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![20/25
November 29, 2023 4th
African Human Computer Interaction Conference (AfriCHI 2023)
Results: Evaluation of Free and Open Source
PACS Platforms (2/2)
“Integration to an online patient clinical records would
significantly enhance patient care” [Participant 1]
“Suggestions are that it should be a multimodality platform and
should have a provision for reporting
images” [Participant 3]
“Incorporating a DICOM viewer(digital imaging and
communication in medicine) would help to large data
sets(CT scans and MRI Scans)” [Participant 4]](https://image.slidesharecdn.com/talks-africhi23-usercentreddesignofpacsforeffectiveradiologicalworkflows-231206130127-38444733/75/User-Centred-Design-and-Implementation-of-Useful-Picture-Archiving-and-Communication-Systems-for-Effective-Radiological-Workflows-in-Public-Health-Facilities-in-Zambia-20-2048.jpg)
![21/25
November 29, 2023 4th
African Human Computer Interaction Conference (AfriCHI 2023)
Results: Evaluation of Free and Open Source
PACS Platforms (2/2)
“There is supposed to be free access to the internet in the
department.” [Participant 5]
“IT WOULD ADD A LOT OF VALUE IF IMAGES WERE EXPORTABLE.”
[Participant 6]
“Order of metadata should prioritise patient pertinent details as
opposed to technical lingo” [Participant 8]
“It's a step in the right direction” [Participant 2]](https://image.slidesharecdn.com/talks-africhi23-usercentreddesignofpacsforeffectiveradiologicalworkflows-231206130127-38444733/75/User-Centred-Design-and-Implementation-of-Useful-Picture-Archiving-and-Communication-Systems-for-Effective-Radiological-Workflows-in-Public-Health-Facilities-in-Zambia-21-2048.jpg)
![[1] Zulu, E.O., and Phiri, L. (2022). Enterprise Medical Imaging in the
Global South: Challenges and Opportunities. In Proceedings of
2022 IST-Africa Conference (IST-Africa 2022).
[2] Zulu, E.O. and Phiri, L. (2021). Enterprise Medical Imaging for
Streamlined Radiological Diagnosis in Zambian Public Health
Facilities. The University of Zambia.
[3] C. J. Roth, L. M. Lannum, and K. R. Persons, ‘A Foundation for
Enterprise Imaging: HIMSS-SIIM Collaborative White Paper’, J.
Digit. Imaging, vol. 29, no. 5, pp. 530–538, Oct. 2016, doi:
10.1007/s10278-016-9882-0. [Online]. Available:
https://doi.org/10.1007/s10278-016-9882-0
Bibliography](https://image.slidesharecdn.com/talks-africhi23-usercentreddesignofpacsforeffectiveradiologicalworkflows-231206130127-38444733/75/User-Centred-Design-and-Implementation-of-Useful-Picture-Archiving-and-Communication-Systems-for-Effective-Radiological-Workflows-in-Public-Health-Facilities-in-Zambia-25-2048.jpg)
Uploaded byLighton Phiri
User Centred Design and Implementation of Useful Picture Archiving and Communication Systems for Effective Radiological Workflows in Public Health Facilities in Zambia
The document discusses the design and implementation of user-centered picture archiving and communication systems (PACS) aimed at enhancing radiological workflows in public health facilities in Zambia. It outlines the methodology for evaluating existing PACS platforms and addresses challenges in medical imaging workflows, emphasizing the need for user-friendly and interoperable solutions. The study highlights ongoing efforts to refine these systems while integrating advanced technologies to improve patient care.
