{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:02:49Z","timestamp":1790744569269,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Traditional physical film-based imaging services impose a heavy financial and operational burden on public hospitals. This study aims to evaluate the actual effectiveness of a digital cloud imaging platform\u2014deployed under a model where \u201cservice providers make upfront investments and hospitals pay based on performance\u201d\u2014in terms of controlling medical costs, optimizing clinical workflows, and enhancing the patient experience, thereby providing a replicable management pathway and empirical evidence for the digital transformation of imaging services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-center, quasi-experimental before-and-after study design was adopted, supplemented by interrupted time series (ITS) analysis as the primary method for causal inference, with Deyang People\u2019s Hospital serving as the study site. Prior to project implementation, the study included data from 160,183 eligible imaging examinations; after implementation, it included data from 295,940 eligible imaging examinations. The platform was built on a hybrid cloud architecture. Through collaboration with a third-party technology provider, the hospital was able to deploy the system without upfront capital expenditures, replacing traditional physical films with \u201ccloud films.\u201d Operational data was collected from the hospital\u2019s PACS system and the administrative backend of the digital cloud imaging service platform both before the platform\u2019s launch (January 1, 2022\u2013December 31, 2022) and after (August 12, 2024\u2013August 11, 2025). Descriptive statistical methods, the Mann\u2013Whitney U test, and interrupted time series analysis to compare differences in data before and after project implementation, thereby evaluating the system\u2019s actual effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Within 12\u202fmonths of the platform\u2019s operation, the hospital achieved net savings of 4,159,500 yuan on film-related consumables; the median time from examination to reporting for physicians was reduced from 6.86\u202fh to 2.41\u202fh (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), a decrease of approximately 64.9%, resulting in a significant improvement in work efficiency. Patients experienced \u201czero wait time\u201d for film retrieval, shortening their total visit duration; interrupted time series analysis showed that patient satisfaction exhibited a sustained quarterly upward trend following the intervention, increasing by an average of 0.46 percentage points per quarter (\n                      <jats:italic>P<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), though no immediate jump in satisfaction was detected at the time of intervention implementation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.440).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Within the framework of this study\u2019s single-center, quasi-experimental design, a temporal association was observed between the \u201cservice provider upfront investment, pay-for-performance\u201d model of the digital cloud imaging platform and reductions in film and consumable costs, improvements in physicians\u2019 image-reading efficiency, and enhancements in patient satisfaction. However, due to limitations in the study design, further evidence is needed to confirm the causality of these associations. The long-term financial sustainability and cross-institutional scalability of this model require validation through longer-term follow-up and multicenter studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1904169","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:52:15Z","timestamp":1790743935000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a digital cloud imaging platform based on a \u201cpay-for-performance\u201d model: an empirical study on cost control and resource conservation"],"prefix":"10.3389","volume":"14","author":[{"given":"Xingbo","family":"Long","sequence":"first","affiliation":[{"name":"Department of Medical and Information Engineering, Deyang People\u2019s Hospital","place":["Deyang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Quality Improvement, Deyang People\u2019s Hospital","place":["Deyang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Medical and Information Engineering, Deyang People\u2019s Hospital","place":["Deyang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical and Information Engineering, Deyang People\u2019s Hospital","place":["Deyang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1007\/s42399-020-00713-2","article-title":"Implementing 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