MODELING AND EVALUATING IMAGE MANAGEMENT SYSTEMS

图像存档和通信系统(PACS)有望取代 目前的电影系统在十年内。然而，目前 目前还没有正式的方法来评估图像的成本效益 管理系统。该计划项目的目标是开发一个 比较PACS和现有PACS的成本效益的方法 电影管理系统。我们将在医疗领域衡量成本效益 重症监护病房、急诊科和门诊 神经科套房。诊断结果对健康结果的影响 也将被估计。 第一个项目开发并评估一个描述 影像管理系统的诊断价值。模型将是 经过验证和测试以确定其预测能力。第二 Project评估工作站的临床有效性，分析 放射科医生-参考医生互动，并研究医生 接受。放射科医生和转诊医生之间的远程会诊 医生包括来自转诊的外部图像的传输 医生对放射科医生也将进行研究。第三个项目 利用临床病史派生的规则来优化显示 与诊断相关的信息。第四个项目使用结果 其他项目以衡量PACS的成本效益。两者都有 实施PACS之前和之后的直接和间接成本将是 与来自诊断价值模型的数据相结合以得出 增量成本效益并将PACS的有用性与 其他医疗干预措施。运营核心负责 软件开发、数据收集和质量控制。 该计划项目将为其他机构提供方法论 确定在其环境中实施PACS的价值。 此外，它还可适用于其他医疗机构的评估 技术，并协助比较对这些技术的投资 技术。

Picture Archiving and Communication Systems (PACS) are expected to replace the currently existing film systems within the decade. However, presently there are no formal measures to evaluate the cost-effectiveness of image management systems. The objective of this Program Project is to develop a methodology to compare the cost-effectiveness of a PACS and the existing film management system. We will measure cost-effectiveness in the Medical Intensive Care Unit, the Emergency Department, and in the outpatient Neurology suite. The effects of diagnostic outcomes on health outcomes will also be estimated. The first project develops and evaluates a model that describes the diagnostic value of an image management system. The model will be validated and tested to determine its predictive capability. The second project evaluates workstations for clinical effectiveness, analyzes the radiologist-referring physician interaction, and studies physician acceptance. Teleconsulting between the radiologist and the referring physician including the transmission of outside images from the referring physician to the radiologist will also be studied. The third project utilizes clinical-history derived rules to optimize the display with diagnostically-relevant information. The fourth project uses the results of the other projects to measure the cost-effectiveness of PACS. Both direct and indirect costs before and after implementing PACS will be combined with data from the diagnostic value model to derive the incremental cost-effectiveness and to compare the usefulness of PACS to other medical interventions. The Operations core is responsible for software development, data collection, and quality control. This Program Project will provide the methodology for other institutions to determine the value of implementing PACS in their environment. Additionally, it may be applicable for the assessment of other medical technologies and to aid in the comparison of investments in such technologies.