Trend Tracker: Connecting Workflow & Radiology

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Doug OrrWorkflow — it just might be the most over-used term in radiology today. It’s always among the buzzwords at every major and minor tradeshow exhibit hall, and increasingly in the meeting rooms, too. If you haven’t had your daily fix, just pick up the phone when the next salesperson calls. They can’t go 50 words without saying it — workflow.

So, exactly what is the point of it all, when have you bought enough workflow?  You don’t need to buy a super-computer to do workflow, but you had better know exactly what workflow you are buying. 

The primary business of radiology has always been imaging, readily reflected in the laser-like focus on imaging modalities and improving equipment for the past 110 years. X-ray, nuclear, ultrasound, CT, MR, PET — every radiologist knows these touch-points like the back of his or her hand. But few radiologists really understand IT — although I agree that that number is growing.

Radiology is clearly a market on the move, both on the imaging front-end and the IT back-end. Everyone sees the continuing pressure of departments to keep up with the latest imaging technology, more procedures and more images per procedure. But today’s IT is primarily about managing, not imaging. And managing is not taught in medical school. But capable radiology administrators and business managers have the know how to either possess or hire the expertise to tackle this area.

The work of a radiology department or imaging center is actually fairly straight-forward — once you start building models comprised of tasks, transactions, files, databases, documents and workstations. In this scenario, tasks such as scheduling or patient check-in become just as important as the imaging procedure, the diagnosis, the report and the bill. OK, maybe billing is still a little more important!

So, first things first, map your current workflow. Then start working, and fast! 

When you begin looking at more efficient workflow models, it quickly becomes apparent that real benefits are there for the buying. Some of these benefits are readily identified by continuously monitoring developments in RIS, PACS and IHE-enabled products. Ever chat with your colleagues about the “IT” end of the department? How long does it take to get a report out, anyway? Trust me, there is more going on in radiology related to IT than you know, and it may or may not be coming from your favorite brand-name supplier. 

Yesterday’s isolated departments and imaging centers are gradually transitioning into connected operations. Every new device sold into radiology applications contains some element (some more, some less) of network capability and IHE interoperability. These capabilities are built from the traditional DICOM & HL7 standards, but the impact is far more significant — a more organized and error-free approach to tasks. The continuous addition of network and IT capabilities facilitates the ability to actively manage a radiology operation in the need-it-now world of healthcare.

The challenge for radiology departments today is investing the same level of resources and effort in IT as they currently invest in imaging. It is not so much a need to invest equivalent dollars in IT projects, but a need to recognize the opportunities that IT-related investments bring to the work of a modern day department and hospital.

Many facilities today have achieved some degree of film-less and paper-less operation, essentially internal to the department. There is an increasing capability to connect with the outside world, especially report distribution to referring clinicians. RIS/PACS integration also facilitates many departmental business activities, and can make the radiologist’s life much simpler. Network capabilities are an area ripe for expansion, to be followed by two-way transactions with the outside world such as scheduling and orders.

And don’t forget that electronic medical records are coming too, so a trip to the next annual HIMSS meeting may be in order (New Orleans, Feb. 25 — Mar. 1, 2007), adding to the accumulating number of radiology IT/PACS conferences that already populate the calendar outside of RSNA.

If your specialty is radiology, it’s long past the time to give workflow the attention and investment that make for a substantially improved workplace — where everyone is focused on the patients and their images, and the rest of the operation runs smooth as butter.

Douglas F. Orr is principal of J &M Group. Send Trend Tracker questions and comments to