David S. Hirschorn MD, Presenter: Medical Advisory Board, Planar Systems, Inc

Stuart Pomerantz MD, Abstract Co-Author: Speakers Bureau, General Electric Company Research grant, General Electric Company

Leonid Lempert MD, Abstract Co-Author: Nothing to Disclose

Radiologists need to utilize PACS, RIS and speech recognition systems (SRS) to perform image interpretation. However, seldom do these systems interact well to share patient and exam context. This results in the need for the radiologist to manually synchronize the applications through either a barcode, or through typing in medical record or accession numbers, which is highly subject to human error.

Some custom integrations exist to address this problem. One such solution has been in place at Staten Island University Hospital for over 2 years which allows the RIS to provide the worklist and launch the images in the PACS. While it usually performs well, it does have some limitations. We therefore developed our own solution using 3rd party macro software which automates computer tasks by manipulating screen elements. That is, it can read, change or click on almost any textbox, dropdown list, menu item or button of any application on the desktop. Thus, it can read the exam accession number from our RIS worklist, for example, and enter it into both the PACS and the SRS, even if they are on separate computers. We then compared the 2 methods.

The vendor supplied method incorporates a single sign-on which enables the radiologist to log on to the PACS and then launch the RIS worklist. Clicking on the “Mark Dictated” button in the PACS sets the same exam status on the RIS. The RIS allows several cases to be checked off at once and launched as a batch for dictation. The macro software method is not limited to just synchronizing the RIS and PACS, but can also share context with the SRS and electronic medical record. As a homegrown solution it is readily adaptable within minutes as requirements change without requiring vendor support.

Each method has features that the other lacks, and a vendor supplied solution should come with vendor support. However, the macro method is cheap, simple, and far more versatile than the vendor supplied one.

Macro software can tie together disparate information systems to share patient and exam context, thereby reducing medical errors.

Hirschorn, D, Pomerantz, S, Lempert, L, PACS, RIS, and Speech Recognition Desktop Integration: Vendor Supplied versus 3rd Party Macro Software.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5008319.html