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User Centred Design and Implementation of Useful Picture Archiving and Communication Systems for Effective Radiological Workflows in Public Health Facilities in Zambia
- 1. User Centred Designand Implementation of Useful Picture Archiving and Communication Systems for Effective Radiological Workflows in Public Health Facilities in Zambia 1 DataLab Research Group, University of Zambia, ZAMBIA 2 Adult Hospital, University Teaching Hospitals, ZAMBIA Brighton Mwaba1 · John Mwanza1 · Wilkins Sikazwe1 Andrew Shawa1 · Ernest Obbie Zulu2 · Elijah Chileshe1 Lighton Phiri1 4th African Human Computer Interaction Conference (AfriCHI 2023) November 27– December 1, 2023 | East London, South Africa
- 2. 2/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Outline ● About the DataLab Research Group ● About the Enterprise Medical Imaging Project ● Radiological Workflow ● Medical Imaging Workflow Challenges ● Methodological Approach ● Results and Discussion ● Conclusions, Ongoing Work and Future Work ● Acknowledgments
- 3. 3/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) About the DataLab Research Group at The University of Zambia ● The DataLab research group at The University of Zambia is composed of faculty staff and students—undergraduate and postgraduate—working in three main areas ○ Data Mining ○ Digital Libraries ○ Technology-Enhanced Learning https://datalab.unza.zm
- 4. 4/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) About the Enterprise Medical Imaging in Zambia Project https://emi.org.zm
- 5. 5/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Radiological Workflows: Acquisition, Examination and Interpretation (1/2)
- 6. 6/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Radiological Workflows: Acquisition, Examination and Interpretation (2/2) ● Radiological workflows involve a series of cadres ○ Referring Physicians, Data Entry Clerks, Radiographers and Radiologists ● Medical images are utilised at various stages of radiological workflows
- 7. 7/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Radiological Workflows: Acquisition, Examination and Interpretation (2/2) ● Radiological workflows involve a series of cadres ○ Referring Physicians, Data Entry Clerks, Radiographers and Radiologists ● Medical images are utilised at various stages of radiological workflows
- 8. 8/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Efficient and Effective Workflows Using Enterprise Medical Imaging Strategies https://wiki.ihe.net
- 9. 9/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Efficient and Effective Workflows Using Enterprise Medical Imaging Strategies https://wiki.ihe.net
- 10. 10/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Methodological Approach The main objective of this work was to investigate the feasibility of designing and implementing a useful, usable, user-friendly and interoperable Picture Archiving and Communication System (PACS) that will be used for efficient and effective storage of medical images that are produced in public health facilities in Zambia 1. Understand medical imaging workflows 2. Evaluation of Free and Open Source PACS platforms 3. Usability evaluation of PACS platform
- 11. 11/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Methodology: Understanding Medical Imaging Workflows ● Study setting ○ Two (2) large referral hospitals in Zambia: University Teaching Hospitals and Levy Mwanawasa University Teaching Hospital ● Target population and sampling technique ○ Two (2) cadres involved in the study: Radiologists and Radiographers ○ Convenience sampling was used to identify potential study participants ● Procedure ○ Guided interviews were conducted to determine how images are stored, managed and accessed
- 12. 12/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Methodology: Design and Implementation of PACS Platform (1/4) ● Desk review ○ Document analysis of PACS FOSS platform document was conducted ● Selection criteria ○ Active FOSS PACS projects were used as a basis to identify tools to include in the analysis ● Procedure ○ Evaluation matrix was devised to enable an objective selection of appropriate FOSS PACS platforms ○ Factors utilised involved development-centric aspects and subjective aspects
- 13. 13/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Methodology: Design and Implementation of PACS Platform (2/4) Dicoogle DCM4CHEE EasyPACS ClearCanvas Orthanc Base Language Java Java Java C# C++ Extensibility High High High Medium High Extensibility Language Java Java Java · Python · Ruby C++ · VB.NET C++ · Python Operating System Support Windows · Linux · MacOS Windows · Linux · MacOS Windows · Linux · MacOS Windows · Linux · MacOS Windows · Linux · MacOS Database Support NoSQL Apache Derby · PostgreSQL · MySQL · Oracle MySQL PostgreSQL NoSQL Search Searving Lucene Lucene Lucene PostgreSQL SQLite Authentication Support Local Auth LDAP LDAP · SSO · 2FA OAuth 2.0 Local Auth
