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Karsten Kortuem, Wolfgang Mayer, Simon Leicht, Lukas Reznicek, Anselm Kampik, Marcus Kernt; Efficiency improvements using an ophthalmological Picture Archiving and Communication System (PACS) in the diagnostic workflow of an eye hospital. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4415.
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To evaluate improvements in imaging workflow by the implementation of a Digital Imaging and Communications in Medicine (DICOM) standard based specific ophthalmological PACS in an university eye hospital setting, using various imaging modalities
In 2011 a specific ophthalmological PACS (Forum Version 3.0, Carl Zeiss Meditec, Jena, Germany (DE)) was implemented at the Department of Ophthalmology at the Ludwig-Maximilians-University of Munich, Germany. It linked various imaging modalities - Optical Coherence Tomography (OCT), Angiography, Wide field fundus photography, fundus photography, keratometry, biometry, Heidelberg Retina Tomograph (HRT) and ultrasound - to one PACS using DICOM standard. To assess the level of efficiency improvement, we analyzed the OCT imaging process of our age related macular degeneration (AMD) clinic and identified 5 process steps. In 64 patients time demand for each step of the process was evaluated. Potential time and resource savings were analyzed.
In average OCT examination process took 3min 25sec (see figure 1 for detailed timing). Major savings of process time and resources were identified: patient data acquisition (data are sent from the Electronic Health Record (EHR) System through PACS to the OCT), printing resources (no need to print paper report, as exams are stored and archived digitally and available online for reviewing). In summary, a potential process time saving of 92sec (10s for data entry, 58s for printing and 24s for record keeping) and resources for four color printing pages per patient was calculated.
In our study, the implemented ophthalmological PACS has proven to efficiently integrate equipment from a variety of different manufacturers in a larger university eye hospital setting. It resulted in time-saving for clinical and technical staff, cost-saving regarding printing costs and labor and shorter average waiting time for patients. Calculated on an average of 30 patients per day, 26 working days and more than 30.000 color printing pages can be saved per annum. An even deeper integration of imaging modalities could provide even more increased efficiency.
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