Increasing Productivity in the Radiology Department
Reading Time: 9 minutes read
Techniques to improve workflow in the X-ray imaging department.
Radiology administrators are constantly looking for ways to improve productivity in the imaging department. As modality software has evolved, so have the features that enhance automation and efficiency in the workflow. But in my interactions with customers, I often find that departments are overlooking some of these time-saving features.
In this blog, I’ll review:
- Existing and new features that make image capture more efficient.
- How standardizing on equipment enhances productivity and ease of use.
- The role of integration in improving radiology workflow.
Existing and new tools for radiologic technologists to make image capture more efficient.
Modality Performed Procedure Step. Most radiology departments are familiar with the DICOM worklist. However, many facilities are not aware of – and thus don’t use – the Modality Performed Procedure Step (MPPS) for scheduled workflow. This optional software feature automatically sends a message to the RIS to complete the study when the acquired images have been accepted. The automated behind-the-scenes workflow saves the radiographer from needing to manually complete the study from their RIS application. This feature may not suit your workflow if you require the radiographer to answer questions prior to completing the study. However, it is a time-saving option for other X-ray facilities.
Automated Workflow with EVP Plus software. Radiographic technologists expect a high degree of automation and efficiency in the technology they use in their daily workflow. They expect minimal interaction with the technology’s modality software.
At the same time, radiologists expect exams that meet their individualized diagnostic viewing preferences while achieving consistent results. Consequently, your image-processing technology needs to deliver a high degree of automation while simultaneously delivering flexibility and ease of use.
Carestream’s EVP Plus Software successfully overcomes this challenge for digital-projection radiography. EVP Plus automatically processes and delivers diagnostic-quality DR and CR images to PACS, based on look preferences that can be uniquely specified by each site. An intuitive user interface provides independent controls for the five fundamental attributes of image quality: brightness, latitude, detail contrast, sharpness and noise. The user interface can be used for initial setup in setting the unique “look” preferences for a clinical site. Once the preferences are established, EVP Plus automatically processes images to the specified “look.”
Single-screen Workflow for Fewer Screen Transitions. This new time-saving layout was recently introduced in Carestream’s ImageView software. With ImageView, the most commonly used operations are a single button press away, without the need to toggle back and forth between multiple screens.
From within a single screen, radiographers can view and access patient data, study data and views; the image viewer and positioning aids; and formatting and workflow controls. After the image is captured, it is displayed on the center panel, replacing the image viewer and positioning aids. The acquisition controls on the right are replaced with markers and image manipulation/processing/formatting tools.
QA Operating Mode: At most imaging facilities in the United States, radiographers acquire an image, review it for quality assessment, and then accept or manually select the next view for acquisition. In contrast, many radiology departments outside the United States review images by study. Each image is acquired, displayed for a short period of time, then the system automatically moves to the next view for acquisition. After all the images have been acquired, they are more thoroughly reviewed for quality assessment and annotated. The QA-by-study approach can potentially provide a workflow improvement at facilities with a high volume of imaging studies.
Leverage custom configuration and automated controls. Use the configurability, and view and workflow settings available in your imaging system to expedite exams. Doing so can nearly automate the exam process while providing repeatable results. For example, North Colorado Medical Center has found that the automated controls in the DRX-Evolution system “expedite the capture of cross-table, trauma, scoliosis, long-length, spine, extremity and general X-ray exams,” explained Rafael Hernandez, Medical Imaging Senior Manager.
Additionally, automated controls such as auto-centering, auto-positioning and auto-tracking can eliminate the need to manually move equipment to the required position. Aside from improving efficiency, these can help reduce fatigue and injury of the radiographer.
If you’re unsure whether your staff is using all these time-saving tools, ask your imaging supplier to provide refresher training on your default settings and other time-saving features.
Repeat Exposure Feature. This feature is very popular in radiology departments large and small. With the press of a single button, the radiographer can quickly create a duplicate view using the same technique and grid settings. This saves the radiographer the multiple steps that would have been previously required to add a view. Before performing the repeat capture, the radiographer has the ability to adjust the exposure factors as needed to produce the desired outcome.
