A Web-based Flexible Communication System in Radiology
 
Authors:
Alexander V. Rybkin, MD, University of California San Francisco; Mark W. Wilson, MD
 
Background:
A web-based system for rapid multidirectional communication has been created in the Radiology department at San Francisco General Hospital. The system allows messaging among various members of the radiology department, such as residents, fellows, attending physicians and technologists, as well as other members of the hospital community, such as Emergency Department and Trauma physicians and nurses. Instead of being tied to a particular workflow, this system provides a flexible communication infrastructure (based on the principles of Service Oriented Architecture), which can be easily adapted for different functions and user roles.
 
Evaluation:
The system has, so far, been configured to successfully support the standard “wet reading” workflow, to support marking and tracking of critical results, as well as multiple educational and quality improvement workflows. Further, the system allows non-radiology users, such as referring providers and nurses, to access the list of studies to be performed in the department. In the 17 months of operation, the system has gained over 1,700 users (virtually all providers at our institution), and has been accessed over 36,000 times by radiologists, and over 31,000 times by non-radiologists. It has become an integral part of the radiology department operations and non-radiology clinical workflows.
 
Discussion:
Web-based systems for communicating “wet reading” and critical results are becoming common in radiological practice. Unlike most existing software, our system is not a task-specific application, but a multipurpose communication system. It is able to effectively accommodate multiple workflows and user roles through configuration (without additional programming). This flexibility has helped this system to be rapidly and widely adopted within our enterprise. Pleuripotency of the system has the additional benefit of allowing extensive monitoring and documentation of processes that was never documented before.
 
Conclusion:
This presentation reports a successful design and implementation of a flexible communication system based on the principles of Service Oriented Architecture. Our goal is to underscore the importance of flexibility as a goal in design of computerized communication systems in radiology.
 
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