Skip to main content
Top
Published in: Journal of Digital Imaging 2/2018

01-04-2018

A General Framework for Monitoring Image Acquisition Workflow in the Radiology Environment: Timeliness for Acute Stroke CT Imaging

Authors: Timothy P. Szczykutowicz, Christina L. Brunnquell, Gregory D. Avey, Carrie Bartels, Daryn S. Belden, Richard J. Bruce, Aaron S. Field, Walter W. Peppler, Peter Wasmund, Gary Wendt

Published in: Journal of Imaging Informatics in Medicine | Issue 2/2018

Login to get access

Abstract

Many facets of an image acquisition workflow leave a digital footprint, making workflow analysis amenable to an informatics-based solution. This paper describes a detailed framework for analyzing workflow and uses acute stroke response timeliness in CT as a practical demonstration. We review methods for accessing the digital footprints resulting from common technologist/device interactions. This overview lays a foundation for obtaining data for workflow analysis. We demonstrate the method by analyzing CT imaging efficiency in the setting of acute stroke. We successfully used digital footprints of CT technologists to analyze their workflow. We presented an overview of other digital footprints including but not limited to contrast administration, patient positioning, billing, reformat creation, and scheduling. A framework for analyzing image acquisition workflow was presented. This framework is transferable to any modality, as the key steps of image acquisition, image reconstruction, image post processing, and image transfer to PACS are common to any imaging modality in diagnostic radiology.
Literature
1.
go back to reference Boland GW: Enhancing CT productivity: strategies for increasing capacity. American Journal of Roentgenology 191(1):3–10, 2008CrossRefPubMed Boland GW: Enhancing CT productivity: strategies for increasing capacity. American Journal of Roentgenology 191(1):3–10, 2008CrossRefPubMed
2.
go back to reference Gunn ML, Maki JH, Hall C, Bhargava P, Andre JB, Carnell J, ... Beauchamp NJ: Improving MRI scanner utilization using modality log files. J Am Coll Radiol 14(6):783–786, 2017. Gunn ML, Maki JH, Hall C, Bhargava P, Andre JB, Carnell J, ... Beauchamp NJ: Improving MRI scanner utilization using modality log files. J Am Coll Radiol 14(6):783–786, 2017.
3.
go back to reference Flug J, Nagy P: The lean concept of waste in radiology. Journal of the American College of Radiology 8(6):443–445, 2011CrossRefPubMed Flug J, Nagy P: The lean concept of waste in radiology. Journal of the American College of Radiology 8(6):443–445, 2011CrossRefPubMed
4.
go back to reference Hirschorn DS, Hinrichs CR, Gor DM, Shah K, Visvikis G: Impact of a diagnostic workstation on workflow in the emergency department at a level I trauma center. Journal of digital imaging 14:199–201, 2001CrossRefPubMedPubMedCentral Hirschorn DS, Hinrichs CR, Gor DM, Shah K, Visvikis G: Impact of a diagnostic workstation on workflow in the emergency department at a level I trauma center. Journal of digital imaging 14:199–201, 2001CrossRefPubMedPubMedCentral
5.
go back to reference Reiner BI, Siegel EL, Hooper FJ, Pomerantz S, Dahlke A, Rallis D: Radiologists’ productivity in the interpretation of CT scans: a comparison of PACS with conventional film. American Journal of Roentgenology 176(4):861–864, 2001CrossRefPubMed Reiner BI, Siegel EL, Hooper FJ, Pomerantz S, Dahlke A, Rallis D: Radiologists’ productivity in the interpretation of CT scans: a comparison of PACS with conventional film. American Journal of Roentgenology 176(4):861–864, 2001CrossRefPubMed
6.
