Made available in DSpace on 2015-07-22T20:49:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-04-29. Added 1 bitstream(s) on 2015-08-11T03:25:40Z : No. of bitstreams: 1 Publico-058.pdf: 1174030 bytes, checksum: 6102ccff4fb9134a645e0915a421a08f (MD5) / O registro de informações do paciente é um instrumento de grande importância na área médica. O processo de geração de laudos em radiologia pode ser dinamizado e melhorado com a utilização de sistemas eletrônicos baseados em tecnologias de informação e comunicação que podem trazer benefícios como o aumento de produtividade e redução de tempo e custo. Esta pesquisa comparou tempos de geração e digitação de laudos entre um sistema eletrônico, que possibilitou ao médico radiologista gravar seus laudos gerados por voz em formato digital e o sistema tradicional no qual o radiologista escreve o laudo a mão. Para realização da pesquisa foi necessário modelar e construir o sistema eletrônico proposto para fins de comparação com o tradicional já existente. Por meio de formulários, radiologistas e digitadores anotaram os tempos de geração e digitação dos laudos nos dois sistemas. Comparadas as médias entre eles, o sistema eletrônico apresentou redução de 20% (p=0,0410) do tempo médio de geração do laudo em comparação com o sistema tradicional. Por outro lado, o sistema tradicional foi mais eficiente em relação ao tempo de digitação já que a média de tempo do sistema eletrônico foi três vezes maior (p<0,0001). / The patient medical record is extremely important in medicine. The radiology report generation process can be improved using electronic models based in communication and information technologies that can improve productivity, reduce time and cost. This research compares generation and transcription times of the radiology report between a radiology information system where the radiologist can record radiology reports by voice in digital format and the traditional system in which the radiologist writes the radiology reoport by hands. To conduct the study was necessary to model and construct the electronic system for comparison with the existing traditional system. Using forms, radiologists and transcriptionists register the generation and transcription times in both systems. Comparign the averages, the electronic system reduced 20% (p=0,0410) the generation average time of radiology report compared with traditional system. Moreover, the traditional system was more efficient in relation to transcription time whereas the average time of eletronic system was three times bigger (p<0,0001). / TEDE

Thesis (M.Sc.). / Title from title page of PDF (viewed 2008/01/30). Written for the Medical Physics Unit, Faculty of Medicine. Includes bibliographical references.

Lic.-avh. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 2 uppsatser.

Orientador: Frab Norberto Bóscolo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-22T13:39:06Z (GMT). No. of bitstreams: 1 Frazao_MarcoAntonioGomes_D.pdf: 4262109 bytes, checksum: 0e3256f8a0dd02738990d526d5a2329b (MD5) Previous issue date: 2012 / Resumo: Com este estudo, teve-se a proposta de avaliar a modificação da densidade de 4 cores (branco, cinza claro, cinza escuro e preto) em filmes radiográficos impressos por duas tecnologias dry seca: termográfica (AGFA) e fototermográfica (KODAK). Para isso, foi utilizada uma amostra formada por 18 grupos com 6 corpos de prova para cada uma das tecnologias de impressão totalizando um experimento com 216 corpos de prova submetidos às temperaturas de 40ºC, 60ºC e 80ºC, pelos tempos de 30, 60 e 120 minutos com e sem a exposição solar. Nestes foram realizadas analises densitométricas antes e depois da exposição aos fatores estudados e os dados obtidos submetidos aos testes estatísticos de: Kruskal Wallis, Mann-Whitney e Wilcoxon para dados pareados com nível de significância de 5%. Pôde-se observar que as cores avaliadas impressas no filme pela tecnologia termográfica (AGFA) modificam sua densidade a partir de combinações de exposição a 60ºC e 120 minutos e a 80ºC e 30 minutos sem a exposição ao sol e a partir de 40ºC e 30 minutos com exposição solar, e no filme impresso pela tecnologia fototermográfica (KODAK) modifica sua densidade a 40ºC a partir de 30 minutos com e sem a