Redfern RO et al. 2000 "Radiology workflow and patient volume: effect of picture archiving and communication systems on technologists and radiologists."
Reference
Redfern RO, Horii SC, Feingold E, et al. Radiology workflow and patient volume: effect of picture archiving and communication systems on technologists and radiologists. J Digit Imaging 2000;13 (2 Suppl 1):97-100.
Abstract
"This study was performed to evaluate the changes in workflow and efficiency in various clinical settings in the radiology department after the introduction of a picture archiving and communication system (PACS). Time and motion data were collected when conventional image management was used, and again after the introduction of a PACS. Changes in the elapsed time from examination request until the image dispatch to the radiologist, and from dispatch until report dictation, were evaluated. The relationship between patient volume and throughput was evaluated. The time from examination request until dispatch was significantly longer after the introduction of PACS for examinations taken on patients from the emergency department (ED) (pre-PACS, 20 minutes; post-PACS, 25 minutes; P < 0.0001), and for examinations taken on patients in the medical intensive care unit (MICU) (pre-PACS, 34 minutes; post-PACS, 42 minutes; P < 0.0001). The interval from image dispatch until report dictation shortened significantly after the introduction of PACS in the ED (pre-PACS, 38 minutes; post-PACS, 23 minutes; P < 0.0001) and in the outpatient department (OPD) (pre-PACS, 38 minutes; post-PACS, 20 minutes; P < 0.0001). Simple least squares regression showed a significant relationship between daily patient volume and the daily median time until report dictation (F = 43.42, P < 0.001). PACS slowed technologists by prolonging the quality-control procedure. Radiologist workflow was shortened or not affected. Efficiency is dependent on patient volume, and workflow improvements are due to a shift from batch to on-line reading that is enabled by the ability of PACS to route enough examinations to keep radiologists fully occupied."
Objective
To evaluate "the relationship between patient volume and workflow for" radiologists "who began interpreting images from multiple clinical sites after the introduction of PACS to determine the effect of increased volume."
Tools Used
Type Clinic
Primary care and specialty care
Size
Large
Geography
Urban
Other Information
The study was conducted at the University of Pennsylvania Medical Center, Philadelphia.
Type of Health IT
Computed radiography (CR)
Picture archiving and communication system (PACS)
Type of Health IT Functions
"The...CR [computed radiography] system is interfaced to the radiology information system via a patient terminal where technologists can look up the scheduled examination information and have it automatically added to the processed CR image. A separate CR quality-control workstation then receives the images, where the CR processing parameters can be manipulated if necessary. Finally, the images are forwarded into the PACS archive. Once images from any of the CR readers are received at the PACS, they are available for final demographic changes and some basic image manipulations. After this step, they are dispatched to the radiologist."
Context or other IT in place
A radiology information system (RIS), which had an interface to the CR system, was already in place.
Workflow-Related Findings
"The time interval from dispatch until report dictation...was significantly shorter after the introduction of PACS in the [outpatient department]."
After PACS implementation, outpatient images were routed to the ED radiologists for reading, the daily patient volume for these radiologists increased 258 percent. Nevertheless, the "median daily elapsed time until report dictation decreased from 61 minutes before PACS to 26 minutes after PACS."
Study Design
Pre-postintervention (no control group)
Study Participants
Study participants included staff and patients of the University of Pennsylvania Medical Center radiology department.