Workflow assessment of digital versus computed radiography and screen-film in the outpatient environment

An objective assessment and comparison of computed radiography (CR) versus digital radiography (DR) and screen-film in terms of workflow, productivity, speed-of-service, and potential cost justification for imaging ambulatory patients is presented. Perceived ease-of-use and workflow of each device is collected via a technologist opinion survey. Productivity is measured as the rate of patient throughput from normalized timing studies. The overall speed-of-service is calculated from the time of examination ordering as stamped in the radiology information system (RIS), to the time of image availability on the picture archiving and communication system (PACS), to the time of interpretation rendered (from the RIS). Comparative results of screen-film (analog) versus a CR reader and a DR dedicated chest unit show a higher patient throughput for the digital systems. A mean of 10.7 patients were moved through the DR chest room per hour, and 9.2 patients per hour using CR, versus 8.2 patients per hour for the analog device. Measured time to image availability for interpretation is much faster for both DR and CR versus screen-film, with the mean minutes to image availability calculated as 5.7 +/- 2.5 minutes for DR, 6.7 +/- 1.5 minutes for CR, and 29.2 +/- 14.3 minutes for screen film. DR and CR can improve workflow and productivity over analog screen-film in a PACS for delivery of projection radiography services in an outpatient environment, but DR requires high volume to be cost effective over CR.