exposição solar. Concluiu-se que o aumento da temperatura de armazenamento bem com a exposição à luz solar modificam a densidade dos filmes radiográficos impressos pelas tecnologias dry seca avaliadas / Abstract: The purpose of this study was to evaluate the density modification of 4 colors (white, light gray, dark gray and black) in films printed by two dry technologies: thermographic (AGFA) and photothermographic (KODAK). A sample consisting of 18 groups with six specimens per printing technologies was used, totaling an experiment of 216 evaluated specimens when subjected to temperatures of 40°C, 60°C and 80°C, for periods of 30, 60 and 120 minutes with and without sunlight exposure. These specimens were submitted to densitometric analysis before and after exposure to the studied factors and data were subjected to the following statistical tests: Kruskal Wallis, Mann-Whitney and Wilcoxon for paired data. It was observed that the evaluated colors printed on the film by thermographic technology (AGFA) modify their density at exposures to 60°C and 120 minutes, and without sunlight exposure at the temperature of 80°C after 30 minutes, and with sunlight exposure from 40°C and 30 minutes, and the film printed by photothermographic technology (KODAK) modifies its density at 40°C from 30 minutes with and without sunlight exposure. It was concluded that the increase of storage temperature and sunlight exposure modify the density of radiographic films printed by dry technologies / Doutorado / Radiologia Odontologica / Doutor em Radiologia Odontológica

Syfte: Att beskriva den organisationsförändring som fem röntgenkliniker i Sverige genomgick i samband med att radiologin digitaliserades. Frågeställningar: Hur förändrades antalet genomförda radiologiska undersökningar och undersökningstyper från tidpunkten två år före digitaliseringen till två, fyra och sex år efter digitaliseringen? Hur förändrades antalet arbetade timmar och fördelningen av arbetade timmar mellan de olika personalkategorierna från tidpunkten två år före digitaliseringen till två, fyra och sex år efter digitaliseringen? Hur förändrades arbetsuppgifterna inom och mellan de olika personalkategorierna på röntgenklinikerna efter digitaliseringen? Hur beskriver personal med en nyckelfunktion genomförandet av digitaliseringen och eventuell förändring av arbetet efter digitaliseringen? Metod: Kvantitativ och kvalitativ metod har använts och kombinerats för att besvara studiens frågeställningar. Fem svenska röntgenkliniker ingick i studien och material avseende produktionsutfall samlades in från respektive röntgenklinik. Totalt intervjuades 22 personer, med tre till sex intervjuer per röntgenklinik. Teoretiska ramverk: För att försöka förstå de positiva fynden, avseende utökade antalet undersökningar och minskning av arbetade timmar, efter digitaliseringen, genomfördes vid en av röntgenklinikerna en fallstudie med ytterligare två frågeställningar: Hur genomfördes digitaliseringen? Hur har uppföljningen vad avser arbetsflöden, genomförandet och förändringar i detalj genomförts efter digitaliseringen? Delar av Bramson m.fl. (2005) perspektiv och Kotter och Cohens (2002) framgångsfaktorer har applicerats vid analysen av det resultatet. Resultat: Samtliga röntgenkliniker uppvisade en liten ökning av antalet radiologiska undersökningar, medan datortomografi- och magnetkameraundersökningarna ökade markant under den studerade tiden. Efter digitaliseringen genomförs således fler komplicerade undersökningar, vilket anses ha medfört en kvalitativt bättre och säkrare diagnosticering. Övriga undersökningstyper uppvisar varierande resultat. Vid tre av röntgenklinikerna minskade den totala arbetade tiden, och vid två ökade den. Antalet arbetade timmar ökade för röntgenläkare och röntgensjuksköterskor, men minskade för sekreterare och undersköterskor under den studerade tiden. Generellt utför röntgenläkarna och röntgensjuksköterskorna fler arbetsuppgifter efter digitaliseringen, och många av de traditionella arbetsuppgifterna för sekreterare och undersköterskor har försvunnit eller tagits över av datorn. Bättre tillgänglighet, förhöjd kvalitet och utökad diagnostik, tydligare arbetslistor som styr arbetsflödet, förbättrad ergonomi och miljö samt samordning med