Summary
Objectives: To assess the impact of introducing a new Picture Archiving and Communication System
(PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes;
and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency
Department (ED).
Methods: We employed a mixed method study design comprising: (i) semi-structured interviews
with Medical Imaging Department staff; and (ii) retrospectively extracted ED data
before (March/ April 2010) and after (March/April 2011 and 2012) the introduction
of a new PACS/RIS. TATs were calculated as: processing TAT (median time from image
ordering to examination) and reporting TAT (median time from examination to final
report).
Results: Reporting TAT for x-rays decreased significantly after introduction of the new PACS/RIS;
from a median of 76 hours to 38 hours per order (p<.0001) for patients discharged
from the ED, and from 84 hours to 35 hours (p<.0001) for patients admitted to hospital.
Medical Imaging staff reported that the changeover to the new PACS/RIS led to gains
in efficiency, particularly regarding the accessibility of images and patient-related
information. Nevertheless, assimilation of the new PACS/RIS with existing Departmental
work processes was considered inadequate and in some instances unsafe. Issues highlighted
related to the synchronization of work tasks (e.g., porter arrangements) and the material
set up of the work place (e.g., the number and location of computers).
Conclusions: The introduction of new health IT can be a “double-edged sword” providing improved
efficiency but at the same time introducing potential hazards affecting the effectiveness
of the Medical Imaging Department.
Citation: Georgiou A, Prgomet M, Lymer S, Hordern A, Ridley4 L, Westbrook J.The impact of a
health IT changeover on Medical Imaging Department work processes and turnaround times:
a mixed method study. Appl Clin Inform 2015; 6: 443–453
http://dx.doi.org/10.4338/ACI-2015-01-RA-0014
Keywords
Medical Imaging - Picture Archiving and Communication Systems - Radiology Information
Systems - Evaluation - Health Informatics