Abstract
We prospectively compared image and report delivery times in our Urgent Care Center (UCC) during a film-based practice (1995) and after complete implementation of an electronic imaging practice in 1997. Before switching to a totally electronic and filmless practice, multiple time periods were consistently measured during a 1-week period in May 1995 and then again in a similar week in May 1997 after implementation of electronic imaging. All practice patterns were the same except for a film-based practice in 1995 versus a filmless practice in 1997. The following times were measured: (1) waiting room time, (2) technologist’s time of examination, (3) time to quality control, (4) radiology interpretation times, (5) radiology image and report delivery time, (6) total radiology turn-around time, (7) time to room the patient back in the UCC, and (8) time until the ordering physician views the film. Waiting room time was longer in 1997 (average time, 26∶47) versus 1995 (average time, 15∶54). The technologist’s examination completion time was approximately the same (1995 average time, 06∶12; 1997 average time, 05∶41). There was also a slight increase in the time of the technologist’s electronic verification or quality control in 1997 (average time, 7∶17) versus the film-based practice in 1995 (average time, 2∶35). However, radiology interpretation times dramatically improved (average time, 49∶38 in 1995 versus average time 13∶50 in 1997). There was also a decrease in image delivery times to the clinicians in 1997 (median, 53 minutes) versus the film based practice of 1995 (1 hour and 40 minutes). Reports were available with the images immediately upon completion by the radiologist in 1997, compared with a median time of 27 minutes in 1995. Importantly, patients were roomed back into the UCC examination rooms faster after the radiologic procedure in 1997 (average time, 13∶36) than they were in 1995 (29∶38). Finally, the ordering physicians viewed the diagnostic images and reports in dramatically less time in 1997 (median, 26 minutes) versus 1995 (median, 1 hour and 5 minutes). In conclusion, a filmless electronic imaging practice within our UCC greatly improved radiology image and report delivery times, as well as improved clinical efficiency.
Full Text
The Full Text of this article is available as a PDF (883.1 KB).
References
- 1.Bryan S, Weatherburn G, Watkins J, et al. Radiology report times: Impact of picture archiving and communication systems. Am J Roentgenol. 1998;170:1153–1159. doi: 10.2214/ajr.170.5.9574575. [DOI] [PubMed] [Google Scholar]
- 2.Kundel HL, Seshadri SB, Langlotz CP, et al. Prospective study of a PACS: Information flow and clinical action in a medical intensive care unit. Radiology. 1996;199:143–149. doi: 10.1148/radiology.199.1.8633138. [DOI] [PubMed] [Google Scholar]
- 3.Kundel HL, Seshadri SB, Arenson RL. Clinical experience at the University of Pennsylvania. Comput Med Imaging Graph. 1991;15:197–200. doi: 10.1016/0895-6111(91)90010-S. [DOI] [PubMed] [Google Scholar]
- 4.Simone DN, Kundel HL, Arenson RL, et al. Effect of a digital imaging network on physician behavior in an intensive care unit. Radiology. 1988;169:41–44. doi: 10.1148/radiology.169.1.3420281. [DOI] [PubMed] [Google Scholar]
- 5.Kato H, Kubota G, Kojima K, et al. Preliminary time-flow study: Comparison of interpretation times between PACS work-stations and films. Comput Med Imaging Graph. 1995;19:261–265. doi: 10.1016/0895-6111(95)00010-N. [DOI] [PubMed] [Google Scholar]
- 6.Krupinski EA, Lund PJ. Differences in time to interpretation for evaluation of bone radiographs with monitor and film viewing. Acad Radiol. 1997;4:177–182. doi: 10.1016/S1076-6332(05)80287-9. [DOI] [PubMed] [Google Scholar]
- 7.Piraino DW, Davros WJ, Lieber M, et al. Direct digital versus conventional film screen radiography of the musculoskeletal system. J Digit Imaging. 1998;11:172–173. doi: 10.1007/BF03168295. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Procacci C, Minniti S, Biondetti PP, et al. Comparison between conventional radiography and thoravision in the study of the normal chest. J Digit Imaging. 1997;10:183–184. doi: 10.1007/BF03168695. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Kundel HL, Gefter W, Aronchick J, et al. Accuracy of bedside chest hard-copy screen-film versus hard- and soft-copy computed radiographs in a medical intensive care unit: Receiver operating characteristic analysis. Radiology. 1997;205:859–863. doi: 10.1148/radiology.205.3.9393548. [DOI] [PubMed] [Google Scholar]
- 10.Steckel RJ, Batra P, Johson S, et al. Comparison of hard-and soft-copy digital chest images with different matrix sizes for managing coronary care unit patients. Am J Roentgenol. 1995;164:837–841. doi: 10.2214/ajr.164.4.7726034. [DOI] [PubMed] [Google Scholar]
- 11.Mattern CWT, Erickson BJ, King BF, et al. Impact of electronic imaging on clinician behavior in the urgent care setting. J Digit Imaging. 1999;12(suppl 1):148–151. doi: 10.1007/BF03168785. [DOI] [PMC free article] [PubMed] [Google Scholar]
