title: Clinical integration of picture archiving and communication systems with pathology and hospital information system in oncology.
abstract: The complexity of our current healthcare delivery system has become an impediment to communication among caregivers resulting in fragmentation of patient care. To address these issues, many hospitals are implementing processes to facilitate clinical integration in an effort to improve patient care and safety. Clinical informatics, including image storage in a Picture Archiving and Communication System (PACS), represents a tool whereby clinical integration can be accomplished. In this study, we obtained intraoperative photographs of 19 cases to document clinical stage, extent of disease, disease recurrence, reconstruction/grafting, intraoperative findings not identified by preoperative imaging, and site verification as part of the Universal Protocol. Photographs from all cases were stored and viewed in PACS. Images from many of the cases were presented at our interdepartmental cancer conferences. The stored images improved communication among caregivers and preserved pertinent intraoperative findings in the patients' electronic medical record. In the future, pathology, gastroenterology, pulmonology, dermatology, and cardiology are just a few other subspecialties which could accomplish image storage in PACS. Multidisciplinary image storage in a PACS epitomizes the concept of clinical integration and its goal of improving patient care.
authors.affiliation: Department of Pathology, University of Tennessee Medical Center, Knoxville, Tennessee 37920, USA. ldduncan@utmck.edu
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Duncan
authors.forename: Keith
authors.initials: K
authors.lastname: Gray
authors.forename: James M
authors.initials: JM
authors.lastname: Lewis
authors.forename: John L
authors.initials: JL
authors.lastname: Bell
authors.forename: Jeremy
authors.initials: J
authors.lastname: Bigge
authors.forename: J Mark
authors.initials: JM
authors.lastname: McKinney
mesh_terms: D006751:Hospital Information Systems / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D007432:Intraoperative Period; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016522:Oncology Service, Hospital / Q000458:organization & administration*; D010337:Pathology Department, Hospital / Q000458:organization & administration*; D010348:Patient Care Team; D011859:Radiography; D011873:Radiology Information Systems / Q000458:organization & administration*; D013714:Tennessee