{"id":138942,"date":"2013-10-28T17:34:52","date_gmt":"2013-10-28T19:34:52","guid":{"rendered":"http:\/\/revistapesquisa.fapesp.br\/?p=138942"},"modified":"2015-10-29T15:31:25","modified_gmt":"2015-10-29T17:31:25","slug":"digital-access","status":"publish","type":"post","link":"https:\/\/revistapesquisa.fapesp.br\/en\/digital-access\/","title":{"rendered":"Digital access"},"content":{"rendered":"
\"Hospital

TATO ARAUJO<\/span>Hospital das Cl\u00ednicas (HC) saves R$7,000,000 per year by not having to archive and print reports and imagesTATO ARAUJO<\/span><\/p><\/div>\n

The increasing use of images in hospitals in recent years, such as x-rays, ultrasound, MRIs and CAT scans, created the need to develop systems to manage them. With an eye on this market, large information technology companies such as Siemens, Toshiba, Agfa, GE, Carestream and Philips have created solutions, which are generically known as picture archiving and communication systems or PACS. Now a small company based in the city of Ribeir\u00e3o Preto, S\u00e3o Paulo State, is positioned alongside these large companies to develop its own PACS. The system is already in use and has had good results after more than two years at the Hospital das Cl\u00ednicas of the University of S\u00e3o Paulo School of Medicine (HCFMRP-USP).<\/p>\n

The system, which is called LyriaPacs, was created by i-Medsys, a company founded in 2005 in Ribeir\u00e3o Preto by three young USP trained researchers, postgraduates in information technology and computer science. \u201cLyria is a storage, communication, distribution and visualization system that follows the DICOM (digital imaging and communication in medicine) protocol specifications, which is the standard for the archiving and distribution of medical images,\u201d explains Diego Fiori de Carvalho, a founding partner of the firm. \u201cIt is a complete solution for medical image management in hospitals, diagnostic centers and clinics and by health professionals,\u201d says Carvalho.<\/p>\n

\u201cBased on the functionalities of the DICOM standard, Lyria is able to interconnect with the health information systems of the hospital and allows full control of the flow of image data,\u201d says Paulo Mazzoncini de Azevedo Marques, a professor of biomedical computer science and medical physics and coordinator of the medical physics and radiation protection service of the Ribeir\u00e3o Preto Hospital das Cl\u00ednicas. Lyria is connected to the hospital\u2019s computer system and receives information about patients who will have certain tests on a specific day, and the system generates a list. It then connects to the equipment generating the images for those tests\u2014for example, an MRI machine\u2014and enters the patient data. Following the test, Lyria transfers the images to a filing system, maintaining the link between the patient data already in the hospital information system and the new test data that were generated. \u201cData remain on file as long as necessary, or as defined by the institution under current law,\u201d says Azevedo Marques.<\/p>\n

Tests can be viewed by means of the hospital\u2019s information system, which oversees the rights of whoever is allowed to access the data according to predefined user profiles. For example, the radiologist is allowed data access when making the patient report. With a password, the radiologist can connect to Lyria from a computer anywhere in the hospital, s\/he selects a test, downloads the images and makes the report using the interface of the information system of the appropriate hospital. The document is then linked to its respective test and available for consultation, which can be done by a clinician, for example, in order to read the report prepared by the radiologist or see the image.<\/p>\n

To develop Lyria, i-Medsys received funding from two projects of the FAPESP Innovative Research in Small Businesses Program (Pipe), both started in 2005. The first project, which was coordinated by Jos\u00e9 Antonio Camacho Guerrero, a partner of the company, involved developing a system for linking documents. It was called Linkdigger and its purpose was to create innovative solutions for individuals and businesses that needed to link data available from various sources of information. The second project resulted in the ArcaMed system to develop various software programs for hospital use, which led to Lyria, in addition to other products.<\/p>\n

