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Progress of Digital Radiology in Latvia Baltic IT&T 2005 Diagnostic Radiology • Diagnostic modalities include – – – – – radiography computed tomography (CT) magnetic resonance imaging (MRI) ultrasound (US) nuclear medicine • Each of these modalities has strengths and limitations which dictate use of different technical solutions migrating towards digital radiology Computers and Networking for Radiology • Hospital information system (HIS) tracks the patient throughout the hospital stay and is text based • Radiology information system (RIS) tracks the examination through the department of radiology and is also text based • Picture archiving and communication system (PACS) contains all the image-based information in the department of radiology. • Information systems use protocols to transfer data: – Health Level 7 (HL-7) is a text-based information protocol typically used by the HIS and RIS. – The Digital Imaging and Communications in Medicine (DICOM) standard is an image-based information protocol typically used by PACS and digital imaging modalities. Digital Imaging for Hospital Hospital wards Hospital wards Workstations Workstations Department of Radiology Hospital wards Workstations Servers Intensive Care Unit Hospital wards Outpatient Clinic Workstations Workstations Workstations Digital Radiography Operation Radiology - Today Radiology - Digital (Full Field Digital Detector) Main advantages of Digital Radiology • Information can be shared with multiple users at the same time regardless their location – Flexible scheduling of work for radiologists – Fast delivery of results of examinations – Fast and broad availability of results of past examinations – Decreased number of rejected films and unnecessary repeated examinations Components of Digital Radiology in Latvia at present time • Hardware equipment with DICOMM interfaces and necessary software installed – – – – Digital X-Ray – 3 and 5 more are planned US - unknown CT – 32 MRI – 3 Preconditions for Digital Imaging • Medical and technical professionals skilled and fluent not only in medicine but also in information and communication technologies • Availability of computers, software and network for every medical professionals • Availability of digital radiological equipment • Willingness to cooperate between different medical institutions at local, regional, national and international scale Components of Digital Radiology in Latvia at present time • Software and workstations for radiologists • Software and workstations for doctors • Picture archiving and communication system (PACS) • Storage capacity for imaging – approximately 50 MB per examination – 500 GB per 100 000 examinations • High speed networking Main Obstacles Towards Digital Radiology • Computer skills can be learnt, fluency comes only with time and practice • Digital radiology is more expensive than analogue and much more expensive than radiology in Latvia today. But that’s the radiology of today! • The whole mindset of medical professionals (administrative, medical, technical) has to be changed Application of Digital Radiology Problem 1: Today doctors in small hospitals are reluctant to send patients to regional medical centres therefore they loose professional experience Solution : Digital Radiology can help to increase level of cooperation, knowledge and experience sharing between doctors Application of Digital Radiology Problem 2: Lack of radiologists and radiology assistants (almost no technical personal in hospitals) Solution : Digital Radiology can help to optimize the use of available human resources by flexible distribution of medical examinations for analyses by network of digital imaging Application of Digital Radiology Problem 3: Steep increase of number of examinations Solution : Digital Radiology can help to organize network of digital equipment to increase the capacity of radiology department Application of Digital Radiology Problem 4: Shortage of financial resources available Solution : Digital Radiology is expensive, but high capacity regional centres can keep costs per examination at reasonable levels What happens today? • Radiology become much more expensive these days: – minimization of patients exposure to x-rays, – dose accounting, – new standards of examinations change requirements for equipment being used and its service levels – migration of professionals staff towards professions with higher salaries • Radiology will become extinct in small hospitals during next few years Where that leads? • Load of examinations will radically increase in regional and local hospitals • Delayed examinations will decrease the quality of treatment • State financed programs will be used and abused, but medical services will become more expensive and the availability of examinations will decreased Coordinated Migration or (R)evolution? • We can keep waiting for problems to accumulate and then avalanche of the problems • Coordinated action at national level: – Increase necessary skills for administrative, medical and technical professionals involved, include the digital radiology in education programs – Include the digital radiology in structural plan for healhtcare Thank You for Your attention!