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So, another annual meeting of the Radiological Society of North America has come and gone. The ghosts of contracts past fade as we await the transmogrification of handshakes present into the ghosts of contract future. We sit back and decompress a bit, perhaps loosen the belt a notch, crack open a ‘vieux Armangnac’, gaze into the pensieve and begin to winnow the chaff that are customer dreams. It is an eternal conundrum that potential customers want what they know but know not what they need and existing customers have what they need but now know what they want. Yet, come Monday, January 4, father time will be burning engineering hours (at both ends?!) to do something! But, what?!

The key to the workstation must be radiologist productivity in a complex workflow aggravated by increasing procedure volume, increasing procedure set size, increasing regulation all the while amidst declining reimbursements. We need to examine each part of THE use case* (see below) to make sure that both the human and machine are each doing what they do best in absolutely the most efficient way possible; a truly cyborg relationship. It turns out that the computer’s and the human’s abilities are complimentary. The computer can be notoriously good at managing the process and the human, remembering things, searching, organizing, filtering, displaying and communicating. The human, as it turns out, is spectacularly bad at those tasks yet surprisingly good at some very hard tasks; image segmentation, content-based image memory retrieval and general and specific medical knowledge inferencing.

It would seem, therefore, relatively straightforward to provide the computer with all of the data and interfaces it needs to get its job done while providing the human with the minimum graphical user interface to get its job done as rapidly and as accurately as possible. Looking at the use case, it becomes apparent where the computer’s smarts can be applied: clever use of worklists to gather necessary data, sophisticated hanging protocols, fast, automated display, context sensitive, embedded lexicons and reference materials. For the human, the workstation can provide fast, standards based annotation and markup tools, and powerful embedded reporting in a variety of flavors.

The good news is that there are de facto, if not true standard ways to assimilate all of this functionality into the workstation. Remember, “We are the Borg. Lower your shields and surrender. We will add your biological and technological distinctiveness to our own. Your culture will adapt to service us.”

Dr. David S. Channin

– David S. Channin, M.D., CPHIMS, CRA, CIIP

* The Radiology use case grammar (anything enclosed in [] is optional):

[Resident Display [with historical(s)]] [Resident Annotation] [Resident Prelim Report] [Resident Critical Result Notification] Radiologist display [with historical(s)] [Radiologist Annotation] Radiologist Final Report [Resident Feedback] [Resident Discrepancy Notification] [Radiologist Critical Result Notification] [Technical QA] [ Professional QA] [Clinical Trial Specific Processing] [Clinical Trial Specific Annotation] [Clinical Trial Case Report Form Submission]  [TF Creation]

Editor’s Note: Dr. Channin is a paid guest-speaker for Carestream Health.


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