SIIM: PACS navigation devices at a glance

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MINNEAPOLIS—‘User-unfriendly’ PACS navigation is one of radiologists’ top complaints, said David Weiss, MD, physician coordinator of imaging informatics at Carilion Roanoke Memorial Hospital in Roanoke, Va., during a presentation at the annual meeting of the Society of Imaging Informatics in Medicine (SIIM) last week.

Plus, PACS input devices like the traditional mouse or right-click tools can hamper efficiency and pose ergonomic challenges. Weiss and his colleagues at Carilion attempted to solve this thorny problem by testing multiple input devices. After investigating a series of devices, they concluded that there is no single solution to streamline PACS navigation, but a combination of existing devices can work well.

“Every radiologist needs to maximize efficiency. The eyes should focus on images, not on the keyboard; and the brain should concentrate on image interpretation, not right mouse clicks. Input devices should help radiologists minimize look-away and think-away time,” explained Weiss.

The range of input options is fairly broad and includes the mouse, keyboard, voice input, Philips Healthcare's speech microphone, Shuttle Pro, Twiddler, gyroscopic mouse and joystick. Weiss shared the pros and cons of each option.

Philips' speech microphone provides seven user-defined buttons that can control PACS and speech. Functionality travels with the user instead of remaining at the workstation.

Five- and eight-button mice offer workstation-specific functions. Functionality remains at the workstation, so tools don’t accommodate individual preferences.

Several of the options Weiss studied originated in the gaming industry and seemed to hold promise for radiology applications. Shuttle Pro features 15 workstation-specific buttons, and Twiddler offers more than 1,000 device-specific functions. Increasing the number of functions, however, does not serve the radiology community.

Twiddler is difficult to program and complex to use, said Weiss. The gyroscopic mouse, which controls the cursor with wrist movement, proved to be too uncomfortable for eight or more hours of daily use, and the utility of joystick was hindered by poor cursor control and limited tactile feedback.

After the survey, the team identified two popular combinations depending on the type of image review. The five-button mouse and Shuttle Pro combination work well for scrolling modalities, and the Philips speech microphone and multi-button mouse work best for point-and-click applications like CR and DR, said Weiss.