Table 1.
Attribute comparison between existing paper and identified local VA electronic advanced medical imaging protocol assignment systems with optimized solution design
| Attribute | Existing paper processes | Existing Class III (local) electronic processes | Optimized Class I prototype solution |
|---|---|---|---|
| Environment | Paper | Terminal window or VistA CPRS Shared templates window | Web-based |
| Level of interoperability | Level 1 (paper) or Level 2 (scanned) | Level 3 (retrievable electronic input) | Level 4 (computational electronic data) |
| User access | Poor security controls | Access through desktop/application login | Access through authenticated secure web services |
| User roles | Radiologists, Technologists, Schedulers | Radiologists, Technologists, Schedulers | Radiologists, Technologists, Schedulers and System Administrators |
| Interface—textual input | Manual | CPRS orders | CPRS orders |
| Interface—images and reports | None | None | Yes, integrated information dashboard |
| Signature | Technologist and radiologist initials on paper form | None or digital | Digital |
| Record management | Can be scanned into EHR, but typically shred | Log file with suboptimal accessibility or Windows explorer folder | Saved and accessible for management |
| Workflow distribution | Paper stack | Work list | Work list |
| Urgency | Listed; not prioritized | Listed; can be prioritized | Listed; baskets; prioritized |
| Communications with requestor | Telephone contact listed, but not integrated | Telephone contact listed, but not integrated | Secure messaging through Outlook |
| Communications with technician | Freehand text comments field | Electronic free text comments field | Electronic free text comments field; Secure messaging through Outlook |
| Provider alerts | Not automated | Contrast allergy alert | Automated detection of patients at high risk for IV contrast administration (allergies, renal function, informed consent flag), and repeat/duplicated exams. |
| Availability | 24/7 | Variable; 24/7 possible | 24/7 |
| Bar codes | Not integrated, printed on form | Not integrated, printed on form | Integrated with bar code system |
| Integrated scheduling | No | No | Integrated |
| Contrast dose recording | No | No | Yes |
| Radiation dose recording | No | No | Yes |
CPRS Computerized Patient Record System, VistA Veterans Health Information Systems and Technology Architecture