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Paging System Hastens Clinician Access to Medical Images

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Researchers have identified a shared wealth of knowledge at an Australian hospital; as pages sent out to MDs, informing them their images were available in the PACS significantly diminished the time between when studies were ready and when they were viewed.

The team from Sir Charles Gairdner Hospital in Perth, Western Australia, discovered that integrating a straightforward paging notification system diminished the average waiting time for clinician image review from three hours to just half an hour.

And although the team admits that manually paging a physician each time a study has been documented by a radiologist and is ready to be viewed in PACS isn’t likely to stand on its own two feet, they trust their data exemplifies the clinical pros of notification and would make-way for the use of automated notification systems.

Paging system hastensIn a two-part study spanning over two months, participants from the general medicine, general surgery, vascular surgery, neurosurgery, and orthopedic surgery departments were requested to manually record the time and date at which they viewed radiological images they had asked for. They were also asked to record any differences from their usual practice.

Data was collected from over 10 working days for 45 patients. Data was then weighed against information in the RIS to calculate the time between when a study was requested and when it was available for viewing in the PACS. Images from X-ray, CT, MRI, ultrasound, and bone scans were also part of the study.

There was an average delay of 180.02 minutes (95% confidence interval [CI]: 135.1 to 225 minutes) between when the image was ready and when it was viewed. When asked what could possibly be the main factor in such a delay, 33 (72%) of 46 doctors based it on the simple fact of not knowing the images were indeed ready and viewable. 

For the second part of the study, junior doctors were paged by senior author of the study, Dr. Madusha Chandratilleke, spanning six days between 8 AM and 5 PM, when images were viewable on PACS. Pages were sent out a full 30 minutes after images were ready and prepared.

The new paging system, used for 52 patients in eight inpatient departments, decreased the average time-delay between image accessibility and viewing to 33.95 minutes (95% CI: 24.1 to 43.8 min), earning positive feedback on the system.

"There were high levels of satisfaction from all staff involved regarding a notification system for radiology with reported increased working efficiency and shorter delays to intervention and changes in management. A notification system also has the benefits of urgent imaging being viewed immediately and acted upon earlier, as well as less 'missed' pathology and errors,” noted the study.

While automated notification systems are available on the market they are expensive and take time to install, and until now it was uncertain whether the use of them would effectively assist physicians.

“This is the first study that has demonstrated that clinician notification will reduce the time between the images becoming available and actually being viewed. Hereafter, it may be that clinical care may be provided in a more timely fashion. There is therefore potential for more efficient and timely healthcare provision,” said co-author and consultant neurosurgeon Dr. Stephen Honeybul.

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