Uncoupling image from case selection speeds up teaching file development

Integrating teaching file creation into a busy radiologist's workflow just got a little bit easier. Radiologists can save time by whittling down the steps used to creating a file, relegating more time-consuming tasks such as image selection for later.

"Much of the radiology department has been transformed by digital technology, but the teaching file often gets left behind," said Dr. Barton F. Branstetter IV, associate director of radiology informatics at the University of Pittsburgh Medical Center.

Workflow integration is typically the culprit in this dilemma, Branstetter said. Because selecting a case and then immediately selecting the right image can take a lot of time, radiologists may let good cases go by because they just don't want to interrupt workflow.

Branstetter outlined the three basic steps for digital teaching file creation used at his institution during an informatics scientific session:

• case selection: encounter case, flag case, store case

• authoring: image creation, image selection, image manipulation, annotation, legend creation, text creation, image inclusion, multimedia inclusion, and reorganization

• publication: editing, validation, publication

The workflow was also presented at an infoRAD exhibit.

Image selection should come during the authoring phase of the process and not the case selection phase, he said. This approach allows physicians to quickly select cases and then go back to select the appropriate image when they have more time.

Some PACS and digital teaching file options force image selection during case selection, however, because integration between the teaching file program and the PACS is lacking, according to Branstetter.

To solve this dilemma, the medical center has a PACS that feeds a digital teaching file database and authoring tools that then link to a PACS, allowing radiologists full access to the PACS when they do go back to select an appropriate image.

The advantages to later image selection include improved reading room workflow and improved image selection, Branstetter said.

For more information from the online Diagnostic Imaging archives:

Digital case file system collects interdisciplinary 'intellectual capital'

Teaching file system cuts through cumbersome process

Teaching file system uses e-mail to share knowledge