Digital Tomosynthesis. If you perform linear tomography exams, Digital Tomosynthesis (DT) can help simplify your workflow and reduce exam time. Carestream’s DT technology uses a single sweep of X-ray exposures and simplifies the operator’s workflow by separating the process of DT exposure acquisition from image volume formation. As a result, multiple projections are acquired during a single DT acquisition sweep. The exam time is greatly reduced with DT than with linear tomography, doing away with the trial-and-error process in locating the anatomical region of interest. Carestream’s DT technology is an upgradable option on the DRX-Evolution Plus System.
Standardizing on equipment enhances productivity and ease of use.
Standardization of Equipment. Often, radiologic technologists move among different pieces of equipment within a facility or network of facilities. Having a consistent user interface for mobile and/or room-based imaging systems not only reduces the training required, but also enhances productivity and ease of use.
At OSF Saint Francis Medical Center, standardizing on Carestream medical equipment makes the X-ray imaging workflow more efficient, said Lisa A. Stevens, Manager of Diagnostic Radiology, Ultrasound and Informatics. “Our techs are very comfortable with the equipment. They can move easily from the ER to NICU to the general floor, as well as from one facility to another.”
Ask your imaging equipment supplier for refresher training for your rad techs.
Rafael Hernandez agreed.“Having a consistent user interface for our X-ray mobile and room-based imaging systems enhances productivity and ease of use. We also have the same imaging systems at two additional affiliated hospitals. This enables us to move technologists from one hospital to another without the need for additional training,” he explained.
Integration improves X-ray imaging workflow.
In addition to making the most of the features available within your acquisition device, there are efficiencies to be gained by integrating your image capture with other systems.
Integration with RIS: Having integration with your RIS allows for a modality worklist to be automatically queried and presented on the capture console. The radiographer can simply pick the procedure to be imaged from the list. If the procedure code has already been mapped, it automatically creates the procedure and associated default views. This significantly reduces the time and error that can occur with manually creating the procedure and keying in all of the patient information.
Integration with PACS: Having integration with PACS can allow a radiographer to view priors, and then copy those settings to the new exam. Or they can optimize their technique based on the prior. Copying the prior technique settings can be a significant time saver, especially for more challenging patients.
Access to RIS and PACS: Having access to your RIS and PACS from your portable not only provides information not typically available when moving from room to room, but can streamline the radiographer’s workflow. When a radiographer needs more information on the patient, s/he can pull it up directly on the portable rather than going back to the department. Additionally, this access enables the radiographer to update the status (e.g. compete the study) right from the floor, which can be especially useful when MPPS is not utilized.
Integration with Standardized Protocols: Utilizing standardized protocols such as DICOM, in adherence with IHE (Integrating the Healthcare Enterprise) Integration Profiles, allows for optimal interoperability between different vendor systems. This is especially important for the integration of modalities, RIS and PACS since these three systems provide the foundation of most imaging facilities.
Improving efficiency in radiology department paves way for increased demand.
Some of these time-saving techniques might seem insignificant. However, small time savings can add up. And they will be even more important to meet the growing demands on imaging departments.
According to the World Health Organization (WHO), the proportion of the global population over 60 years of age will rise from 12% to 22% from 2015 to 2050. Additionally, their report states that, “the effective use of medical imaging equipment will be required to provide high-quality patient care.”(1) Likewise, Stuart Clark, managing director of The Advisory Board Company, told Imaging Technology News (ITN) that he expects radiography gains of 6 percent over the next 5 years. (2)
I hope you found a useful suggestion or two in this recap of productivity features available for image capture. By applying optimal techniques to imaging and workflow, not only will your department become more efficient, you can also minimize the need for repeat exams and additional radiation exposure. Equally important, leveraging automation features frees up your radiologic technologists to spend less time working on the equipment and more time interacting with patients.
#patientcenteredimaging #patientcareradiology #radiologyproductivity
Ron Muscosky is a Product Line Manager at Carestream Health. He has more than 30 years of experience in healthcare/medical imaging.