- 期刊
無片化醫院建立與評值
The Establishment and Evaluation of Effectiveness in a Filmless Hospital
摘要
目的：慈濟醫學中心為解決目前醫院內大量X光片儲存、建檔、管理、借閱、傳輸等問題，提供快速影像資料存取、提昇診療品質及生產力、節省儲存影片所需空間、減少環境污染、並降低資源及人力浪費。方法與材料：花蓮慈濟醫學中心的PACS含蓋有：(1)影像擷取：兩台電腦斷層、兩台磁振造影、一般X光（有CR和DR兩種）、超音波、內試鏡、核醫和心導管等。(2)影像儲存與管理：使用關連式資料庫和階層式儲存。(3)影像通訊：院內使用主幹和快速乙太網路，遠距會診使用ADSL和T1線。(4)高備援不當機系統：使用雙主機兩台作高備援連接。(5)儲存設備：以高階磁碟陣列為短期儲存，以低速的磁碟陣列作為長期儲存。(6)影像顯示：個人電腦作為使用者端，配置21吋灰階螢幕或17吋彩色螢幕。(7)影像處理：具備各種查詢、影像編輯、亮度或對比調整、縮小放大、測量、多格顯示和動畫顯示功能等。(8)其它的硬體設備尚有如不斷電和電力設備等。我們比較無片化前與無片化後的效能差別，以平均值變化來評估。結果：無片化後的效益總括有(1)病患等候時間由27分鐘降為10分鐘。(2)片庫管理，簡易方便節省人力。(3)CD片儲存資料，降低儲存空間，由5年100坪縮減為1坪。(4)各式洗片耗材及設備成本，每年平均節省八百二十四萬四千元。(5)降低污染及符合環保，平均每年減少二十三萬九千張X光片和洗片廢水一萬四千七百四十四公升。(6)遠距醫療及跨院區會診之便利與彈性。結論：如前面成本效益分析，十年本院應該可以節省至少六千萬元。所以在這裡我要呼籲大家，越早完成全院性PACS達到無片化越好。
並列摘要
Purpose: There are many complicated problems of the X-ray Department using traditional X-ray films. They include large storage space, difficulty to maintain, manpower consumption, and time consumption in film retrieval. These make the X-ray Department inefficient. We have tried to solve these problems and improve our productivity and patient service in Tzu-Chi Medical Center. Materials and methods: Our PACS covers (1) Image capture for dual-computed tomography, routine X-ray (DR and CR), ultrasound, endoscope, nuclear medicine, and cardiac laboratory. (2) With storage and management: using relational database and directory storage. (3) Image intranet with dual backbone and fast Ethernet, teleradiology with ADSL, T1 or Internet. (4) Two severs to form high availability structure. (5) Storage with high speed and low speed RAID. (6) Display with: 21' high contrast monitors and 17' PC monitors. (7) Displany functions including searching, image editing, contrast and brightness, window and level adjust, zoom, measurement, montage, and cine function. 8. Other devices including UPS, power supply etc. We compared the efficiency of filmless with mean values of different measurement. Results: Filmless advantages include (1) Patient waiting time drop from 27 minutes to 10 minutes. (2) Man power saving with decrease 2 person. (3) Decrease file storage space from 330 M^2 to 3.3 M^2 (4) Money saving of NT$ 8,240,000 from films, developer and fixer saving. (5) Decrease pollution by decrease of film waste of 239,000 pieces and water waste of 14744 liters. (6) Versatile and convenient teleradiology and telecosultation. Conclusion: As the above results, PACS of our hospital is cost-effective and may save NT$ 60,000,000 in ten years. We suggest to set up PACS and work in filmless environment as soon as possible.