Simple macros can eliminate repetitive mouse operations

Reducing the risk of repetitive motion injury from long hours at a workstation can be achieved inexpensively via an open source freeware program that carries custom hotkey and mouse/cursor operations beyond what commercial user interfaces allow, according to Dr. Lawrence Yao, formerly director of MRI at the National Institutes of Health Clinical Center and now president of teleradiology service MRIDx.

The ubiquity of filmless operations and teleradiology, increasing workloads and image data volumes, and dependence on nonergonomic computer user interfaces puts radiologists at serious risk for repetitive stress injury. Yao has reduced hundreds of daily mousing operations by customizing his keyboard using AutoHotkey, a free program developed to run on Windows.

In the past, when Yao wanted to approve a report, he'd use the mouse to do so and then use the mouse again to activate the next report. Today, both steps are done with one keyboard stroke, thanks to a hotkey macro. Assuming one goes through 50 reports a day, that change eliminates approximately 2300 mouse clicks a year.

Yao also shaved mouse clicks from the process involved in launching cross-sectional MRI studies to be viewed on a workstation. Using the vendor's graphical user interface, the process took five mousing operations before the study actually appeared. Now, just hitting a single key eliminates all five mouse operations, as the study appears ready for inspection. Again, assuming 50 studies per day at 230 days per year, this eliminates 57,500 mouse operations, he said.

"My own pain motivated me to find solutions. The best one is to modify the interaction with the software system to use the mouse less frequently. That has a much greater impact on reducing hand and wrist problems than ergonomic factors such as posture and furniture," Yao told Diagnostic Imaging.

The most common injury to radiologists manipulating studies all day is hand and wrist pain, generally related to using some sort of mouse. Tendinitis is also common, especially in the second finger, said Yao, who presented the study at the 2007 American Roentgen Ray Society meeting.

Yao has created customized scripts to use with several browser-based applications. Usually, within each script, a large number of macros could be compiled together. In his daily practice, he uses between five and eight simple scripts all the time.

"If we work for institutions or large businesses, we are generally at the mercy of whoever acquires the equipment and software. Frequently, we work on equipment that is not designed or optimized to efficiently facilitate our work," Yao said. "That's where a lot of problems with repetitive motion are created or worsened, just by having to use-at a high volume-software interfaces that are not production-oriented in their design."