andra har möjliggjorts efter digitaliseringen. Utifrån intervjuerna i fallstudien framkom teman som beskriver: information, superanvändare, utbildning, tydliga arbetsflöden och rutiner, personalbehov och motivation, liksom ett tydligt ledarskap som genomsyrat förändringsprocessen. Dessa teman är, enligt Bramson och Bramson (2005) och Kotter och Cohen (2002), viktiga att beakta för att lyckas med en förändring. Konklusion: Ingen av de intervjuade vill återgå till ett analogt arbetssätt. Digitaliseringen har inneburit att mycket förändrats för de berörda personalkategorierna, men fördelarna anses uppväga nackdelarna. För att lyckas med en förändring bör Bramsons perspektiv och Kotters framgångsfaktorer tas i beaktande. / Background: Since Wilhelm Conrad Röntgen’s discovery of X-rays in 1896, radiology has undergone great changes. In Sweden, the process of digitalisation radiology was initiated in the mid 1990s. Aim: To describe the organisational changes that took place in five radiol- ogy clinics in Sweden in connection with the digitalisation of radiology. Study questions: How did the number and type of radiological examinations change when comparing two years before with two, four and six years after digitalisation? How did the number and distribution of hours worked change among different staff categories when comparing two years before with two, four and six years after digitalisation? How did the duties change after digitalisation within and between different staff categories at the radiology clinics? How do staff members in key positions describe the implementa- tion of digitalisation and any changes in their professional prac- tice after digitalisation? Method: Quantitative and qualitative methods were combined in order to answer the study questions. Five Swedish radiology clinics took part in the study, and production outcome data were gathered from each clinic. A total of 22 individuals were interviewed, with three to six interviews per radiology clinic. In order to gain an understanding of the positive results at one of the radiology clinics in terms of the increased number of exami- nations and reduction in the number of hours worked after digitalization a case study was conducted at this clinic, in which two questions were posed: How was the digitalisation carried out? How were workflow, im- plementation and changes followed up in detail after digitalisation? Ele- ments of Bramson and Bramson ́s (2005) perspectives and Kotter and Cohen’s (2002) success factors were applied. Findings: All radiology clinics had a small increase in the number of radio- logical examinations, while computed tomography and magnetic reso- nance imaging examinations increased significantly during the period un- der investigation. Thus, more complex examinations were carried out post digitalisation, a fact considered to have led to qualitatively better and safer diagnoses. The total working time was reduced at three clinics, while two exhibited an increase. The total number of hours worked increased for radiologists and radiographers but decreased for secretaries and assistant nurses. In general, radiologists and radiographers performed more tasks post digitalisation, and many of the traditional duties of secretaries and assistant nurses were eliminated or taken over by the computer. Digitalisa- tion enabled greater access to radiological images and patient data in addi- tion to improved quality and diagnostics of the radiological examination. Digitalisation also allowed a better-controlled workflow, as well as im- proving ergonomics, the environment and the coordination with other clinics. The case study interviews revealed themes describing: information, super users, education, clear work flows and routines, staff needs and motiva- tion as well as clear leadership throughout the change process. According to Bramson and Kotter, these themes are important for successful change. Conclusion: None of the individuals interviewed wished to return to the analogue mode of working. The digitalisation led to great changes for the different staff categories, with the advantages outweighing the disad- vantages. To succeed with change, Bramson’s perspectives and Kotter’s success factors should be taken into consideration.

