At the Heart of Breast Imaging: Keeping Workflow Moving

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  The Sectra IDS5 mqa/ workstation enables technologists to communicate with radiologists via text messages at University Hospitals Cleveland in Ohio.

As breast imaging centers and departments make the transition to digital imaging, department heads, IT professionals and administrators struggle to identify how to maximize all of their imaging modalities and read and distribute images, while increasing patient throughput for financial stability. With a move to digital mammography, the brass ring that everyone seems to be reaching for, is a combination of efficiency and productivity gains, controlled costs and accelerated, quality patient care.

Diligence and planning the ins and outs of breast imaging workflow—from image acquisition, to patient flow, to tracking and monitoring exams—are paramount to the success of the digital transition, along with healthcare IT tools and techniques to ensure the delivery of quality patient care.

A strong IT backbone

“In breast imaging, quality of care is always the first consideration, but this must be delivered in an environment that is efficient and had rapid throughput,” says Gary Levine, MD, director of breast imaging at the Hoag Breast Care Center in Newport Beach, Calif. With an annual imaging volume of approximately 60,000 studies, the center offers diagnostic and screening mammography services.  

The first step to increasing efficiency is having qualified technical staff acquire the images. Hiring proficient technologists with many years of experience in multiple technologies can help keep things moving with minimal interruption in workflow. For example, at Hoag, most diagnostic technologists perform ultrasound as well as mammography exams, so that if additional imaging is required, the patient is imaged by the same technologist. This results in two efficiencies—no loss of information between staff as a patient is moved and better efficiency and flow of patient care throughout the department.

Hoag also recognizes the advantages of having all modalities at one site. “You don’t want to have to move patients between offices since information can be lost and patients are inconvenienced,” he adds.

Just as important, if not more, is a strong IT backbone to support the variety of imaging modalities and technologies in use. At Hoag, the Magview mammography reporting and distribution system is “the heart of the department because all of our reports are available in the system,” Levine adds. Approximately 98 percent of reports are template-generated reports through Magview, which enables faster throughput. Radiologists can dictate, use check-off sheets or create reports directly using the AutoScribe feature, which lets them enter findings directly at the workstation/viewstation. Reports can be ready before the patient leaves and auto-faxed to the referring physician’s office.

The center can automatically track and follow-up on patients, ensuring that no patient falls through the cracks. For mammography, perhaps more than any other modality in radiology, tracking patients is extremely important, especially in light of an abnormal finding which requires follow up. In a manual system, the potential for human error is present—but in a digital environment all of the manual processes are seemingly replaced. When the patient has an exam, she or he is automatically entered into Magview, which tracks when the patient is scheduled for the next study and alerts the provider when those patients are due for follow up.

Levine stresses the importance of planning and site visits to organizations utilizing digital mammography, and design a workflow up front that best suits their needs. “It is vital to have an IT backbone to support a digital mammography environment, and facilities must consider this in their transition plan,” he says.

A ‘central nervous system’ workflow

While a strong healthcare IT backbone is critical to the success of streamlining workflow in a breast imaging environment, keeping the interactions and communications open between staff is also key. To tackle this challenge, it is helpful to design how you want the work to flow before the transition is complete. “We really have no issues anymore in workflow because of the way we set it up when making the transition to digital,” according to Donna Pletcha, MD, director of breast imaging at University Hospitals in Cleveland. In going digital in 2006, the hospital designed a new workflow across four sites,