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3 . 2022

Opportunities of the regional center for CT diagnostics of COVID-associated pneumonia

Abstract

Coronavirus infection (COVID-19) today occupies one of the leading places among diseases, the prevalence of which is characterized by a particularly rapid and steady increase in the population. The practical value of computed tomography (CT) of the chest organs for the diagnosis of patients with suspected COVID-associated pneumonia has been repeatedly described in the literature. On the part of the radiodiagnosis service, it is assumed that they will be ready for high-intensity work, under conditions of increasing workload, against the background of losses among medical personnel. This is carried out by a set of organizational and anti-epidemic measures, including zoning of departments, redistribution of human resources and patient flows, ensuring infection control, and restructuring production processes. Telemedicine and other digital technologies play a significant role in this. It is assumed that a change in the functionality of the Department of Radiation Diagnostics and Patient Routing may affect the duration of the formation of a protocol for describing CT examinations.

Aim was to formulate the principles of SMART routing, which will ensure the widest, most timely and prompt coverage of the population of Nizhny Novgorod and districts of the Nizhny Novgorod Region with CT diagnostics of COVID-associated pneumonia.

Material and methods. On the basis of the “Clinical Diagnostic Center”(CDC), a pilot project “Organization of a center for CT diagnostics of COVID-associated pneumonia” is being implemented. The objective of the project is to ensure high throughput (mass examination) and quality of CT diagnostics of patients, rapid receipt and sending of examination results to the referring medical organization. Chest CT was performed according to standard scanning protocols. The formation of protocols of medical reports was carried out in the Unified Radiological Information Service as part of the Unified Medical Information and Analytical System of the Nizhny Novgorod Region.

Results. On the basis of the department of X-ray diagnostics, CT and MRI, round-the-clock daily admission of patients with suspected pneumonia caused by a new coronavirus infection COVID-19, both PCR-confirmed and without test results in combination with a pronounced clinical picture of the disease, is organized. The staffing table has been changed, additional training for employees to work with a CT scanner has been carried out. To facilitate work and optimize processes in the face of an increasing volume of work, a cloud solution based on Artificial Intelligence (AI) was used.

To optimize the process, a standard operating procedure (SOP) for conducting CT examinations of patients was developed and approved, including work with personal protective equipment (PPE), the stages of interaction between medical and nursing staff tomography with patients suspicious (confirmed) for a new CVI.

The continuity of the workflow is ensured by remote work with images at night. The obtained CT images at any time of the day are sent electronically to the local data storage (LAS) for description to radiologists. Upon completion of the work, the medical opinion is transmitted via secure ViPNet communication channels to the medical organization that referred the patient, which significantly accelerated the receipt of the result by the attending physician. Support of the medical image archive system is carried out by technical specialists of the information and computing department in 24/7 mode.

During the 13 months of operation of the CT Center of the CDC, 31 704 CT-COVID examinations were performed, which accounted for 27% of all cases of COVID-19 in the Nizhny Novgorod Region.

Keywords:coronavirus infection; computed tomography; organizational aspects

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Concept development, research, critical revision of the manuscript with the introduction of valuable intellectual content, definition of scientific design, approval of the final version of the article – Tarasov Yu.I.; preparation, writing a draft version of the article and ensuring the translation of the manuscript, editing, participation in scientific design – Karpova S.S.; idea formation, formulation of key goals and objectives – Gudushina O.Yu.; data collection, taking responsibility for all aspects of work – Shalenkov I.V.; collection, analysis and interpretation of the data obtained – Polushkova A.Yu.

For citation: Tarasov Yu.I., Karpova S.S., Gudushina O.Yu., Shalenkov I.V., Polushkova A.Yu. Opportunities of the regional Center for CT diagnostics of Covid-associated pneumonia. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ [HEALTHCARE MANAGEMENT: News, Views, Education. Bulletin of VSHOUZ]. 2022; 8 (3): 85–94. DOI: https://doi.org/10.33029/2411-8621-2022-8-3-85-94 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Guzel E. Ulumbekova
MD, MBA from Harvard University (Boston, USA), Head of the Graduate School of Healthcare Organization and Management (VSHOUZ)

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