於現今的網路醫學影像服務平台中提供一個以病人安全為中心之醫學計數器(Medical Calculator)乃必要的工具及設計,不僅可與web-based enterprise PACS (Picture Archiving and Communication system)系統整合並可有效地藉由單一帳號系統登入機制讓醫師幫助檢查單位進行快速正確的檢查作法評估。以近來常較被關注的腎因性全身纖維化病變(nephrogenic systemic fibrosis, NSF)為例,在醫院放射線部門的磁振造影檢查時常需要藉助施打對比劑來判斷病灶位置,加強診斷結果。受檢者腎絲球過濾率(glomerular filtration rate, GFR)值是常被用來作為評估磁振造影對比劑施打合適與否的指標,但若是因各種實驗室數據LIS (laboratory information system)或病人基本資料取得不易或需人工手動輸入相關數值、計算繁瑣等因素存在時,將難以避免人為疏失導致相關計算結果不正確。因此,我們提供一個方便的GUI (graphic user interface)設計來強化報告判讀醫師及檢查單位放射師間的作業流程。根據Cockcroft-Gault GFR與MDRD (Modification of Diet in Renal Disease) GFR方程式將可用的現有資訊(例如:性別、年齡、種族、肌酸酐數值)透過平台整合,讓GFR數值可以快速地自動提供正確的計算結果,審核檢查作法之放射科醫師與執行檢查的放射師就可根據數值挑選合適的磁振造影檢查protocol,讓檢查執繼續進行,我們希望這樣全新的流程改變可有利於病人安全降低醫療錯誤發生的機率。
The profile of medical calculators for web-based enterprise PACS solutions is now on the horizon to be a mandatory tool for clinicians to increase patient safety. Not only because this new profile could be seamlessly integrated into the existing PACS platform under single sign-on algorithm, but also it could be used to enhance the clinical workflows in many aspects. Citing the hot topic of NSF (nephrogenic systemic fibrosis) as example, GFR (glomerular filtration rate) is a major factor for radiologists to determine which MR contrast to be used. To eliminate the possible error of manual data retrieveing from LIS (laboratory infromaton system) and erreous calculation, we try to provide a user-friendly GUI (graphic user interface) of medical calculators to enhance the workflows of imaging for technicians and reporting for radiologists. GFR calculator is one of the trials using the available data (ex. Age, sex, race, and creatinine level) provided by the platform now running at our hospital based on typical MDRD (Modification of Diet in Renal Disease) GFR and Cockcroft-Gault GFR equations to obtain immediate results. The radiologists and technicians could use the results to determine the logistic MR protocol for the patient to go through. We believe that this new profile could be beneficial for increasing patient safety and decreasing medical dissension and related law Issues.
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