Improving Hospital Management

Clinic for Diagnostic Imaging and Interventional Radiology

BG Kliniken / Germany
R. Braunschweig
Introduction

2
 Introduction
Development of hospitals in Germany

Development of patients, beds and duration of stay in Germany

25

20

15

10

0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

beds per 1.000 inhabitants number patients per 100 inhabitants average duration of stay in days

All data copyright – Federal Statistical Office Wiesbaden, June 2015 3

 Introduction
Development of hospitals in Germany

Number of
Beds per 100,000 inhabitants in 2013 Inhabitants
facilities
9000 Germany 80,767,463 1,996
7790 Baden-Wurttemberg 10,631,278 272
8000 7252 7498
6989 6847 Bavaria 12,604,244 366
7000 6497 6352 6453 6506
6024 5906 6202 5995 Berlin 3,421,829 81
5434 5680
6000 5351 Brandenburg 2,449,193 55
5000 Bremen 657,391 14
4000 Hamburg 1,746,342 52
Hesse 6,045,425 172
3000
Mecklenburg Western
2000
1,596,505 39
Pomerania
1000 Lower Saxony 7,790,559 197
North Rhine-Westphalia 17,571,856 370
0
Rhineland-Palatinate 3,994,366 91
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990,718 21
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Sa Sax
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Saxony 4,046,385 79
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Saxony Anhalt 2,244,577 48

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2,815,955 95
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Schleswig-Holstein
Rh
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Thuringia 2,160,840 44
nb
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Federal city states:

M

147
Berlin, Bremen, Hamburg

All data copyright – Federal Statistical Office Wiesbaden, June 2015 4

Introduction
BG-Network („Berufsgenossenschaften“)

9 Hospitals in Germany
Hamburg Hamburg
Berlin Berlin
Bochum NRW
Halle Sachsen-Anhalt
Duisburg NRW
Frankfurt/Main Hessen
Ludwigshafen Rheinland-Pfalz
Tübingen Baden-Württemberg
Murnau Bayern

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Introduction
DACS - Example

LZ-Archiv 1 Hospital 1
Hamburg
Hospital 2 LZ-Archiv 2
Berlin
LZ-Archiv 3 Hospital 3
Bochum
Hospital 4 LZ-Archiv 4
Duisburg
LZ-Archiv 5 Hospital 5
Halle
Hospital 6 LZ-Archiv 6
Frankfurt
LZ-Archiv 7 Hospital 7
Ludwigshafen
Hospital 8 LZ-Archiv 8
Tübingen
LZ-Archiv 9 Hospital 9
Murnau
Central-Archive

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X-Ray

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X-Ray
Computed Tomography

1. Single scan
+ Good quality
- Slow
- Reconstructing difficult

2. MSCT (volume scanner)

+ High contrastl
+ Low contrast
+ Fast reconstructing
Cave: extreme amounts of data

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MR

9
Angiography

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Angiography
Data: 1980 / 40 slices

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Angiography
Data: 1990 / 160 slices

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Angiography
Data: Late 1990‘s / 560 slices

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Angiography
Data: 2005 / 2240 slices

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Angiography
Data: 2006 / 4000 slices

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What is to come?
„Volume Scanner“

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Analysis of Processes

Sub-process Sub-process
Core process 1. Hierarchy levels 2. Hierarchy levels

IT-Structure

KIS

RIS

PACS

PDMS

LIS

Etc.

Outdoor patient Imaging for Formalities

Outdoor patient

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Challenges

Local
a) Number of patients Will increase drastically

b) Highly specialized
Interdisciplinary Number of hospitals required
c)
approach decreases drastically

Non-Local
d) Regional networks Will increase drastically

e) Technical innovation Improves/increases

f) Cost DRG / Efficiency Increase

- Added value of Radiology

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Image Acquisition and Distribution
Status Quo

Current Systems Future Systems

HIS
MIS
RIS/PACS
DACS
PDMS, LIS Radiology (example)

Order

Indication

Report

Demonstration

Archiving/Distribution

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Image Acquisition and Distribution
What is the problem?

Site details
Site name BG Klinik Bergmannstrost IMPAX Version IMPAX 6.5.5-SU3
City Halle Dbase Server PACSDB01
Country Germany SNDB id DEU_HALLE_BERGMANNST
Region EMEA DCA analysis performed on 11.01.2016

Production start October 2000 183 Month(s)

Architecture Database #Frontend WFM #Frontenmd WFM/AS Curator

Oracle on Sloaris 0 1 No
#Backend WFM #AS #Inactive servers
0 0 0

Production #Studies #Images Storage

Last 12 months 104,861 6,427,137 1,891,399 MB
Per month 8,738 535,595 157,617 MB
Per working day 338 15,618 5,122 MB
Per working hour 25 1,243 394 MB
Main modality CR (60%) CT (74%) CT (54%)
Maximum per hour 3,017 896 MB
Growth
Average growth per year (for 2014-2015) -1% 5% 2%
Extrapolated growth (for 2016) -3% 3% -3%
Total count in database
1,354,185 52,858,711 188,523,042 MB

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Image Acquisition and Distribution
Data management

Total count in database

1,354,185 52,858,711 188,523,042 MB

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Image Acquisition and Distribution
Data history

90% of studies are younger

than 1 year

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Image Acquisition and Distribution
CT Reimbursement 2013

25-30%
Payment

January February March April May June July August September October November December

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Image Acquisition and Distribution
MR Reimbursement 2013

25-30%
Payment

January February March April May June July August September October November December

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Enterprise-wide solution

DACS ®
Data Archiving and Communication Services ®

Archiving

Communication

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Summary I

Local is part of the whole system

meaning

Local is Social

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Summary II

Local concept

including

Global possibilities

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Iran Sectors
By geography, politics and cultural differences

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Storage improvement

Production #Studies #Images Storage

Growth
Average growth per year (for 2013-2014) 0% 8% 8%
Extrapolated growth (for 2015) -1% 6% 6%

Extrapolation for
current year (based on
previous 6 months)

Start of production

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Growth

Production #Studies #Images Storage

Last 12 months 104,861 6,427,137 1,891,399 MB
Per month 8,738 535,595 157,617 MB
Per working day 338 15,618 5,122 MB
Per working hour 25 1,243 394 MB
Main modality CR (60%) CT (74%) CT (54%)
Maximum per hour 3,017 896 MB

Total count in database

1,354,185 52,858,711 188,523,042 MB

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Thank you for your attention.