go back to reference Reiner BI, Siegel EL, Hooper FJ, Glasser D: Effect of film-based versus filmless operation on the productivity of CT technologists. Radiology 207(2):481–485, 1998CrossRefPubMed Reiner BI, Siegel EL, Hooper FJ, Glasser D: Effect of film-based versus filmless operation on the productivity of CT technologists. Radiology 207(2):481–485, 1998CrossRefPubMed
7.
go back to reference Kato H, Kubota G, Kojima K, Hayashi N, Nishihara E, Kura H, Aizawa M: Preliminary time-flow study: comparison of interpretation times between PACS workstations and films. Computerized medical imaging and graphics 19(3):261–265, 1995CrossRefPubMed Kato H, Kubota G, Kojima K, Hayashi N, Nishihara E, Kura H, Aizawa M: Preliminary time-flow study: comparison of interpretation times between PACS workstations and films. Computerized medical imaging and graphics 19(3):261–265, 1995CrossRefPubMed
8.
go back to reference Redfern RO, Horii SC, Feingold E, Kundel HL: Radiology workflow and patient volume: effect of picture archiving and communication systems on technologists and radiologists. Journal of Digital Imaging 13:97–100, 2000CrossRefPubMedPubMedCentral Redfern RO, Horii SC, Feingold E, Kundel HL: Radiology workflow and patient volume: effect of picture archiving and communication systems on technologists and radiologists. Journal of Digital Imaging 13:97–100, 2000CrossRefPubMedPubMedCentral
9.
go back to reference Siegel E, Reiner B: Work flow redesign: the key to success when using PACS. American Journal of Roentgenology 178(3):563–566, 2002CrossRefPubMed Siegel E, Reiner B: Work flow redesign: the key to success when using PACS. American Journal of Roentgenology 178(3):563–566, 2002CrossRefPubMed
10.
go back to reference Reiner B, Siegel E, Scanlon M: Changes in technologist productivity with implementation of an enterprisewide PACS. Journal of digital imaging 15(1):22–26, 2002CrossRefPubMedPubMedCentral Reiner B, Siegel E, Scanlon M: Changes in technologist productivity with implementation of an enterprisewide PACS. Journal of digital imaging 15(1):22–26, 2002CrossRefPubMedPubMedCentral
11.
go back to reference Reiner BI, Siegel EL: Technologists’ productivity when using PACS: comparison of film-based versus filmless radiography. American Journal of Roentgenology 179(1):33–37, 2002CrossRefPubMed Reiner BI, Siegel EL: Technologists’ productivity when using PACS: comparison of film-based versus filmless radiography. American Journal of Roentgenology 179(1):33–37, 2002CrossRefPubMed
12.
go back to reference Siegel EL, Reiner BI, Siddiqui KM: Ten filmless years and ten lessons: a 10th-anniversary retrospective from the Baltimore VA Medical Center. Journal of the American College of Radiology 1(11):824–833, 2004CrossRefPubMed Siegel EL, Reiner BI, Siddiqui KM: Ten filmless years and ten lessons: a 10th-anniversary retrospective from the Baltimore VA Medical Center. Journal of the American College of Radiology 1(11):824–833, 2004CrossRefPubMed
13.
go back to reference Lepanto L, Paré G, Aubry D, Robillard P, Lesage J: Impact of PACS on dictation turnaround time and productivity. Journal of digital imaging 19(1):92, 2006CrossRefPubMedPubMedCentral Lepanto L, Paré G, Aubry D, Robillard P, Lesage J: Impact of PACS on dictation turnaround time and productivity. Journal of digital imaging 19(1):92, 2006CrossRefPubMedPubMedCentral
15.
go back to reference Humphrey LM, Fitzpatrick K, Atallah N et al.: Time comparison of intensive care units with and without digital viewing systems. J Digit Imaging 6:37–41, 1993CrossRefPubMed Humphrey LM, Fitzpatrick K, Atallah N et al.: Time comparison of intensive care units with and without digital viewing systems. J Digit Imaging 6:37–41, 1993CrossRefPubMed
