Automated examination notification of emergency department images in a picture archiving and communication system

This study compares the timeliness of radiology interpretation of Emergency Department (ED) imaging examinations in a picture archiving and communication system (PACS) before and after implementation of an automated paging system for notification of image availability. An alphanumeric pager for each radiology subspecialty (chest, pediatrics, bone, neuroradiology, and body) was used to alert the responsible radiologist that an ED imaging examination is available to be viewed on the PACS. The paging system was programmed to trigger off of the PACS database when an image is received on the appropriate radiology display station. The pager message includes the radiology accession number and examination description (such as chest, two-view, or c-spine, etc). The PACS paging tool performance was assessed by calculating the time elapsed, for each ED imaging examination, from the Time Imaged to the Time of Interpretation, where the Time Imaged is the actual image completion time measured at the imaging modality, and the Time Interpreted is the time a radiology interpretation is rendered to the ED, and is measured from the Radiology-to-ED fax time stamp. These measures were analyzed pre- and post-paging system implementation to determine any impact of the automated notification tool on radiology service turnaround time. Results show an improved radiology response time from image completion to interpretation rendered to ED clinicians, down from hour(s) to minutes, with the automated paging examination notification system. Examinations are read by the appropriate radiology specialty section in a more timely fashion, and fewer cases go unread by radiology.