<title>Problem of data quality and the limitations of the infrastructure approach</title>

Abstract

The 'Infrastructure Approach' is a PACS implementation methodology wherein the archive, network and information systems interfaces are acquired first, and workstations are installed later. The approach allows building a history of archived image data, so that most prior examinations are available in digital form when workstations are deployed. A limitation of the Infrastructure Approach is that the deferred use of digital image data defeats many data quality management functions that are provided automatically by human mechanisms when data is immediately used for the completion of clinical tasks. If the digital data is used solely for archiving while reports are interpreted from film, the radiologist serves only as a check against lost films, and another person must be designated as responsible for the quality of the digital data. Data from the Radiology Information System and the PACS were analyzed to assess the nature and frequency of system and data quality errors. The error level was found to be acceptable if supported by auditing and error resolution procedures requiring additional staff time, and in any case was better than the loss rate of a hardcopy film archive. It is concluded that the problem of data quality compromises but does not negate the value of the Infrastructure Approach. The Infrastructure Approach should best be employed only to a limited extent, and that any phased PACS implementation should have a substantial complement of workstations dedicated to softcopy interpretation for at least some applications, and with full deployment following not long thereafter.© (1998) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.