Macro-scripting unifies desktop within PACS at MGH

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Diagnostic imaging clinicians working within a PACS environment often find themselves leaving the interpretation space on the workstation to perform other tasks. These can include accessing the department’s RIS, interrogating the institution’s electronic medical record (EMR), sending or responding to an email from a referring physician, or consulting an online reference. Because of the incremental nature of system deployment at most institutions, these application interfaces are often independent from one another.

A group of developers at Massachusetts General Hospital (MGH) in Boston have utilized macro-scripting to deliver their interpreting physicians a unified desktop in their PACS workspace. They presented the results of their efforts at the 93rd scientific assembly and annual meeting of the Radiological Society of North America last month in Chicago.

“Simultaneous access to PACS, RIS, voice dictation, EMR, paging, email, and online references is increasingly crucial for accurate diagnosis and timely communication in radiology,” said Stuart Pomerantz, MD. “However, the isolated manner in which these applications typically operate forces the user to repeatedly enter the same data, often across multiple PCs via numerous interface devices.”

Pomerantz and his team at MGH sought to achieve accuracy, efficiency and ergonomic benefits by utilizing third-party macro-scripting software, Quick Macros 2, to integrate all functions into a unified interface.

“Without formal programming, we were able to use simple menu-driven routines of an inexpensive shareware macro-scripting application to generate flexible yet robust conduits for automated information exchange between PACS and all other informatics applications at reading stations,” he said.

Pomerantz reported that the software uses sampling tools to characterize any passive or active element of the application screen display. He said that these “hooks” can then be used as triggers or targets for any desired sequence of actions; either within a particular application or for sharing data and synchronizing functions between programs and even across a network.

He noted that a macro to launch a patient's EMR entries for the current study being edited in the dictation application has been stably implemented at 14 workstations in the radiology department at MGH for more than three months.

“Numerous key strokes and mouse clicks are eliminated which otherwise discourage utilization of the EMR,” he observed.

The developers also have created a full set of PACS and informatics functionalities within a unified interface using the macro software’s menu creation dialog. These include entry of patient and physician data from the active PACS study into relevant fields within dictation software, physician-alert pages, and emails as well as teaching file creation with batch import of selected images and EMR entries, according to Pomerantz.

“A unified radiology desktop integrating the full range of PACS and informatics functionalities can be achieved with ease by the end-user through external macro-scripting software,” he said.

Next on the agenda for the team at MGH is further development of the macro-scripting approach to incorporate automated metrics to quantify radiology workflow improvements as well as potential increase diagnostic quality and ergonomics, Pomerantz said.