Radiology pulls the plug

Wireless PDAs and tablet PCs are poised to improve radiology workflow, according to a study presented at the Society for Computer Applications in Radiology meeting earlier this month.

Wireless devices provide the ideal tool for a mobile radiologist, said Dr. Khan Siddiqui, a radiologist at Geisinger Medical Center in Danville, PA.

"The attraction is access to reference and educational tools in your pocket," he said. "The ability to access the EMR and RIS, as well as dictate reports and sign them anywhere anytime within the hospital, is now a reality."

Recent technological advances and decreases in cost have encouraged some hospitals to begin deploying wireless local area networks (WLAN). Currently, WLAN technology is used mostly by clinicians during rounds. PDA use is still basically untried in radiology.

Siddiqui evaluated wireless (802.11b) PDAs and portable computers for routine use in radiology practice. Two radiologists and two residents were given PDAs for five working days to use as much as possible for routine work, although not for primary reads.

Radiologists were able to access the EMR to get patient information during interpretation or during teaching rounds. They were also able to retrieve images from the hospital PACS.

They found the best feature was the ability to dictate studies on the PDA, which was synchronized with the dictation system server. The capability to sign reports anywhere, anytime from the RIS was another favorite.

The increase in PDA size due to necessary 802.11b antenna expansion packs was universally disliked, since the device no longer fit in a pocket. Battery life was another liability.

Security is a concern. PDAs containing medical data cannot be carried home due to the constraints of the Health Insurance Portability and Accountability Act.

Residents found PDAs useful to log procedures and interesting case data, as well as to access radiology e-books. Radiologists uniformly agreed that image quality on small PDA screens is still insufficient for primary reads, although tablet PCs were better for image viewing. Add-on diagnostic-grade displays are on the horizon.

"As PDAs become more robust, we will see more uses unique to radiology," Siddiqui said.

He predicts every PDA device will soon have ubiquitious wireless connectivity (phone, WiFi, Bluetooth), e-mail, text and voice messaging, and speech recognition built in. Within 15 years, PDAs will be built into clothing, belts, or shoes.

"All information will be accessible instantaneously, projected in high-resolution using next-generation retinal projection systems," Siddiqui said.

Hand gestures, speech recognition, and perhaps direct neuronal input will control data entry and retrieval, he said.