Hospital das Cl\u00ednicas (HC) implemented ArcaMed as a pilot program in 2007. \u201cIn 2008 we obtained funding from CNPq [National Council for Scientific and Technological Development] to hire professionals,\u201d said Fiori. \u201cThe pilot project at HC Ribeir\u00e3o Preto created the need for a computer platform that would enable the consistent and automatic exchange and storage of images. Thus, i-Medsys created Lyria.\u201d According to Fiori there are few companies in Brazil with the ability to develop this type of solution. \u201cMost are representative of foreign systems, just the translation of software into Portuguese,\u201d he says.<\/p>\n

Contract and customization<\/strong>
\n\u201cThere are interesting PACS out there, but none offers a complete solution. For example, there are viewers that are often used, such as KPACS, OsiriX (for Apple), E-Film, and servers for storage and distribution, which have been developed by large companies. Such solutions typically require customization, at an additional cost, plus spending on acquisition.\u201d<\/p>\n

In another hospital at the same university, Hospital das Cl\u00ednicas of the University of S\u00e3o Paulo School of Medicine, located in the capital city of S\u00e3o Paulo, has a contract for services with Philips to supply the system used to manage medical images throughout the hospital complex. \u201cUnder this agreement, Philips is responsible for providing the hardware, software and system maintenance of the RIS [radiology information system] \/ PACS, which allows the hospital staff to remain focused on patient care,\u201d explains Vilson Cobello Junior, Systems Manager of the Information Technology Center at the Hospital. According to Cobello, the project began in 2007 and became operational in December 2008. \u201cThis solution is responsible for managing the entire work flow of the Hospital\u2019s Department of Radiology,\u201d he says. \u201cThis includes not only patient registration, scheduling, patient preparation, performance of the test, storage and distribution of images, but also completion and distribution of radiological reports throughout the Hospital complex by means of an electronic portal that consolidates medical imaging, follow-up reports and the results of laboratory tests.\u201d<\/p>\n

Fiori says that in the case of Lyria the results after two years of use at the hospital in Ribeir\u00e3o Preto are good and showed costs in line with the competition. As of December 2012, 389,764 studies were stored\u2014sets of medical images of patients\u2014for various tests such as x-rays, ultrasound, CAT scans and others. \u201cIn total, these studies comprise 53,020,858 images, which are stored in the hospital system,\u201d says Fiori. According to the prevailing market prices for storage, printing images and reports, an institution the size of the Ribeir\u00e3o Preto Hospital saves about R$7,000,000 per year with this system. The Hospital performs close to 600,000 consultations or procedures per year. \u201cThe cost of system implementation in a hospital that generates about 14,000 images per month is R$1,000,000, including equipment, installation services and training,\u201d says Fiori.<\/p>\n

Projects<\/strong>
\n1. ArcaMed: a framework for building systems to support medical diagnosis (No. 2005\/60038-5<\/a>); Grant Mechanism<\/strong> Innovative Research in Small Businesses Program (Pipe); Coordinator<\/strong> Diego Fiori de Carvalho – i-Medsys; Investment<\/strong> R$164,733.15 (FAPESP).
\n2. Linkdigger: services created to link information available on the Web (No. 2003\/07968-9<\/a>); Grant Mechanism<\/strong> Innovative Research in Small Businesses Program (Pipe). Coordinator<\/strong> Jos\u00e9 Antonio Camacho-Guerrero i Medsys. Investment<\/strong> R$397,632.09 (FAPESP).<\/p>\n","protected":false},"excerpt":{"rendered":"Hospital uses national system to manage medical images","protected":false},"author":20,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[1560,169],"tags":[219,247],"coauthors":[112],"class_list":["post-138942","post","type-post","status-publish","format-standard","hentry","category-innovative-research-in-small-business-pipe-en","category-technology","tag-computation","tag-medicine"],"acf":[],"_links":{"self":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/138942","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/comments?post=138942"}],"version-history":[{"count":0,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/138942\/revisions"}],"wp:attachment":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/media?parent=138942"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/categories?post=138942"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/tags?post=138942"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/coauthors?post=138942"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}