碩士 / 元培科技大學 / 醫學影像暨放射技術研究所 / 102 / To reduce the disparity of available medical resources in urban and rural areas, better safeguard the health of people living in remote villages, and address the shortage of radiologists in rural areas, the government set up the Image Reading Center (IRC) and made teleradiology services available to public health centers in mountainous regions and off-shore islands beginning May 1, 2010. However, no integrated assessment model currently exists to determine the performance and service quality of the IRC. The IRC’s interpretations must be conducted promptly in order to be effective, but they are often compromised due to delays in image transmission caused by systemic or human errors. The aim of this study was to evaluate the efficiency of IRC by using various research methods including a field survey, study of the IRC database, expert interviews, and a questionnaire. This study investigated feedback on remote interpretations of X-ray images collected from public health centers and local residents in mountainous regions and off-shore islands that were enrolled in the IRC program. Our investigation covered domains including implementation status, service intention, service benefit, system quality, and satisfaction.
Results show that only 47.4% of public health centers owned full-time radiological technologist. From May 2010 to December 2013, a total of 20,858 radiology reports were written by remote consultation of IRC for public health centers in mountainous regions and off-shore islands. Totally 4,855 cases were abnormal findings (1,435 cases of fracture, 743 cases of pulmonary infection, 1,032 cases of pulmonary tuberculosis, 1,422 cases of Cardiomegaly, 82 cases of mass and 141 cases of renal calcification ) . The on time completion rate of X-ray images reading time was 99.2%, and the mean reading time of on time completeness of emergent and regular cases were 11.1 hours and 4.19 days respectively in 2013. The overall satisfaction of remote consultation of IRC was 59.3%. The lowest satisfactions were the insufficient integration of PACS and HIS (54%) and the timeliness of X-ray images reading time (54%). In terms of public questionnaire in Fusing Township, Taoyuan Country, only 12.7% of respondents knew IRC service; 56.9% of respondents agreed that remote consultation of IRC could improve rural public health; 76.5% of respondents agreed that IRC service would save medical costs in remote residents.
Results of the investigation showed that teleradiology was indeed beneficial in terms of helping people save money on medical care. Nevertheless, satisfaction with the quality of the IRC and interpretation reports needed to improve the performance among participants. We suggest simplifying the procedure for transferring images and improving the integration of software and hardware in addition to setting up an independent supervisory unit could improve the efficacy of the IRC in the future, and expanding the scope of available services at local public health centers based on the experience gained through this program of providing rural areas with telemedicine services.
| Identifer | oai:union.ndltd.org:TW/102YUST5770011 |
| Creators | Chia-Hsiang Chiang, 江家祥 |
| Contributors | Chiung-Wen Kuo, 郭瓊文 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 98 |
Page generated in 0.0534 seconds