An Evaluation of Digital Imaging Studies in an Outpatient Orthopedic Setting

Document Type : RESEARCH PAPER

Authors

The Rothman Institute, Philadelphia, PA, USA

Abstract

Background: Distribution of radiographic images in the outpatient setting on compact discs-recordable (CD-R) is
commonplace. Opening, manipulating and interpreting these can be challenging. This study evaluated the availability
and ease of use of CD-R to evaluate digital images in an outpatient orthopedic setting.
Methods: 118 CD-R containing diagnostic studies were evaluated by seven board certified orthopaedic surgeons.
Surgeon age and self-perceived “tech savvy” scores were tabulated using a visual analog scale (VAS). Surgeons
evaluated: ability and number of computers to open, autorun, and specific reader software. Time to load was recorded
in seconds, type of study, presence of “not for diagnostic use”, and if the disc required additional software. Studies were
graded using a VAS for ease of opening, ability to move from image to image and/or between series, to manipulate
the image, and to zoom and pan.
Results: There were 79 radiographs, 29 MRI’s, and 10 CT scans. Seven (6%) had to be manually opened and
four (3%) required software installation. Thirteen (11%) contained a warning that the studies should not be used for
diagnostic purposes. Six (5%) of the studies could not be opened. For the opened studies, average time from disk
insertion to image was 43.7 seconds overall (range 3-350), 65.3 seconds (range 21-191) for MRI and CT, and 35.2
seconds (range 5-177) for radiographs.
Conclusion: The present digital imaging systems include different software types and a variety of interfaces.
Improving this would decrease time and effort necessary to open and evaluate these studies, and improve
efficiency.
Level of evidence: III

Keywords

Main Subjects


1. Hosch RE, Rivard AL. Evaluation of self-contained
PACS viewers on CD-ROM. J Digit Imaging. 2014;
27(4):470-3.
2. van Ooijen PM, Guignot J, Mevel G, Oudkerk M.
Incorporating out-patient data from CD-R into the
local PACS using DICOM worklist features. J Digit
Imaging. 2005; 18(3):196-202.
3. van Ooijen PM, Roosjen R, de Blecourt MJ, van Dam R,
Broekema A, Oudkerk M. Evaluation of the use of CDROM
upload into the PACS or institutional web server.
J Digit Imaging. 2006; 19(Suppl 1):72-7.
4. Worthy S, Rounds KC, Soloway CB. Strengthening
your ties to referring physicians through RIS/PACS
integration. Radiol Manage. 2003; 25(2):18-22.
5. Miller AJ, Jones C, Liss F, Abboudi J, Kirkpatrick W,
Beredjiklian PK. Qualitative evaluation of digital hand
x-rays is not a reliable method to assess bone mineral
density. Arch Bone Jt Surg. 2017; 5(1):10-3.
6. Ö􀇆 zkan S, Mellema JJ, Ring D, Chen NC. Interobserver
variability of radiographic assessment using a mobile
messaging application as a teleconsultation tool. Arch
Bone Jt Surg. 2017; 5(5):308-14.
7. Tai‐Seale M, McGuire TG, Zhang W. Time allocation
in primary care office visits. Health Serv Res. 2007;
42(5):1871-94.
8. Juenemann S, Hasler C, Brunner R. Digital imaging
data on CD-R: a time trap for orthopaedic surgeons
in outpatient clinics. J Child Orthop. 2009; 3(1):59-62.