title: Managing a Multisite Academic-Private Radiology Practice Reading Environment: Impact of IT Downtimes on Enterprise Efficiency.
abstract: OBJECTIVE
  The aim of this study was to assess whether the complex radiology IT infrastructures needed for large, geographically diversified, radiology practices are inherently stable with respect to system downtimes, and to characterize the nature of the downtimes to better understand their impact on radiology department workflow.
  
  
  METHODS
  All radiology IT unplanned downtimes over a 12-month period in a hybrid academic-private practice that performs all interpretations in-house (no commercial "nighthawk" services) for approximately 900,000 studies per year, originating at 6 hospitals, 10 outpatient imaging centers, and multiple low-volume off-hours sites, were logged and characterized using 5 downtime metrics: duration, etiology, failure type, extent, and severity.
  
  
  RESULTS
  In 12 consecutive months, 117 unplanned downtimes occurred with the following characteristics: duration: median time = 3.5 hours with 34% <1.5 hours and 30% >12 hours; etiology: 87% were due to software malfunctions, and 13% to hardware malfunctions; failure type: 88% were transient component failures, 12% were complete component failures; extent: all sites experienced downtimes, but downtimes were always localized to a subset of sites, and no system-wide downtimes occurred; severity (impact on radiologist workflow): 47% had minimal impact, 50% moderate impact, and 3% severe impact.
  
  
  CONCLUSIONS
  In the complex radiology IT system that was studied, downtimes were common; they were usually a result of transient software malfunctions; the geographic extent was always localized rather than system wide; and most often, the impacts on radiologist workflow were modest.
authors: Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; University Radiology, East Brunswick, New Jersey. Electronic address: mbecker@univrad.com.
authors: Murray
authors: M
authors: Becker
authors: Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; University Radiology, East Brunswick, New Jersey.
authors: Alberto
authors: A
authors: Goldszal
authors: University Radiology, East Brunswick, New Jersey.
authors: Julie
authors: J
authors: Detal
authors: University Radiology, East Brunswick, New Jersey.
authors: Judith
authors: J
authors: Gronlund-Jacob
authors: Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; University Radiology, East Brunswick, New Jersey.
authors: Robert
authors: R
authors: Epstein
mesh_terms: D017598:Efficiency, Organizational; D006801:Humans; D011216:Practice Management, Medical / Q000458:organization & administration*; D011331:Private Practice; D011872:Radiology Department, Hospital / Q000458:organization & administration*; D011873:Radiology Information Systems; D057188:Workflow
keywords: Radiology practice management; radiology IT; workflow