Reinventing radiologist workflow

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“We all know that informatics impacts the practice of radiologists, and it particularly impacts today’s practicing radiologist,” Bruce Reiner, MD, director of research at the VA Maryland Health Care System in Baltimore, told audience members at the 2006 RSNA show on Monday. “The evolution of image and IS technology has increased the size and complexity of data, and this is putting increasing expectations on today’s radiologists.”
Reiner’s presentation, The Evolution of Radiologist Productivity and Workflow, was hosted in the Informatics Classroom of RSNA’s Lakeside Learning Center. It was part of a larger session called Practical Informatics for the Practicing Radiologist. Informatics is a hot topic this year at RSNA, so much so that the society decided to do away with 20-year-old infoRad and integrate informatics with the rest of the conference’s education exhibits and posters being held at Lakeside Learning Center.

What is the state of radiology today? The volume and complexity of studies are increasing, technology is evolving and expectations of the radiologists are increasing, Reiner explained to the audience.

Reiner used multi-detector CT (MDCT) as a metaphor for what is happening in the radiology community today. “The size of MDCT studies are now 10 times the size of conventional CT images,” he said. Radiology is being confronted with an imaging volume crisis, and informatics is offering a way to cope.

To confront the challenges associated with digital imaging technology and digital imaging interpretation, Reiner said, is to leverage the technology through workflow optimization.

To do this and maximize the radiologists’ productivity, Reiner suggested factoring the following into workflow:

  • Data extraction and presentation: Create a digital dashboard, Reiner said.
  • Visual perception: Reiner emphasized the importance of optimizing viewing technology and the user interface.
  • Image display and presentation: “Existing hanging protocols are relatively crude and inflexible,” Reiner explained, “especially for MDCT studies. We need individually based, intuitive hanging protocols. We need to create context-specific, ‘best-practice’ protocols based on large scale research and development collection.”
  • Image processing: “We need to integrate pathology-specific image processing into workflow, create multi-image display formatting and create automated user-specific profiles for image optimization,” Reiner said.
  • Navigation: Reiner suggested to use multi-programmable input devices and allow the radiologists to use “eyes-free” navigation
  • Interpretations
  • Reporting and communication: Develop a standard and create structured reporting nomenclature for reporting, he said. Also, find ways to close the communication loop by automating the process, especially critical results reporting, Reiner concluded.