Original Title: Sistema PACS y su posible aplicación en la gestión de objetos clínicos NO-DICOM

Authors' objectives: 1. Review existing evidence on the usefulness of PACS systems for storing and transmitting clinical objects NON-DICOM. 2. Describe experiences on technological solutions detected to integrate NON-DICOM objects into PACS.

Authors' results and conclusions: Results The literature review found a total of 2.556 references, of which 1.483 were found after eliminating duplicates. Excluded, according to the experts consulted, were those published before 2010, with 920 references that were reviewed by title and summary. Subsequently, 73 studies were selected as potentially relevant, which were reviewed in full text and, finally, 15 studies were included that proposed technological solutions for different clinical specialties. We detected 7 successful experiences whose technological solution allowed the integration of NON-DICOM clinical objects in PACS systems by transforming them into DICOM clinical objects; 2 experiences in which the technological solution employed a method in which it was not necessary to transform the clinical objects NON-DICOM into DICOM; and 6 experiences in which the technological solution allowed the integration of NON-DICOM clinical objects in PACS systems under the framework of a different technological environment such as the IHE Integration Profile XDS (cross enterprise document sharing) and/or a VNA (vendor neutral archive). These experiences were grouped according to the clinical area or specialty with which they related: 4 experiences on radiology service, 3 experiences in cardiology, 3 experiences on laboratory service, 3 experiences on different forms of telemedicine, 1 on neurology service, and another on radiotherapy. Conclusions Technological solutions to integrate NON-DICOM clinical objects into PACS systems are relatively new. The heterogeneity of medical devices and the lack of standardization of processes in each of the specialties and/or of framework agreements that are widely accepted in the health sector have led to the appearance of multiple technical options and solutions that involve the sale of products and services that are making it difficult to make efficient use of the clinical objects stored for the management of patients' health problems. The planning and consensus among the different actors within the healthcare organization (healthcare professionals, electromedical engineers, information systems technicians, area specialists, etc.) are necessary to define the strategies for implementing information systems that allow for easy management of the workflows of each specialty or object and that allow their integration into the workflow of the corresponding professionals. In addition to considering technical aspects, the introduction of information technologies in the National Health System also requires to considerate ethical, organisational, legal and patientrelated aspects

Authors' methods: A systematic and structured literature search was conducted from 2000 to the last week of June 2017; combining a simple strategy (based on the keyword "NON-DICOM") with a complex strategy that, once merged, resulted in the global search strategy. The MEDLINE, EMBASE, WOS, PubMed, IEEE Xplore Digital Library and Computing Databases, websites of national and international Health Technology Assessment Agencies or Units and of governmental or non-governmental organizations and initiatives related to this area of knowledge were consulted. The selection criteria for the studies were: type of clinical object, type of technological solution, type of user or environment and type of outcome measure reported (times of delay, image quality, loss of images, errors in the association of subjects and information, user satisfaction, costs and savings, security, interoperability and/or accessibility). Two reviewers independently selected and analysed studies and extracted data from included studies. The information collected was summarized through narrative synthesis of the included studies with tabulated results. Finally, ethical considerations affecting patients were not systematically included, as well as other ethical, social, legal and organizational aspects

Project Status: Completed

Year Published: 2019

URL for published report: https://www3.gobiernodecanarias.org/sanidad/scs/content/83f2c888-b833-11e9-8954-c79d218b7bdf/SESCS_2017_PACS.pdf

Requestor: Ministry of Health

English language abstract: An English language summary is available

Publication Type: Other

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es