ARRS: PACS upgrade slashes image reading time

2019 05 03 19 57 9383 Honolulu 20190503193859

Sometimes, little things make a big difference. Pennsylvania researchers improved the efficiency of their radiologists by tweaking their PACS software to look for prior imaging exams with more specific search criteria, according to research presented at the American Roentgen Ray Society (ARRS) annual meeting in Honolulu.

After implementing a change that enables the PACS to automatically open prior studies specific to the current body part being imaged, a team of researchers from Penn State Health in Hershey, PA, found that the median time spent searching for these prior studies was cut in half. In addition, total mean study interpretation time dropped by 17%.

"Just about every radiologist and every radiology department is interested in saving time to improve production, so the value of time saved with simple user interface tweaks cannot be underestimated, especially when significant change can be made with little, if any, negative effects," wrote the researchers led by Dr. Bryce Lowrey. Their scientific exhibit at ARRS 2019 was awarded the certificate of merit in the category of efficacy/education/administration/informatics.

Previously, Penn State Health's PACS had sorted imaging studies by just modality and body system, such as "digital x-ray" and "musculoskeletal." With the upgrade, however, a new dictionary of studies allowed users to further narrow the imaging examination by sorting with more specific terms, such as "foot or ankle."

"The newer dictionary allows the system to automatically open a user-defined number of prior studies specific to the body part being imaged rather than the entire body system," the authors wrote.

Using video recordings of attending radiologists, the researchers then evaluated the impact of the upgrade using metrics such as time spent searching for prior studies that were necessary and total interpretation time. They recorded interpretations of 219 studies, including 204 plain-film studies, on the older PACS and 110 studies, including 98 plain-film exams, after the system upgrade.

Radiologists' performance metrics on old PACS vs. upgraded PACS
  Old PACS PACS after upgrade
Mean time searching for prior study 6.1 sec 4.6 sec
Median time spent searching for prior study 4 sec 2 sec
Maximum time spent searching for prior study 40 sec 25 sec
Mean study interpretation time 137 sec 113 sec
All differences were statistically significant.

"These results show that the upgraded PACS system is superior to the prior system in time spent searching for prior studies and total time spent reading studies," the authors wrote. "This is an important metric to evaluate in a time when many patients have hundreds of prior studies to sift through, and our increasingly complex array of modalities and techniques complicate comparing prior images."

The researchers also observed an improvement -- from 56.2% to 62.7% -- in the number of exams that automatically opened all the necessary prior studies. This increase failed to reach statistical significance (p = 0.25), however.

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