One of the driving factors influencing many practices in South Africa, to upgrade or refresh their PACS solutions, is the requirement to have mobile access to the radiology images. This demand comes from the radiologists themselves and the clinician who refer to them. Accessing radiology images on a mobile device is not new technology and many vendors have mobile apps or web viewers to provide the functionality.
For me the question is not about the technology but more about what other considerations a practice should take when deploying such a solution. In this article I would like to explore the need to create DICOM key objects, especially in large cross sectional imaging studies.
My question is does the advancements in mobile technology and accessing radiology images, increase the need for radiologist to save DICOM key objects while reporting? For some of you this may seem like a dumb question, because flagging significant “key” images, referenced in the diagnostic report is common practice and part of your everyday workflow, but for others I’m not so sure this practice is that common.
This may be due to a number of reasons.
The PACS application and how easy it is to flag the images, is it intuitive or does it require multiple mouse clicks?
A general lack of understanding of DICOM and DICOM Key objects and the benefits they bring to referring clinicians.
Adding additional steps to the reporting workflow may be perceived to impact on report turnaround times.
The general perception that clinicians want to view all the images in a study.
So why would mobile technology increase the need to flag significant images in large cross sectional studies? Well here are a few factors worth considering.
The first is how clinicians may use the device and under which circumstances. Beyond showing their patients how fancy they are I believe the true benefit of mobile technology allows clinicians to quickly reference patient images. They may be on call or doing a ward round and just want to see the report and some reference images, a mobile device is perfect for such scenarios, but scrolling through hundreds of images may be frustrating and time consuming. If the clinicians wanted to review the study in more detail they may prefer to do this in the comfort of their consulting rooms and on a larger monitor.
Secondly we need to consider mobile data costs. Depending on the connectivity in the hospital many clinicians will access images on a mobile device by using 3G or 4G mobile networks. In South Africa data is not cheap. I’m not so sure clinicians will be happy to use all their data on scrolling through 100’s of images trying to find the relevant ones. While if the radiologist has flagged key images the access would be so much easier and cheaper.
Thirdly with the introduction of RESTful services to the DICOM standard, called DICOMweb™, the future way we access images will change, and the audience wanting access to images will also change. Mobile devices will be at the forefront of using these services already evident with the development of patient portals, mobile apps and other web based applications. The use of web based technology is changing PACS as we know it. By radiologists flagging key images, other users and applications can gain quick access to these images without having to download the whole study. This has far reaching benefits across the imaging enterprise.
Flagging key images is a workflow function performed by radiologists during reporting, with the intention of making it easier to access significant images in a study. Mobile technology lends itself to consuming this type of DICOM object.
So yes creating DICOM key objects is an important function worth considering, and even more so when mobile access to image is deployed as part of the solution.