Workflow optimization: Study reports current trends and future directions

Increasing attention is focusing on workflow as an area where productivity within medical imaging can be maximized.

"Workflow optimization is one of the most overlooked areas of study within digital imaging, and it holds the greatest potential to improve productivity of clinicians, radiologists, technologists, and ancillary staff," said Dr. Bruce Reiner, a radiologist at the University of Maryland School of Medicine and the VA Maryland Healthcare System in Baltimore.

Many PACS adopters make the mistake of replacing film with PACS without carefully evaluating and optimizing workflow, he said. Workflow optimization is an attempt to improve operational efficiency by automation and task consolidation.

"In the end, workflow optimization should provide the ability to improve productivity, reduce staffing requirements, and potentially reduce errors in a number of tasks, such as data entry," Reiner said.

A number of factors should be considered, however, including the stochastic nature of the workload, availability of human resources, and the specific technologies being employed.

Reiner recently completed a study (J Digit Imaging 2002 Dec. 17 [epub ahead of print]) to determine how workflow can be optimized to improve technologist productivity by determining the complex relationship that exists between information technology and the radiologic technologist.

"This relationship takes on greater importance as more imaging departments are undergoing the transition from film-based to filmless operation," Reiner said.

The study reports a nationwide survey conducted to compare technologist workflow in film-based and filmless operations for all imaging modalities. The individual tasks performed by technologists were defined, along with the amount of time allocated to them. The index of workflow efficiency was determined to be the percentage of overall technologist time allocated to image acquisition, since this is the primary responsibility of the radiologic technologist.

"Preliminary analysis indicates technologist workflow in filmless operation is enhanced when compared with film-based operation, for all imaging modalities," Reiner said.

The specific tasks that require less technologist time in filmless operation are accessing data and retake rates, due to both technical factors and lost exams. Surprisingly, no significant differences were reported for the task of image processing.

Reiner said additional research is planned to evaluate the potential workflow gains achievable through workflow optimization software, improved systems integration, and automation of advanced image processing techniques.