C. C. Tchoyoson Lim MBBS, Abstract Co-Author: Nothing to Disclose

K. N. Bhanu Prakash PhD, Abstract Co-Author: Nothing to Disclose

Anand Ananthasubramaniam MEng, Abstract Co-Author: Nothing to Disclose

Guo Liang Yang PhD, Presenter: Nothing to Disclose

Yanjiang Yang PhD, Abstract Co-Author: Nothing to Disclose

Wieslaw Lucjan Nowinski PhD, Abstract Co-Author: Nothing to Disclose

Mahendran Nadarajah, Abstract Co-Author: Nothing to Disclose

Ramarajulu Srinivasan BS, Abstract Co-Author: Nothing to Disclose

Kok Haur Ong MSc, Abstract Co-Author: Nothing to Disclose

Widespread adoption of mobile smart-phones and tablets has potential to facilitate timely clinical care team image review, group communication and decision making, but this is not well supported in hospital PACS. We tested a prototype command center using iStrokeSuite (demonstrated at RSNA 2010) push technologies extending clinical PACS to test acute team coordination and neuro-oncology multidisciplinary team management.

Time-critical acute patients with subarachnoid hemorrhage (SAH) and ischemic stroke had their emergency head CT angiography or MR images (encrypted using HIPPA-compliant symmetric key encryption and fine-grained public key encryption) and sent to a prototype Mobile Stroke Acute Radiology Command Center (m-SARCC). m-SARCC is connected to an SMS/Email/Notification alert system, which alerts defined team members including radiologists, nurses, technologists and clinicians to securely log into the system to review the decrypted images, respond and update all, triggering a “go” procedure (aneurysm coiling or mechanical thrombectomy) or “no-go” conclusion. Non-critical scenarios involved radiologists, medical and radiation oncologists, neurosurgeons and nurses discussing case management options. Multiple input (text, audio, video, and image annotations) and functionalities (multiplanar reformat, volume calculation, anatomical atlas) were assessed by team members in structured and unstructured surveys. 

The system potentially unifies PACS image review with a communication center linking mobile devices. Rapid review and narrowcast of results and decisions decreased communication time, with text preferred to voice files as a vehicle in time-critical situations. Non-critical scenarios were more ambiguous but video and non-radiological image data were requested by clinicians. 

A radiology command center linking PACS to mobile smart-phones and tablets can support image review, group communications and decision making especially in patients with SAH and ischemic stroke.

Lim, C, Bhanu Prakash, K, Ananthasubramaniam, A, Yang, G, Yang, Y, Nowinski, W, Nadarajah, M, Srinivasan, R, Ong, K, m-SARCC (Mobile Stroke Acute Radiology Command Center): Image Review and Neurological Care Team Coordination Linking PACS and Mobile Smart Devices .  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13026027.html