Having an in-house, dedicated radiology information technology (IT) department can make it easier to support a RIS/PACS, allowing for fast and reliable troubleshooting of most problems, according to research from Ludwig-Maximilian-University in Munich, Germany.
Over seven years, the university's dedicated radiology IT group was able to solve more than 96% of issues. They also achieved a high success rate in IT issues considered to be emergencies.
"A departmental IT group provides fast troubleshooting, solves a considerable proportion of occurring and even new IT problems, and therefore, necessitating manufacturer's support only in a small number of cases," said Dr. Hanna Strube. She presented the research during this month's European Congress of Radiology (ECR) in Vienna.
A completely digital radiology department depends on a 24-hour, full-time IT environment with multiple components that can each bring down the whole system. This dynamic requires a fast response from a service provider, she noted. These IT services for a radiology department could be provided from a number of sources, including the system manufacturer. While vendor representatives are well-trained on their individual systems, it can be hard to reach them during off-work hours. This type of support is also expensive and may have long response times.
A clinic-wide IT group can also provide these services, but they work for the whole clinic and are not specialized in radiology systems, Strube added. Long response times can also be experienced. On the other hand, an in-house radiology IT group can provide both fast response times and knowledge of radiology systems, but this model requires extra manpower and special training. As a result, the Munich group sought to evaluate the value of a radiology departmental IT group in comparison with a hospital IT group and system manufacturers.
Completely digitized since 1999, the university has about 40 viewing stations, 18 of which are outside of the radiology department. The radiology department has 18 residents, seven attending physicians, 50 radiographers, and 10 office employees. In addition to radiography units, the department has two multidetector CT (MDCT) scanners and three MRI systems. The RIS consists of two mirrored Linux servers and two mirrored servers for communicating with the health information system. The PACS cluster has three servers. A speech recognition system was implemented in 2008.
Long-term and short-term storage is handled by an archive that is shared between two hospital campuses, she said. A customized, Web-based database and intranet-based reporting system allows for the departmental radiology IT group to track problems, assign a priority level, and provide a time limit for a solution. The database also records the type of problem and the location of the affected system. The radiology IT group includes one full-time specialist and two full-time student assistants, and can be reached outside of work hours via SMS.
Over 90 months, 14,681 IT problems were reported. Of these, 96.5% were solved by the departmental IT group; 82.6% were solved within the designated time limit for the particular problem. The solution rates for specific IT breakdowns were:
- Clinical information systems: 81.4%
- Standard hardware: 84.1%
- Standard software, including RIS: 91.9%
- PACS: 78%
- Imaging devices: 58.7%
Of the IT problems, 1,073 (7.3%) were considered to be emergencies and required troubleshooting within two hours. These emergency cases were solved within 30 minutes by the departmental IT group in 40.6% of the cases; 82.6% were solved within the designated time limit. Manufacturer support was required in 6.7% of cases.
The researchers noted that over time the total amount of IT problems decreased by up to 73.2% for emergency and very urgent problems. However, problems considered to have low urgency increased. The PACS generated the most IT problems over the study period. Many issues, including a relatively high number of emergency problems, were generated during 2005 when the institution's old PACS couldn't manage the amount of data being generated anymore, said Strube.
Implementation of a new RIS/PACS also led to a short increase in the number of IT problems, but those were mostly low-priority issues, she concluded.