury, Victoria, Australia
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Abstract
We obtained price and quality information for nonurgent coronary artery bypass graft (CABG) surgery from a sample of internationally patronized hospitals in low-wage countries. We found rising quality standards, availability of U.S.-trained physicians, and prices far below insurer-negotiated U.S. prices. The price differentials easily accommodated the incentive specified as a condition for surgery abroad by about 30 percent of surveyed households with a sick member. These findings foreshadow growth in offshoring of expensive nonemergency surgeries among increasingly cost-sensitive U.S. consumers and purchasers.
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Colaco CALS. The state of primary care. N Engl J Med 2006; 355:2595; author reply 2595. [PMID: 17167938 DOI: 10.1056/nejmc062650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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