David S. Hirschorn MD, Presenter: Nothing to Disclose

Keith J. Dreyer DO, Abstract Co-Author: Nothing to Disclose

Steve Carlotti, Abstract Co-Author: Nothing to Disclose

Ken Moerschel, Abstract Co-Author: Nothing to Disclose

PACS, RIS and speech recognition (SR) systems are typically devloped by different companies with different sets of expectations for radiologist workflow. The HL7 interfaces among these systems have been fairly well worked out so that they can share information about orders, images and reports. The part that is still in flux, though, is the radiology interpretation workstation desktop. This used to be called the PACS workstation because PACS was the only computer application the radiologist used for image interpretation. This has changed as dictation systems have transformed from specialized telephones which just recorded one’s voice to desktop applications which translate speech to text. It has also changed as RIS systems emerged from the confines of a dumb terminal to also become sophisticated, sometimes web-based applications capable of providing worklists. Now that the radiologist needs to interact with not 1 but 3 systems, what options are there for desktop integration?

We studied the desktop configurations of PACS, RIS and SR at 3 institutions: Massachusetts General Hospital, Staten Island University Hospital and Mercer County Hospital. We compared their options for a) single sign on, b) sharing clinical context (e.g. accession number) and c) sending status updates. We also compared how many computers they used for the 3 applications, which ones they combined on the same computer, and if they used dual processors.

MGH has their RIS feed worklist information via HL7 interface to their PACS and then uses the PACS worklists. SR is run on a 2nd computer independently. SIUH has their RIS launch images in their PACS on the same computer, and RIS sends the accession number over to their SR system on a 2nd computer. MCH also has their RIS feed worklist information via HL7 interface to their PACS and then uses the PACS worklists. However, they run SR on the same dual processor computer and the PACS sends the accession number to the SR system.

There are several ways to set up workflow at the desktop; it depends on the flexibility of the specific systems and the objectives of the radiology department. Each has their merits, and these will be discussed at length.

Hirschorn, D, Dreyer, K, Carlotti, S, Moerschel, K, Integrating the Radiology Desktop: Three Different Ways for PACS, RIS, and Speech Recognition to Work Together.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4417237.html