The PACS road is a well-traveled one. While many facilities have deployed PACS, many more are just jumping into the digital era. Still more facilities are shopping for or deploying second- or third-generation systems. While lots of people are ‘driving’ PACS, travel is not as smooth as it could be. Digital image management has not solved the radiology workflow conundrum; in some cases, it has created new roadblocks. For example, radiologists and administrators often remain unaware of bumps in the road or travel hazards like network bottlenecks or piles of unsigned reports. The upshot? Driving on the digital radiology highway is not as efficient or effective as it could be.
Digital dashboards offer a software solution to common radiology business bottlenecks by providing a bird’s eye view of the department — facilitating maximum productivity among individuals and systems. With help akin to an air traffic controller, patient image and information ‘traffic’ (a.k.a. workflow) is smooth and high-speed.
The “views” are tailored by need to the radiologist, radiology administrator and PACS or IT administrator. Some of the measured parameters include RVUs, unsigned reports, unread studies, average patient wait times and scanner utilization which includes total scans per day and per year and when service is scheduled. Other parameters can include priorities according to patient acuity, patient wait times for imaging studies and the best methods for notifying physicians and administrators to resolve issues such as unsigned and unread studies as well as offering proactive support.
A quick look in the rear view mirror
In the analog era, workflow management was a fairly simple process. A stack of unread films provided a tangible cue of mounting work. In the filmless, paperless environment; however, it’s not clear which studies are stat, which images have been interpreted or which reports need a signature. The challenge for the PACS administrator is equally tough as there is no barometer to gauge the performance of the PACS. In many cases, there is a slow degradation in performance until…the inevitable crash.
While digital has been touted as the solution, radiology departments must undergo the next phase of the digital evolution before realizing the promise of PACS. “Going digital is not the whole story,” asserts Matthew Morgan, MD, MS, radiology resident at University of Pittsburgh Medical Center (UPMC) who in April presented “Flying Blind: Using a Digital Dashboard to Navigate a Complex PACS Environment” at the annual meeting of Society for Computer Applications in Radiology/Society for Imaging Informatics in Medicine, which sponsored the research. Deploying digital image management is a mere first step in the process, says Morgan.
Optimizing workflow is an entirely different, and the next, task. Paul Nagy, PhD, director, informatics research and assistant professor of radiology at University of Maryland School of Medicine in Baltimore agrees. He says the PACS industry is maturing and the next step is a system to optimize PACS.
The ultimate radiology department is an assembly line that incorporates technology to facilitate real-time practice, says Bruce Reiner, MD, director of research VA Maryland Health Care System in Baltimore, Md. The assembly line model relies heavily on immediate and comprehensive access to patient data. From the moment the patient enters the imaging chain, users have access to the data needed to interpret studies, communicate results and proactively meet the patient’s needs such as additional interventions and imaging studies.
The digital radiology dashboard is the cornerstone of next phase in the PACS evolution. It can deliver productivity and performance improvements as well as the business intelligence necessary to optimize the digital department. It’s a tall, and complex, order. And yet, at the same time, the dashboard must be simple for users. If it’s too complex and requires one more password or log-in, it becomes ineffective and will not aid workflow. One common visual representation is a traffic light to alert users to potential problems; other dashboards provide graphical information to allow at-a-glance trending data. Red lights signal urgent matters, yellow lights urge caution and green lights mean workflow is going smoothly.
The dashboard is not a one-size-fits-all product or solution. It can take a number of forms, target various users and be customized to individual facility needs.