In radiology, obtaining the image is only part of the job. Radiology departments and practices also need to be able to share images with referring physicians and patients. It’s an essential function in a state of transition. During the decades-long transition from film to digital to cloud-based image sharing, the majority of images are (and will be) shared via CD or DVD.
Working with CDs can be a challenge, says Mony Weschler, MA, director of clinical ancillary systems and emerging health IT at Montefiore Medical Center in New York City. There may be issues with the embedded viewer, image format and more. Several strategies can ease the burden:
1. Know your needs
While some providers burn CDs straight from PACS, this approach can be hit or miss in terms of quality, according to Nicole Fennell, imaging informatics manager at Southwest Diagnostic Imaging in Scottsdale, Ariz. Discs burned directly from PACS may not conform to DICOM standards, which could make importing the images difficult and in some cases, impossible, for the recipient.
“If all systems produced CDs in a straight DICOM format that could be imported into other systems, it would make the world a lot easier as far as sharing outside images,” says Fennell.
If a PACS isn’t able to produce CDs of acceptable quality, facilities can turn to a CD burner that provides the needed functionality. That’s what Memorial Hospital at Gulfport in Gulfport, Miss., did when it purchased burners for its main facility and two off-site imaging centers, says Griff Van Dusen, PACS administrator. He says providers should look at price and burning speed when purchasing a burner. An economical, but relatively slow, system may not be such a good buy in the long run if it eats into efficiency.
2. A CD with a view
Looking beyond the specifications of the burning device, Van Dusen also stressed the importance of having an easy-to-use viewer. Physicians don’t like interacting with multiple user interfaces and want to know how to get to the images right away, he says.
Discs produced by burners from healthcare technology vendors have embedded viewers, but with all of the different vendors on the market, every CD could have a different viewer with a slightly different interface. Van Dusen says his organization decided to use a locally installed viewer that can display images from any DICOM-formatted CD to have a single, unified program throughout the hospital, rather than rely on the embedded viewer on each disc.
Southwest Diagnostic Imaging uses the same strategy. The reason is straightforward: Referring physicians wanted a familiar system. “We like the consistency,” Fennell says. “The system works in most operating system environments, which is important as far as outpatient imaging goes, because we don’t control our referrers’ systems.”
3. Ease of use & the enterprise
Having a consistent, uncomplicated viewer simplifies image sharing for the referring physician, but ease of use also needs to be considered for any staff who create CDs/DVDs. This is particularly true for specialists outside of radiology who don’t have extensive experience with image management.
Bette Pommerleau, a speech pathologist at Merrimack Valley Hospital in Haverhill, Mass., explains that having an easy-to-use system for producing DVDs helps her and her colleagues when they produce DVDs of modified barium swallow studies.
Speech pathologists are not tech-savvy, she says. Twenty years ago, the fluoroscopy scans that examine the oral cavity and function of swallowing would be recorded by a VCR, with a simple tape recorder from an electronics store used for dictation. DVDs have become standard, but without an integrated system, having to manually record the images to disc can lead to human error.
Merrimack’s current system for acquiring and viewing barium swallow studies has an attached DVD burner, which streamlines and speeds the process.
4. The importance of the import
Memorial Hospital turned to the same vendor that provided its viewer for software that allows images to be imported off the CD and sent to PACS or mammography workstations. The system is a hit with referring physicians. “If it’s not installed on a computer, we hear about it pretty quickly,” says Van Dusen.
Importing may seem to be a matter of making image access more convenient, but it could have other ramifications. A study published in the March issue of the American Journal of Roentgenology demonstrated that when outside images were