- 14. 14/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Methodology: Design and Implementation of PACS Platform (3/4) Dicoogle DCM4CHEE EasyPACS ClearCanvas Orthanc DICOM Compliance Yes Yes Yes Yes Yes DICOM Modality Worklist Yes Yes Yes Yes Yes API Support RESTful RESTful RESTful .NET RESTful Scalability High High High Low High Relative Adoption Low High Medium Low High Community Support Yes Yes Yes No Yes
- 15. 15/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Methodology: Design and Implementation of PACS Platform (4/4)
- 16. 16/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Methodology: Usability Evaluation PACS Platform ● Controlled experiment conducted to assess potential of PACS platform being adopted into public health facilities in Zambia ● Study setting ○ University Teaching Hospitals ● Target population and sampling ○ Radiology Registrars were recruited using convenience sampling ● Procedure ○ Participants were required to search for a DICOM file in PACS ○ TAM 2 post-experiment questionnaire used to assess Perceived Usefulness and Perceived Ease of Use of PACS platform
- 17. 17/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Results: Understanding Medical Imaging Workflows Experience Storage Medium Image Formats Challenges Radiographer 1 UTHs 5+ Years Hard Drive · Basement Analog · Digital Retrieval challenges Radiographer 2 UTHs 5+ Years Imaging Machine · Storeroom Analog · Digital Retrieval on patient request Radiographer 3 UTHs 5+ Years Hard Drive · Films · Patients Analog · Digital Storage capacity challenges Radiographer 4 UTHs 7+ Years Compact Discs · Film Analog · Digital Accessibility challenges Radiologist 1 LMUTH 11+ Years — Analog · Digital Image preservation Radiologist 2 UTHs 4+ Years — Analog · Digital Limited space · Image retention
- 18. 18/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Results: Design and Implementation of PACS Platform
- 19. 19/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Results: Evaluation of Free and Open Source PACS Platforms (1/2)
- 20. 20/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Results: Evaluation of Free and Open Source PACS Platforms (2/2) “Integration to an online patient clinical records would significantly enhance patient care” [Participant 1] “Suggestions are that it should be a multimodality platform and should have a provision for reporting images” [Participant 3] “Incorporating a DICOM viewer(digital imaging and communication in medicine) would help to large data sets(CT scans and MRI Scans)” [Participant 4]
- 21. 21/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Results: Evaluation of Free and Open Source PACS Platforms (2/2) “There is supposed to be free access to the internet in the department.” [Participant 5] “IT WOULD ADD A LOT OF VALUE IF IMAGES WERE EXPORTABLE.” [Participant 6] “Order of metadata should prioritise patient pertinent details as opposed to technical lingo” [Participant 8] “It's a step in the right direction” [Participant 2]
- 22. 22/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Conclusion and Future Work ● Work conducted to demonstrate the feasibility of designing and implementing potentially cost-effective, useful and easy to use PACS platforms for use in public health facilities in Zambia ○ Exploration of challenges with medical imaging workflows ○ Evaluation of FOSS PACS platforms ○ Usability evaluation of PACS platform ● Ongoing work focused on implementing production-quality PACS platforms ○ Base infrastructure required to explore the use of Artificial Intelligence in addressing challenges with radiological workflows
- 23. 23/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Acknowledgements ● This study was conducted as part of a much larger Enterprise Medical Imaging in Zambia project. The project is funded through generous grants from Google Research, Data Science Africa and The University of Zambia. We are very appreciative of this funding.
- 24. 24/25 November 29, 20234th African Human Computer Interaction Conference (AfriCHI 2023) Q & A Session ● Comments, concerns and complaints?
- 25. [1] Zulu, E.O.,and Phiri, L. (2022). Enterprise Medical Imaging in the Global South: Challenges and Opportunities. In Proceedings of 2022 IST-Africa Conference (IST-Africa 2022). [2] Zulu, E.O. and Phiri, L. (2021). Enterprise Medical Imaging for Streamlined Radiological Diagnosis in Zambian Public Health Facilities. The University of Zambia. [3] C. J. Roth, L. M. Lannum, and K. R. Persons, ‘A Foundation for Enterprise Imaging: HIMSS-SIIM Collaborative White Paper’, J. Digit. Imaging, vol. 29, no. 5, pp. 530–538, Oct. 2016, doi: 10.1007/s10278-016-9882-0. [Online]. Available: https://doi.org/10.1007/s10278-016-9882-0 Bibliography
- 26. User Centred Designand Implementation of Useful Picture Archiving and Communication Systems for Effective Radiological Workflows in Public Health Facilities in Zambia 1 DataLab Research Group, University of Zambia, ZAMBIA 2 Adult Hospital, University Teaching Hospitals, ZAMBIA Brighton Mwaba1 · John Mwanza1 · Wilkins Sikazwe1 Andrew Shawa1 · Ernest Obbie Zulu2 · Elijah Chileshe1 Lighton Phiri1 4th African Human Computer Interaction Conference (AfriCHI 2023) November 27– December 1, 2023 | East London, South Africa