Evaluation of automated information systems in health care: an approach to classifying evaluative studies.

In this paper we discuss an approach to classifying evaluative studies of automated information systems in health care. Selected literature (76 studies) is classified according to the type of automated information system (based on relationship to the care process), the study design used, the data collection methods used, the effect(s) measured and the type of evaluation (e.g.

Costs and effects of a nursing information system in three Dutch hospitals.

VISION is an integrated nursing information system developed in the Netherlands. In mid-1992, a technology assessment of this system was started: the VISTA project. Its aim is to assess the costs and effects of VISION in three different types of hospitals: a University Hospital, a General Hospital, and a Psychiatric Hospital.

PACER: a software tool for PACS decision makers.

This paper describes the development of the software package PACER as it evolved from a cost model to a software package for PACS decision making. PACER was developed as part of the TEASS topic from the EurIPACS project. EurIPACS is an EU subsidized project covering a wide area of PACS related research.

Challenges and opportunities for technology assessment in medical informatics. Case study: PACS.

In this paper the basic steps of cost-effectiveness analysis (CEA) are applied in the evaluation of picture archiving and communication systems (PACS). The exercise demonstrates that evaluations of PACS have been technology-orientated, rather than problem-orientated. Moreover, many of the potential benefits of the system have been insufficiently investigated.

Challenges and opportunities for technology assessment in medical informatics. Report of a MEDINFO '92 workshop.

Technology assessment in medical informatics is an emerging area. One of the recommendations of a joint IMIA-ISTAHC working conference (1990) was that this area should be further explored, e.g.

Methodology for the evaluation of diagnostic image quality.

This paper explains the theoretical backgrounds of various methods for the evaluation of diagnostic image quality. It introduces the Receiver Operating Characteristics (ROC) methodology. The major prerequisites, some important features of the experimental set-up and of the data analysis of an ROC study are explained.

Do the benefits outweigh the costs of PACS? The results of an International Workshop on Technology Assessment of PACS.

On May 26-27, 1991, an International Workshop on the Technology Assessment of PACS was held at Enkhuizen, The Netherlands. During this workshop 35 experts in the field, from 13 different countries, discussed amongst others the required functionality of PACS, diagnostic aspects and the quality of care and organizational aspects. The key question was whether, when and how PACS is feasible, both from a financial and a clinical point of view.

An analysis of the costs of a hospital-wide Picture Archiving and Communication System with the software package CAPACITY.

Within the scope of the Dutch PACS project, the costs of a hospital wide PACS in the Utrecht University Hospital were estimated, with the help of the software package CAPACITY. The cost analysis was based on the most recent specifications of the costs of the equipment, on extrapolations, and on the experience acquired with a PACS prototype in the Utrecht University Hospital. Savings due to a possible reduction in the length of stay, or due to logistic improvements were not taken into account.

First experiences with the modelling and simulation package MIRACLES applied to a picture archiving and communication system (PACS) in a clinical environment.

Since the construction of picture archiving and communication systems (PACS) appears to be extremely difficult, computer modelling and simulation are used as decision support tools. The package MIRACLES (Medical Image Representation, Archiving and Communication Learned from Extensive Simulation) has been developed at BAZIS in order to support the construction of simulation models of image information systems. This article discusses the application of MIRACLES to a prototypical PACS as being installed in a clinical environment.

HIS-PACS coupling: BAZIS/ZIS and Philips/MARCOM on speaking terms.

Nowadays a growing number of experts in the PACS field agree on the necessity of having an integrated HIS-PACS combination available in modern hospitals in order to manage the enormous amounts of patient data, both textual, numerical and image information, in an effective way. Since 1986 BAZIS (the Development and Support Group of the Hospital Information System), Philips Medical Systems and the University Hospital of Utrecht (AZU) are partners in the so-called Dutch PACS Project in the development and evaluation of a fully integrated image information system. The first phase of the coupling (sub)project consists of establishing a communication link between the BAZIS/ZIS and the Philips/MARCOM system with the following restrictions: the only data sent concerns the inpatients of one ward; data will only flow one way, from BAZIS/ZIS to Philips/MARCOM.

Prediction and analysis of PACS performance with the simulation tool MIRACLES.

Since the construction of image information systems appears to be extremely difficult in practice, BAZIS has decided to use computer modelling and simulation as decision support tools. In order to support the construction of simulation models, the simulation package and modelling environment MIRACLES (Medical Image Representation, Archiving and Communication Learned from Extensive Simulation) has been developed by BAZIS. This paper describes modelling and simulation techniques in general, as well as the benefits of simulation within the scope of designing Picture Archiving and Communication Systems (PACS).

FEASIBLE (I): The PC software package for feature evaluation and system inspection by logged experiments.

FEASIBLE is an MS-DOS software package which can be used for the evaluation of: Picture Archiving and Communication System (PACS) components; diagnostic image quality; and image manipulation and representation techniques. The FEASIBLE software allows the user to design any psychophysical study in detail in the fields mentioned above, to execute an arbitrary number of sessions and to statistically analyse the results by way of the Receiver Operating Characteristic (ROC) technique. FEASIBLE consists basically of three modules: DESIGN, which allows the user to set up an experiment; EXECUTION, which allows the user to execute the experimental sessions based on the design entered in the DESIGN module and stored in the program's database; and, STATISTICS, which allows various statistical analyses on the data collected during the psychophysical sessions (including the calculation of ROC curves and related parameters) and can provide a graphical presentation of the results.

Background of the demonstrated IMAGIS activities and future expectations.

In The Netherlands a national PACS development programme has been started, supported by the Dutch Society of Radiology and funded by the Dutch Department of Health because of the national character of the project. Three main partners are cooperating in this development: the Utrecht University Hospital (AZU), BAZIS and Philips International (Product Division Medical Systems), with the Delft University of Technology as the main BAZIS subcontractor. The non-profit foundation BAZIS, developing and supporting the ZIS Hospital Information System (in use in some 30 Dutch hospitals, over 15,000 acute beds), initiated its current IMAGe Information System (IMAGIS) projects in 1984.

PACS costs: modelling and simulation.

The advantages to be expected of full-scale PACS implementation are widely described in the literature. In the decision to introduce such systems, costs will also play an important part. The benefits to be achieved should at least outbalance the costs.