IRIS: an experimental multimedia workstation linking the departments of emergency medicine and radiological sciences

An experimental version of a multimedia medical communication system called IRIS (Integrated Radiological Information System) operated between the Department of Emergency Medicine and the Department of Radiological Sciences at the Ottawa Civic Hospital for 7 weeks during April and May 1989. IRIS is being developed to enhance communication between clinicians and radiology consultants to improve diagnosis and reporting. IRIS supports the capture and distribution of digitized x-ray images and voice reports in the form of "electronic" patient folders that can be accessed at physician workstations throughout the hospital. It also supports on-line consultation between the radiologist and clinician through synchronized workstation operation. Each workstation has 1) a high resolution image screen to display documents and x-ray images; 2) a control screen to access patient folders; 3) a hands-free telephone to dictate, play back reports, and enable realtime consultation between physicians. From an emergency physician's (EP) perspective, such an involved system must allow the viewing and manipulation of images in order to reach diagnostic conclusions and support efficient interchange between the clinician and the consultant radiologist, yet be easy to learn and use without disruption of clinical services. After a briefing session, the trial took place and analogue and digital images were compared. An observer-assistant recorded how EPs used the system and was available to assist the EP. After the trial, six EPs participated in an extensive debriefing interview in order to evaluate the system. Overall, the system was found to be easy to learn and to use, and there was a clear benefit to the full consultation report and the ability to directly consult with the radiologist located at a remote station.