title: [Design and implementation of an integrated HIS-RIS-PACS system: our experience].
abstract: OBJECTIVE
  To develop an integrated information system to support the administrative and healthcare work processes in a highly specialised research-oriented healthcare institution composed of one hospital and a separate outpatient centre. The project, developed within the context of an ongoing process of technological innovation, aimed to improve the efficacy and efficiency of the services provided. In particular, over the past year our efforts focused on developing and implementing a RIS-PACS system to support the management of clinical data and radiological reports and images.
  
  
  METHODS
  The RIS-PACS system was implemented in four phases to meet the technical-functional needs of the Units of the Department of Diagnostic Imaging. The plan was developed considering the work flow between the Department, the outpatient centre and the hospital wards with the aim of creating a filmless and paperless organisational model for the Radiology Units. The four implementation phases were characterised by defining and developing protocols that would integrate the systems (HIS, RIS, PACS and modalities) to guarantee correct and complete management of the work flow.
  
  
  RESULTS
  Phases I and II have already been completed and have led to efficient, safe and complete interaction between the hospital wards, the outpatient centre and the Radiology Units. Overall performance of the hospital has improved and the outpatient centre is now completely managed in digital mode. Phases III and IV will extend these positive results by enabling the routine distribution of radiological reports and images to all hospital wards and clinics and associated facilities. As a result, the use of film and printing and developing materials will gradually be reduced, enabling all the required clinical and diagnostic information to be immediately and securely shared.
  
  
  CONCLUSIONS
  This project is one of the first examples in Italy of the routine implementation of a single virtual radiology department distributed across physically remote locations. In particular, the project was successfully completed thanks to the approach used in planning and defining the clinical and functional specifications, and in the implementation phase. We conclude that setting up an information system truly capable of supporting the routine clinical activity of a Diagnostic Imaging Department requires a detailed operational project and careful planning of each implementation phase.
authors.affiliation: Dipartimento Diagnostica per Immagini, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo.
authors.forename: Mario
authors.initials: M
authors.lastname: Cammisa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Guglielmi
authors.forename: Nicola
authors.initials: N
authors.lastname: Zarrelli
authors.forename: Orazio
authors.initials: O
authors.lastname: Pennelli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Borello
authors.forename: Daniela
authors.initials: D
authors.lastname: Piuri
authors.forename: Pietro
authors.initials: P
authors.lastname: Conti
mesh_terms: D003952:Diagnostic Imaging; D006751:Hospital Information Systems; D006801:Humans; D007558:Italy; D011872:Radiology Department, Hospital; D011873:Radiology Information Systems; D018511:Systems Integration