TECHNOLOGY TODAY I ntegration of the MEDITEe system in the Radiology Department of the University of the Free State J Fourie MBChB R laubscher MBChB Department of Diagnostic Radiology University of the Free State Bloemfontein History The MEDITEC system is a hospi- tal information system (HIS) com- prising various modules. It was first incorporated into all three of the provincial hospitals in Bloemfontein in 1996.At first only the laboratory module was installed to process blood results faster. The final aim was to move to a more assessible and paperless system. Due to the suc- cess of the system it was decided to enlarge it to incorporate other mod- ules.. The departmental module was incorporated at the beginning of 2000. The aim of the departmental module was not only to incorporate a paperless system, but also to give doc- tors permanent and immediate access to results obtained from special exam- inations done and previous patient data. Implementation The departmental module of the MEDITEC system consists of an empty shell that gives the person designing the system a free hand to customise the system to his/her department's individual needs. Doctors from every department were involved in designing the system. In this article we will focus on how the system was customised to our department's individual needs and the advantages we get from using the sys- tem. The three main components of the system are the application forms, the report forms and the retrieval of sta- tistics from the system. Application forms The application form developed for the system was designed to be spe- cific to the examination requested in that the questions on the form were appropriate to the examination done. The application form was designed to give the full details auto- matically for the patient as well as the 41 SA JOURNAL OF RADIOLOGY • June 2002 doctor requesting the examination. The advantage of this was that the requesting doctor could easily be reached. In a teaching hospital com- plex such as ours the doctors also vary from year to year. The advantage of this type of request form is that some of the fields are mandatory and doctors are only asked questions pertinent to the type of investigation. Mandatory fields play a role in ensuring patient safety, for example fields enquiring about metallic implants in requests for MR! investi- gations, or fields relating to known allergies to iodine in requests for examinations where contrast is likely to be administered. These application forms can then be viewed on screen in the depart- ment or (as is the case in our depart- ment) they can be printed out auto- matically in the area where bookings for that examination are made. Certain fields on the application form are examination-specific and are filled in by the radiographer who has done the procedure. These fields include the specific examinations done on the patient and the materials used. This enables the billing system to run smoothly. A statistical field was designed specifically for use in our department and includes the code of the radiogra- pher and/or student who did the examination, and the number and type of films passed and rejected. Report forms The reporting doctor has the advantage of having access, via the MEDITEC database, to all previous results such as haematology, cytology, previous radiological examinations and previous patient notes to assist TECHNOLOGY TODAY him/her in making a diagnosis. As a lot of patients have to go back to the referring clinics after the exam- ination the films can now be given directly to the patient after the exami- nation, and the referring doctor has access to the report on the system. The average time from the reporting doc- tor receiving the films to the report being available in a draft format on the system is about 20 minutes. This report is available not only to the referring doctor, but to all other doc- tors involved in caring for the patient. The patient's information is accessed using a patient enquiry sys- tem. This system groups all the reports from all departments on one page and allows the doctor easy access to the relevant results. The report can be viewed at Universitas and National hospitals (Pelonorni Hospital does not have the departmental module as yet) as soon as it is typed in our department. All reports are signed digitally on the system after they have been checked by the reporting doctor. All changes to reports are monitored by the system for medical-legal reasons. Statistical use Information provided by the doctor as weil as the attending radiog- raphers is fed back into the system. These data can be recalled in any way depending on the statistics needed. For example: • Ordering films in the department. The system can provide the exact amount and size of films used over any given time. • As such a wide spectrum of infor- mation is fed back into the system, the data can also be used for com- piling studies. • Machine use can be evaluated by the number of examinations done per machine over a specific time. • The work done by individual doc- tors can be monitored for individ- ual statistics and work perfor- mance. If the need arises for specific infor- mation, the application forms on the system are flexible enough to be changed easily so that additional data can be gathered. The future Although the system has already changed our department to a large extent there are other modules that can be added to the system. For exam- ple, the MEDITEC offers a PACS sys- tem for the storage of digital film and an internet module that makes patient information as weil as X-ray films available to registered users. Various other modules assist in booking patients and cost control for the hospital and departments. The implementation and continu- ous use of the system was and still is without any problems. It is one of the few complete hospital information systems in the country that not only covers the whole spectrum of needs in a large hospital but because of its modular design also gives the system' the ability to grow with the needs of the hospital. 42 SA JOURNAL OF RADIOLOGY • June 2002