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Image-Sharing Network Allows Patients to take Control of their Medical Exam Records

By MedImaging International staff writers
Posted on 16 Dec 2014

An image-sharing network enables patients to securely store, manage, and share their imaging records through the Internet using personal health record accounts. The network is meeting patient expectations regarding ease of access, timeliness, and privacy.

Patients place importance on direct, independent access to their medical exams, according to a new study presented at the annual meeting of the Radiological Society of North America (RSNA), held in Chicago (IL, USA), from November 30 through December 5, 2014.

Fragmentation of health data among physicians, healthcare institutions or practices, and inefficient exchange of test results can decrease quality of care and contribute to high medical costs. Improving communications and giving patients more control over their care are critical objectives of health information technology (IT) initiatives.

“Easy and timely electronic access to an online unified source of radiologic exams under a patient’s direct control can potentially improve healthcare quality, enhance the patient’s engagement in their medical care, and reduce unnecessary imaging utilization and exposure to ionizing radiation,” said Giampaolo Greco, PhD, MPH, assistant professor in the department of population health science and policy at the Mount Sinai School of Medicine (New York, NY, USA).

Dr. Greco and colleagues set out to evaluate patient and provider satisfaction with the use of RSNA Image Share, an Internet-based interoperable image exchange system that gives patients ownership of their imaging exams and control over access to their imaging records. The network enables radiology sites to make imaging scans available for patients to integrate into personal health record (PHR) accounts they can use to securely store, manage, and share their imaging records. Sites can also use the network to send patient imaging records to other participating sites to support better informed care.

Compared to other systems based on point-to-point private networks, the RSNA Image Share system avoids the legal delays and expenses linked with virtual private networks and enables the same flexibility of access characteristic of physical media such as CDs. Patients who use this system have the ability to allow any provider they wish to access their images, as they do with CDs. “This is a standards-based solution designed to achieve full interoperability of health information technology systems. Anyone, physician or other, no matter their location or affiliation, can view the images with proper patient authorization,” Dr. Greco said.

Patients, for the study, undergoing any radiologic exams in four academic centers were eligible to establish online PHR accounts using the RSNA Image Share network. Patients could then use their PHR accounts to maintain and share their images with chosen providers, creating a detailed medical history accessible through any secure Internet connection.

Between July 2012 and August 2013, the study enrolled 2,562 patients, mean age 50.4, including a significant a segment of older individuals. Older individuals have the highest healthcare utilization and frequently experience or perceive a significant obstacle in using information technology. “The high level of enrollment among people in this age group demonstrates their interest in tools that may facilitate the management of their complex medical records and communication with their providers,” Dr. Greco said.

The median number of exams uploaded per patient was six. Study participants were provided a short survey to assess patient and physician experience with the exchange of images, and 502 patients completed and returned their surveys. Of these, 448 patients identified the technique used at the visit to share images: Internet, CDs, both Internet and CDs, or other, and 165 included a section completed by their physician.

Almost all (96%) of the patients responded positively to having direct access to their medical images, and 78% viewed their images independently. There was no difference between Internet and CD users in satisfaction with privacy and security and timeliness of access to medical images. A greater percentage of Internet users reported being able to access their images without difficulty, compared to CD users (88.3% vs. 77.5%).

“We found almost unanimous agreement from patients on the value of having direct, independent access to their imaging exams,” Dr. Greco concluded. “This report shows that an image-sharing solution that is patient-directed and Internet-based is feasible and not only facilitates access, but also, with respect to privacy and security, generates the same level of user satisfaction as that attained through CDs.”

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62 (620.12672424316): SELECT fid FROM jos_deeppockets WHERE id=294756255 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294756255 AND published='1' LIMIT 1

63 (311.13624572754): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=216 ORDER BY `ordering`

64 (56.982040405273): select jos_twitters.link from jos_twitters where cat=10

65 (29.802322387695): select jos_facebook.link from jos_facebook where cat=10

66 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

67 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

68 (35.04753112793): SELECT fid FROM jos_deeppockets WHERE id=294756255 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294756255 AND published='1' LIMIT 1

69 (30.994415283203): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=216 ORDER BY `ordering`

70 (275.1350402832): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756255 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (231.98127746582): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756255 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (37.908554077148): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (887.87078857422): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (!!!!! 3751.9931793213): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (340.93856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (68.902969360352): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (!!!!! 2599.9546051025): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (817.06047058105): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (68.902969360352): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756255 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (41.007995605469): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756255 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (50.067901611328): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (965.83366394043): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (35.762786865234): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 2170.0859069824): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

105 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

106 (67.949295043945): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294756255 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (581.97975158691): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294756255 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

109 (!!!!! 3612.9951477051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

110 (108.00361633301): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294756255 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (446.08116149902): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294756255 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1423.8357543945): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 2648.8304138184): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (560.99891662598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

115 (520.94459533691): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

116 (!!!!! 3201.961517334): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

117 (472.06878662109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

118 (!!!!! 2058.0291748047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

119 (!!!!! 1844.8829650879): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

120 (364.06517028809): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 144878.14903259): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (133.99124145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

123 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

124 (!!!!! 2768.0397033691): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756255 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756255 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1049351.9306183): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (100.13580322266): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (72.002410888672): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (56.982040405273): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (44.822692871094): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (48.160552978516): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (506.16264343262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (401.97372436523): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (176.90658569336): SELECT name FROM jos_deeppockets WHERE id=216

136 (57.93571472168): SELECT name FROM jos_deeppockets WHERE id=216

137 (623.94142150879): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (714.06364440918): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (107.0499420166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

140 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

141 (!!!!! 28970.003128052): TRUNCATE TABLE jos_trademed_module

142 (192.16537475586): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294756255 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (82.969665527344): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294756255 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 9768.9628601074): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (187.87384033203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (109.91096496582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

147 (64.13459777832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

148 (!!!!! 1607.1796417236): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (129.93812561035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

150 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

151 (65.088272094727): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756255 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756255 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (46.968460083008): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=216 or channel_id is null)

153 (36.954879760742): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=216 or channel_id is null)

154 (41.961669921875): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 1744.9855804443): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

156 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756255 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756255 AND published='1' LIMIT 1

157 (79.870223999023): select jos_twitters.link from jos_twitters where cat=10

158 (47.922134399414): select jos_facebook.link from jos_facebook where cat=10

159 (41.007995605469): select jos_google_plus.link from jos_google_plus where cat=10

160 (152.8263092041): select jos_linkedin.link from jos_linkedin where cat=10

161 (398.15902709961): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 5369.9016571045): insert into jos_banners_delta values (14615,'2025-05-01 18:02:01','3.133.100.106','view'),(14202,'2025-05-01 18:02:01','3.133.100.106','view'),(14203,'2025-05-01 18:02:01','3.133.100.106','view')

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