Imaging Technology News - November/December 2008 - (Page 49)

Advances In RIS/PACS do different things – this slows down the image evaluation process for the radiologist. For instance, on the system that I usually use, the right mouse controls window and level; but on another system that we use, the middle button controls window and level, and if I accidentally click the right mouse, it takes me to a menu that is very hard to get out of again. Not all systems are easily customizable to instruct the mouse on what specific commands to use. The more usercustomizable the controls are, the better the system. Web 2.0 Tools for Radiologists Some Web 2.0 tools commonly used among consumers to better communicate and gather information could be used to enhance the radiologists’ workflow. These include: 1. Virtual World: A virtual world can be created by a radiologist to serve a couple of purposes. In a virtual world, a patient can simulate a CT scan and see what it is like prior to going in for the exam. This could improve throughput by better preparing a patient. A virtual world may allow a physician to offer medical education or train medical students and nurses in the virtual medical center. 2. Open-Source Medical Notes: An open-source notes project for medical students and doctors in training is PimpNotes.org. The site hosts free notes, guides, books or other materials created by and for medical students and residents. 3. Medical Wikis: A physician may find it useful to browse some of the medical wikis created and maintained by physicians from around the world. You may start with Ask Dr. Wiki – www.askdrwiki.com. 4. Communities: Exchange cases or compare findings at www.MyPACS.net - a site used at many hospitals. Some even call it “YouTUBE for radiology.” You might also join one of the medical communities at www.Tiromed.com, a knowledge and mentor network for physicians and students of medicine. There is also Sermo.com (www.sermo.com), a forum for physicians to share their latest medical insights. 5. Medical Blogs: Medical blogs provide content and express opinion on healthcare that you can never find in a medical paper. A few useful radiology blogs are: Dalai Blog (www.doctordalai.blogspot.com) PACS-aholic (www.pacs-aholic.com.blogspot.com) Spidey Knows (www.spideyknows.blogspot.com) Other medical blogs include: Doc in the Machine; EmergiBlog; Kevin, M.D.; Tales from the Womb and The Gene Sherpa. 6. Blog Carnivals: For those short on time, blog carnivals collect the best posts on a subject. Try Grand Rounds, Mendel’s Garden and Gene Genie. 7. Medical Search Engines: When searching for radiology references on Google or Yahoo brings you to a dead end, or one that charges you a fee, try: www.Yottalook.com. Other medical search engines that use peer-reviewed sources and sites selected by experts are Healthline, MedHunt, Mamma Health and Omni Medical Search. 8. Medical Podcasts and Videocasts: Podcasts and videocasts add to the mix of information sources. Medical podcasts: ACC Conversations with Experts; Journal of the American Medical Association; New England Journal of Medicine; Lancet; John Hopkins Medicine; and iCritical Care Podcast. Videocasts: National Institute of Health VideoCasting and Cleveland Clinic Videocast. 9. Continuing Medical Education: Find free medical videos on VideoJug, medical image databases on Flickr or find interesting cases at Clinicalcases.org. 10. International Outreach: Humanitarian missions and other like-minded doctors are using the Internet for educational outreach in developing nations. Again, using MyPACS.net, physicians in developing nations that may lack the expertise to diagnose pediatric cases are invited to upload those cases to MyPACS. Volunteer radiologists respond with educational opinions. Hanging Protocols Functional hanging protocols is another issue. The concept of hanging protocols sounds good, but in day-to-day practice they are often so difficult to set up or they fail so frequently, that many disable the function. Interoperability Interoperability can be an issue particularly from different modalities. Some PAC systems have trouble with the images coming from different modalities, or from modalities from different vendors. On our Merge system at our imaging centers we have no troubles, but I have observed problems with other systems. Viewing All the Images Another feature of PACS that I think would be useful is feedback about whether you have viewed all the images in a study. You may be looking at a study that consists of one or two images, or 450 images. Your responsibility to the patient requires that you look at every single image. With the “old days” of X-ray films, it was easy to see the entire study hanging on the viewboxes, and readily identify everything you had to look at. Now, it is pretty easy to miss a series or some images in a series, unless the PACS gives you a simple way to cycle through all of them. With a good PACS, when you are closing the exam, it would be optimal to have a warning that you haven’t seen all of the images. I know this feature is on the radar screen of vendors. Although our system does not have this feature, it does have a simple system to cycle through the entire study. Web 2.0 Tools Our current RIS/PACS from Merge has the ability to send typed messages back and forth between radiologists – similar to instant messenger. Anyone signed in to a workstation can send and receive these instant messages. There are instances where it is more useful than the phone because the other person can finish what he/she is doing before responding. Also, you can give them typed information, such as a name or number that is more cumbersome to give over the telephone. The message sits on the receiving radiologist’s screen until he/she responds. We find this is a useful way to communicate even when there are only two people working, but would be especially helpful with several radiologists working at different sites. Decision Support Tools Decision support tools are either a reference to a peer review journal or reference to images of similar cases. For many radiologists and residents, the modern technique to search for reference information is to access Google. People don’t get up and refer to a book anymore. It would be quite useful to have something more than what Google provides, which is looking for the diamond in the rough. In many instances, Google may find pertinent abstracts, but you aren’t allowed to see the full text and images. While there are free radiology reference sites such as MyPACS.net, where findings by radiologists are uploaded, and Yottalook.com, the Google site for radiology, Dr. Wells added that there is something lost by radiologists not using books. Lots of times the information on the Internet is superficial or just flat out wrong. The physicians in training rely so much on the Internet and have given up on using reference books. I think that the combination of the two is probably optimal – using the web to supplement reference books. The Internet by itself is not a complete substitute for textbooks and journals. Reference: Robert G. Wells, M.D., founder of Pediatric Diagnostic Imaging, holds an associate clinical professor position at the Medical College of Wisconsin and has been active in the pediatric radiology community for over 20 years. He is active in medical student, resident and fellow education. Dr. Wells has published numerous scientific articles and book chapters. He also coauthored a comprehensive pediatric radiology textbook. He is a frequent participant at conferences, seminars and other educational meetings. ITN For More Information www.pdi-imaging.com www.mypacs.net www.yottalook.com ITNonline.net | Nov/Dec 2008 | ITN | 49 http://www.PimpNotes.org http://www.askdrwiki.com http://www.MyPACS.net http://www.Tiromed.com http://www.Sermo.com http://www.sermo.com http://www.doctordalai.blogspot.com http://www.pacs-aholic.blogspot.com http://www.spideyknows.blogspot.com http://www.Yottalook.com http://www.Clinicalcases.org http://www.MyPACS.net http://www.Yottalook.com http://www.MyPACS.net http://www.pdi-imaging.com http://www.mypacs.net http://www.yottalook.com http://www.ITNonline.net

Table of Contents Feed for the Digital Edition of Image Technology News - November 2008

Image Technology News - November 2008 Contents RSNA CT Systems Imaging An Image is Worth a Thousand Words Ultrasound Systems MBI Takes on FFDM Trouble in Multi-PACS Paradise When is Appropriateness Criteria Appropriate? RIS/PACS in a Web 2.0 World Digital Mammography Helps Center Continue its Commitment to the Best in Patient-Focused Breast Cancer Cardiovascular Imaging Systems PARCA Extends Expertise to World PACS Market

Image Technology News - November 2008

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