Barton F. Branstetter MD, Abstract Co-Author: Nothing to Disclose

Jonathan Leong Mates MD, Presenter: Nothing to Disclose

Paul Joseph Chang MD, Abstract Co-Author: Nothing to Disclose

The transition from film to PACS has improved radiologist efficiency, but many radiology departments still use paper to signal the radiologist that studies have been completed, or to provide additional information about the patients. The purpose of this study was to measure the improvement in radiologist efficiency that accompanies the transition to a paperless radiology environment, in the setting of an established PACS.

We performed a workflow analysis of radiologists in the reading room, with attention to the components of the workflow that are affected by a paperless environment. Using this analysis as a model, we timed radiologists at two different institutions with the same PACS vendor; one institution had a paperless environment, while the other had a paper-driven environment. We also compared individual radiologists when using either paperless or paper-driven models of image interpretation and dictation. To evaluate the relative benefits of PACS versus the paperless environment, we measured reading times for individual radiologists in a film environment and a PACS environment.

The radiologists at the two institutions spent a similar amount of time interpreting images, but associated tasks such as comfirmation of patient identity and inititiaton of dictation took significantly less time in the paperless environment. Time savings was a function of batch size (number of studies read per session) and of the modality being interpreted: conventional radiographs received greater benefit than cross-sectional modalities. When a single radiologist was timed in both paper-driven and paperless environments, similar statistically significant differences were noted. When paper-driven PACS was compared to paper-driven film, the improved efficiency derived from PACS was slightly less than the improved efficiency derived from the paperless environment.

Radiologist efficiency is significantly improved by the transition to a paperless radiology department. PACS upgrades such as integrated dictation and integrated clinical information may be as important as the PACS itself in improving the workflow of the reading room.

P.J.C.,B.F.B.: Stentor, Inc; NIH; NLM; DARPA; US Air Force -- laboratory support

Branstetter, B, Mates, J, Chang, P, The Paperless Radiology Department: Improvements in Radiologist Efficiency.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4407182.html