Contexte : Les premières implantations PACS (Picture Archiving and Communication System) remontent aux années 80. Le rehaussement récent du PACS au sein d’un centre hospitalier universitaire a permis d’étudier l’introduction d’innovations dans une technologie mature. Objectif : Dans un premier temps, effectuer une revue de la littérature sur les études évaluant la perceptions des utilisateurs de l’implantation des PACS. Deuxièmement, évaluer dans une étude de cas si le niveau d’alignement entre les tâches et la technologie prédit l’utilisation et la perception des bénéfices. Méthodes : Il y a eu une revue systématique de la littérature afin d’identifier les études sur la perception des utilisateurs du PACS. Une adaptation du modèle TTF (Task-Technology-Fit) développé par Goodhue (1995) a servi de base théorique pour l’étude de cas effectuée par questionnaire auto-administré. Résultats : Les modèles recensés dans la revue systématique sont mieux adaptés à des nouvelles implantions PACS qu’à des systèmes matures en évolution. Il y a une corrélation significative entre le niveau de l’alignement, tel que perçu par les utilisateurs, et la perception des bénéfices nets, ainsi que l’utilisation de la technologie. L’étude a démontré un écart entre la perception des utilisateurs et celle des développeurs interviewés. Conclusions : Cette étude supporte la validité du concept alignement tâche-technologie dans l’analyse d’un rehaussement PACS. Il est important de maintenir une interaction soutenue entre développeurs et utilisateurs, qui va audelà de la phase initiale de développement. / Context: The first PACS deployments date to the early 1980’s. The recent upgrade of PACS in a university teaching hospital has offered the opportunity to study the introduction of innovations in a mature technology. Objective: First, to conduct a literature review of studies evaluating user perceptions following deployment of PACS. Second, to evaluate in a case study if task-technology fit predicts utilisation and perceived benefits. Methods: A systematic review of the literature was conducted to identify studies evaluating user perceptions. An adaptation of the Task-Technology-Fit model developed by Goodhue (1995) served as a theoretical basis for the case study conducted with an auto-administered survey. Results: The models used in the studies identified in the review are more suited for initial deployments of PACS, rather than mature systems in a state of continuous evolution. There is a significant correlation between the level of task-technology fit and the users’ perception of net benefits, as well as use. The study also revealed a divide between the perception of users and that of developers involved in product evolution. Conclusion: The findings validate the use of task-technology fit to study a PACS upgrade. It is important to maintain a continuous interaction between users and developers beyond the early phases of product development.

Contexte : Les premières implantations PACS (Picture Archiving and Communication System) remontent aux années 80. Le rehaussement récent du PACS au sein d’un centre hospitalier universitaire a permis d’étudier l’introduction d’innovations dans une technologie mature. Objectif : Dans un premier temps, effectuer une revue de la littérature sur les études évaluant la perceptions des utilisateurs de l’implantation des PACS. Deuxièmement, évaluer dans une étude de cas si le niveau d’alignement entre les tâches et la technologie prédit l’utilisation et la perception des bénéfices. Méthodes : Il y a eu une revue systématique de la littérature afin d’identifier les études sur la perception des utilisateurs du PACS. Une adaptation du modèle TTF (Task-Technology-Fit) développé par Goodhue (1995) a servi de base théorique pour l’étude de cas effectuée par questionnaire auto-administré. Résultats : Les modèles recensés dans la revue systématique sont mieux adaptés à des nouvelles implantions PACS qu’à des systèmes matures en évolution. Il y a une corrélation significative entre le niveau de l’alignement, tel que perçu par les utilisateurs, et la perception des bénéfices nets, ainsi que l’utilisation de la technologie. L’étude a démontré un écart entre la perception des utilisateurs et celle des développeurs interviewés. Conclusions : Cette étude supporte la validité du concept alignement tâche-technologie dans l’analyse d’un rehaussement PACS. Il est important de maintenir une interaction soutenue entre développeurs et utilisateurs, qui va audelà de la phase initiale de développement. / Context: The first PACS deployments date to the early 1980’s. The recent upgrade of PACS in a university teaching hospital has offered the opportunity to study the introduction of innovations in a mature technology. Objective: First, to conduct a literature review of studies evaluating user perceptions following deployment of PACS. Second, to evaluate in a case study if task-technology fit predicts utilisation and perceived benefits. Methods: A systematic review of the literature was conducted to identify studies evaluating user perceptions. An adaptation of the Task-Technology-Fit model developed by Goodhue (1995) served as a theoretical basis for the case study conducted with an auto-administered survey. Results: The models used in the studies identified in the review are more suited for initial deployments of PACS, rather than mature systems in a state of continuous evolution. There is a significant correlation between the level of task-technology fit and the users’ perception of net benefits, as well as use. The study also revealed a divide between the perception of users and that of developers involved in product evolution. Conclusion: The findings validate the use of task-technology fit to study a PACS upgrade. It is important to maintain a continuous interaction between users and developers beyond the early phases of product development.