16.
go back to reference Schemmel A, Lee M, Hanley T, Pooler BD, Kennedy T., Field, A., ... John-Paul JY. Radiology workflow disruptors: a detailed analysis. J Am Coll Radiol 13(10):1210–1214, 2016. Schemmel A, Lee M, Hanley T, Pooler BD, Kennedy T., Field, A., ... John-Paul JY. Radiology workflow disruptors: a detailed analysis. J Am Coll Radiol 13(10):1210–1214, 2016.
17.
go back to reference Dhanoa D, Dhesi TS, Burton KR, Nicolaou S, Liang T: The evolving role of the radiologist: the Vancouver workload utilization evaluation study. Journal of the American College of Radiology 10(10):764–769, 2013CrossRefPubMed Dhanoa D, Dhesi TS, Burton KR, Nicolaou S, Liang T: The evolving role of the radiologist: the Vancouver workload utilization evaluation study. Journal of the American College of Radiology 10(10):764–769, 2013CrossRefPubMed
18.
go back to reference John-Paul JY, Kansagra AP, Mongan J: The radiologist's workflow environment: evaluation of disruptors and potential implications. Journal of the American College of Radiology 11(6):589–593, 2014CrossRef John-Paul JY, Kansagra AP, Mongan J: The radiologist's workflow environment: evaluation of disruptors and potential implications. Journal of the American College of Radiology 11(6):589–593, 2014CrossRef
19.
go back to reference Gay SB, Sobel AH, Young LQ, Dwyer SJ: Processes involved in reading imaging studies: workflow analysis and implications for workstation development. Journal of digital imaging 10(1):40–45, 1997CrossRefPubMedPubMedCentral Gay SB, Sobel AH, Young LQ, Dwyer SJ: Processes involved in reading imaging studies: workflow analysis and implications for workstation development. Journal of digital imaging 10(1):40–45, 1997CrossRefPubMedPubMedCentral
20.
go back to reference Beard D: Designing a radiology workstation: a focus on navigation during the interpretation task. Journal of Digital Imaging 3(3):152–163, 1990CrossRefPubMed Beard D: Designing a radiology workstation: a focus on navigation during the interpretation task. Journal of Digital Imaging 3(3):152–163, 1990CrossRefPubMed
22.
23.
24.
25.
26.
go back to reference Cook TS, Zimmerman SL, Steingall SR, Maidment AD, Kim W, Boonn WW: Informatics in radiology: RADIANCE: an automated, enterprise-wide solution for archiving and reporting CT radiation dose estimates. Radiographics 31(7):1833–1846, 2011CrossRefPubMed Cook TS, Zimmerman SL, Steingall SR, Maidment AD, Kim W, Boonn WW: Informatics in radiology: RADIANCE: an automated, enterprise-wide solution for archiving and reporting CT radiation dose estimates. Radiographics 31(7):1833–1846, 2011CrossRefPubMed
27.
go back to reference Gress DA, Dickinson RL, Erwin WD, Jordan DW, Kobistek RJ, Stevens DM, ...: Fairobent LA. AAPM medical physics practice guideline 6. a.: Performance characteristics of radiation dose index monitoring systems. J Appl Clin Med Phys. 2017 Gress DA, Dickinson RL, Erwin WD, Jordan DW, Kobistek RJ, Stevens DM, ...: Fairobent LA. AAPM medical physics practice guideline 6. a.: Performance characteristics of radiation dose index monitoring systems. J Appl Clin Med Phys. 2017
28.
go back to reference Grimes J, Leng S, Zhang Y, Vrieze T, McCollough C: Implementation and evaluation of a protocol management system for automated review of CT protocols. Journal of applied clinical medical physics 17(5):1–11, 2016CrossRef Grimes J, Leng S, Zhang Y, Vrieze T, McCollough C: Implementation and evaluation of a protocol management system for automated review of CT protocols. Journal of applied clinical medical physics 17(5):1–11, 2016CrossRef
