The pros and cons of implementing PACS and speech recognition systems

Area of Science:

• Radiology Informatics
• Health Information Technology
• Medical Imaging

Background:

• Elmhurst Hospital Center, a municipal teaching hospital, faced challenges with radiology report turnaround times and the "lost film" problem.
• The implementation of a hospitalwide image management system and speech recognition dictation system was initiated to address these issues.

Purpose of the Study:

• To evaluate the impact of implementing a radiology information system (RIS), picture archiving and communication system (PACS), and speech recognition on radiology report turnaround times.
• To assess the effects of these new technologies on clinician-radiologist communication and radiologist workflow.

Main Methods:

• Implementation of a HL-7 standards-based RIS, speech recognition dictation system, and PACS.
• Around-the-clock staffing of Board Certified radiologists.
• Comparison of report turnaround times before and after system implementation.

Main Results:

• Radiology report turnaround time improved dramatically, with 86% of examinations reported within 12 hours, compared to 3% previously.
• The percentage of unreported examinations dropped from 25% to less than 1%.
• Face-to-face clinician-radiologist consultations decreased significantly, and radiologist dictation productivity decreased by at least 25% due to speech recognition system use.

Conclusions:

• While PACS and speech recognition systems enhance overall hospital efficiency and patient care by reducing report delays, they negatively impact clinician-radiologist dialogue and radiologist productivity.
• The reduction in direct communication may lead to a less comprehensive understanding of clinical context for radiologists.
• Further strategies are needed to maintain effective radiologist-clinician communication in the era of advanced imaging informatics.