title: Selection and pilot implementation of a mobile image viewer: a case study.
abstract: BACKGROUND
  For health care providers, mobile image viewing increases image accessibility, which could lead to faster interpretation/consultations and improved patient outcomes.
  
  
  OBJECTIVE
  We explored the technical requirements and challenges associated with implementing a commercial mobile image viewer and conducted a small study testing the hypothesis that the mobile image viewer would provide faster image access.
  
  
  METHODS
  A total of 19 clinicians (9 radiologists, 3 surgeons, 4 neurologists, and 3 physician assistants) evaluated (1) a desktop commercial picture archiving and communication system (PACS) viewer, (2) a desktop viewer developed internally over 20 years and deployed throughout the enterprise (ENTERPRISE viewer) and (3) a commercial Food and Drug Administration class II-cleared mobile viewer compatible with Web browsers, tablets, and mobile phones. Data were collected during two separate 7-day periods, before and after mobile image viewer deployment. Data included image viewer chosen, time to view first image, technical issues, diagnostic confidence, and ease of use.
  
  
  RESULTS
  For 565 image-viewing events, ease of use was identical for PACS and mobile viewers (mean 3.6 for all scores of a possible 4.0), and significantly worse for the enterprise viewer (mean 2.9, P=.001). Technical issues were highest with the enterprise viewer (26%, 56/215) compared with the mobile (7%,19/259, P=.001) and PACS (8%, 7/91, P=.003) viewers. Mean time to first image for the mobile viewer (2.4 minutes) was significantly faster than PACS (12.5 minutes, P=.001) and the enterprise viewer (4.5 minutes, P=.001). Diagnostic confidence was similar for PACS and mobile viewers and worst for enterprise viewer. Mobile image viewing increased by sixfold, from 14% (37/269, before the deployment) to 88.9% (263/296, after the deployment).
  
  
  CONCLUSIONS
  A mobile viewer provided faster time to first image, improved technical performance, ease of use, and diagnostic confidence, compared with desktop image viewers.
authors.affiliation: Medical Imaging Informatics, Department of Radiology, Mayo Clinic, Scottsdale, AZ, United States. zwart.christine@mayo.edu.
authors.forename: Christine Marie
authors.identifier: http://orcid.org/0000-0001-5044-2331
authors.initials: CM
authors.lastname: Zwart
authors.forename: Miao
authors.identifier: http://orcid.org/0000-0003-4048-0275
authors.initials: M
authors.lastname: He
authors.forename: Teresa
authors.identifier: http://orcid.org/0000-0002-0529-7048
authors.initials: T
authors.lastname: Wu
authors.forename: Bart M
authors.identifier: http://orcid.org/0000-0001-7262-817X
authors.initials: BM
authors.lastname: Demaerschalk
authors.forename: Joseph Ross
authors.identifier: http://orcid.org/0000-0002-2340-4708
authors.initials: JR
authors.lastname: Mitchell
authors.forename: Amy K
authors.identifier: http://orcid.org/0000-0001-8097-1509
authors.initials: AK
authors.lastname: Hara
keywords: Pilot projects; Radiology; Telemedicine; Teleradiology; mHealth