Ten filmless years and ten lessons: A 10th-anniversary retrospective from the Baltimore VA Medical Center
The authors review a decade's experience in the nation's first filmless radiology department and outline the challenges and rewards of the transition. They summarize their experience with 10 cautionary and informative lessons on making the process more successful, more efficient, and less stressful. A number of possible avenues of new research and assessment on the effects of filmless operation on radiologists, imaging staff, referring clinicians, and patients are highlighted.
[Show abstract] [Hide abstract] ABSTRACT: Adoption of digital images for pathological specimens has been slower than adoption of digital images in radiology, despite a number of anticipated advantages for digital images in pathology. In this paper, we explore the factors that might explain this slower rate of adoption. Semi-structured interviews on barriers and facilitators to the adoption of digital images were conducted with two radiologists, three pathologists, and one pathologist's assistant. Barriers and facilitators to adoption of digital images were reported in the areas of performance, workflow-efficiency, infrastructure, integration with other software, and exposure to digital images. The primary difference between the settings was that performance with the use of digital images as compared to the traditional method was perceived to be higher in radiology and lower in pathology. Additionally, exposure to digital images was higher in radiology than pathology, with some radiologists exclusively having been trained and/or practicing with digital images. The integration of digital images both improved and reduced efficiency in routine and non-routine workflow patterns in both settings, and was variable across the different organizations. A comparison of these findings with prior research on adoption of other health information technologies suggests that the barriers to adoption of digital images in pathology are relatively tractable. Improving performance using digital images in pathology would likely accelerate adoption of innovative technologies that are facilitated by the use of digital images, such as electronic imaging databases, electronic health records, double reading for challenging cases, and computer-aided diagnostic systems.0Comments 20Citations
- "The fatigue was presumed to be higher with the digital slides due to relatively decreased brightness of the monitors (true at that time, but not with newer hardware), monitor flicker, small cursor, and active role in image manipulation. On the other hand, as sharing radiologic images has now become feasible via direct electronic exchange even with large files, there appears to be a greater use of radiology services. "
- [Show abstract] [Hide abstract] ABSTRACT: We present statistics on about clinicians' use of our hospital-wide PACS, in terms of the number of studies retrieved from clinical departments, timing of such retrieval, and how often specific functions of the viewer are used.0Comments 0Citations
- [Show abstract] [Hide abstract] ABSTRACT: Planning and executing the redesign of a traditional institutional radiology reading room to conform to the radically different requirements of digital imaging are reviewed, with examples drawn from the authors' experience and from the growing body of literature on this subject. Included are best-practice recommendations and real-life examples on initial design and planning, stakeholder involvement, identifying and hiring consultants, architectural planning, the designation of a radiology point person, rethinking room and workstation design, the selection of ergonomic furniture and fittings, identifying optimal environmental elements, fine tuning and lessons learned, and going digital.0Comments 22Citations