29.
go back to reference Langer SG: A flexible database architecture for mining DICOM objects: the DICOM data warehouse. Journal of digital imaging 25(2):206–212, 2012CrossRefPubMed Langer SG: A flexible database architecture for mining DICOM objects: the DICOM data warehouse. Journal of digital imaging 25(2):206–212, 2012CrossRefPubMed
30.
31.
go back to reference US Department of Health and Human Services. Security standards: General rules, 46 CFR section 164.308(a)-(c) US Department of Health and Human Services. Security standards: General rules, 46 CFR section 164.308(a)-(c)
32.
go back to reference US Department of Health and Human Services. Technical safeguards. 45 CFR section 164–312 (b) US Department of Health and Human Services. Technical safeguards. 45 CFR section 164–312 (b)
35.
go back to reference Szczykutowicz TP, Siegelman J: On the same page—physicist and radiologist perspectives on protocol management and review. Journal of the American College of Radiology 12(8):808–814, 2015CrossRefPubMed Szczykutowicz TP, Siegelman J: On the same page—physicist and radiologist perspectives on protocol management and review. Journal of the American College of Radiology 12(8):808–814, 2015CrossRefPubMed
36.
go back to reference Szczykutowicz TP, Malkus A, Ciano A, Pozniak M: Tracking patterns of nonadherence to prescribed CT protocol parameters. Journal of the American College of Radiology 14(2):224–230, 2017CrossRefPubMed Szczykutowicz TP, Malkus A, Ciano A, Pozniak M: Tracking patterns of nonadherence to prescribed CT protocol parameters. Journal of the American College of Radiology 14(2):224–230, 2017CrossRefPubMed
37.
go back to reference Szczykutowicz TP, Rubert N, Belden D, Ciano A, Duplissis A, Hermanns A, Monette S, JanssenSaldivar E: A wiki based solution to managing your institutions imaging protocols. J Am Coll Radiol. 2016 Szczykutowicz TP, Rubert N, Belden D, Ciano A, Duplissis A, Hermanns A, Monette S, JanssenSaldivar E: A wiki based solution to managing your institutions imaging protocols. J Am Coll Radiol. 2016
38.
go back to reference Szczykutowicz TP, Rubert N, Belden D, Ciano A, Duplissis A, Hermanns A, Monette S, JanssenSaldivar E: A wiki based CT protocol management system. Radiol Manage. 2015 Szczykutowicz TP, Rubert N, Belden D, Ciano A, Duplissis A, Hermanns A, Monette S, JanssenSaldivar E: A wiki based CT protocol management system. Radiol Manage. 2015
39.
go back to reference Boland GW, Houghton MP, Marchione DG, McCormick W: Maximizing outpatient computed tomography productivity using multiple technologists. Journal of the American College of Radiology 5(2):119–125, 2008CrossRefPubMed Boland GW, Houghton MP, Marchione DG, McCormick W: Maximizing outpatient computed tomography productivity using multiple technologists. Journal of the American College of Radiology 5(2):119–125, 2008CrossRefPubMed
Metadata
Title
A General Framework for Monitoring Image Acquisition Workflow in the Radiology Environment: Timeliness for Acute Stroke CT Imaging
Authors
Timothy P. Szczykutowicz
Christina L. Brunnquell
Gregory D. Avey
Carrie Bartels
Daryn S. Belden
Richard J. Bruce
Aaron S. Field
Walter W. Peppler
Peter Wasmund
Gary Wendt
Publication date
01-04-2018
Publisher
Springer International Publishing
Published in
Journal of Imaging Informatics in Medicine / Issue 2/2018
Print ISSN: 2948-2925
Electronic ISSN: 2948-2933
DOI
https://doi.org/10.1007/s10278-018-0055-1

Other articles of this Issue 2/2018

Journal of Digital Imaging 2/2018 Go to the issue