title: Improved efficiency in clinical workflow of reporting measured oncology lesions via PACS-integrated lesion tracking tool.
abstract: OBJECTIVE. Imaging provides evidence for the response to oncology treatment by the serial measurement of reference lesions. Unfortunately, the identification, comparison, measurement, and documentation of several reference lesions can be an inefficient process. We tested the hypothesis that optimized workflow orchestration and tight integration of a lesion tracking tool into the PACS and speech recognition system can result in improvements in oncologic lesion measurement efficiency. SUBJECTS AND METHODS. A lesion management tool tightly integrated into the PACS workflow was developed. We evaluated the effect of the use of the tool on measurement reporting time by means of a prospective time-motion study on 86 body CT examinations with 241 measureable oncologic lesions with four radiologists. RESULTS. Aggregated measurement reporting time per lesion was 11.64 seconds in standard workflow, 16.67 seconds if readers had to register measurements de novo, and 6.36 seconds for each subsequent follow-up study. Differences were statistically significant (p < 0.05) for each reader, except for one difference for one reader. CONCLUSION. Measurement reporting time can be reduced by using a PACS workflow-integrated lesion management tool, especially for patients with multiple follow-up examinations, reversing the onetime efficiency penalty at baseline registration.
authors.affiliation: 1 Department of Clinical Informatics Solutions and Services, Philips Research North America, 345 Scarborough Rd, Briarcliff, NY 10510.
authors.forename: Merlijn
authors.initials: M
authors.lastname: Sevenster
authors.forename: Adam R
authors.initials: AR
authors.lastname: Travis
authors.forename: Rajiv K
authors.initials: RK
authors.lastname: Ganesh
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.forename: Ursula
authors.initials: U
authors.lastname: Kose
authors.forename: Joost
authors.initials: J
authors.lastname: Peters
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Chang
mesh_terms: D004526:Efficiency; D005500:Follow-Up Studies; D006801:Humans; D009369:Neoplasms / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011859:Radiography; D011873:Radiology Information Systems; D012984:Software; D013996:Time and Motion Studies; D057188:Workflow
keywords: measurement management; quantitative imaging; structured reporting; time-motion analysis