Medicine on the Go: Rapid Access to Radiology Images with a Mobile Image Viewer



Ross Mitchell* Ross Mitchell*, Mayo Clinic Arizona, Scottsdale, United States
Amy Hara, Mayo Clinic Arizona, Scottsdale, United States
Miao He, Arizona State University, Phoenix, United States
Bart Demaerschalk, Mayo Clinic Arizona, Scottsdale, United States
Teresa Wu, Arizona State University, Phoenix, United States


Track: Research
Presentation Topic: Mobile & Tablet Health Applications
Presentation Type: Poster presentation
Submission Type: Single Presentation

Last modified: 2013-09-25
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Abstract


Background: Accurate and rapid interpretation of medical images is critical after hours and in acute care settings. Unfortunately, rapid image access, especially when outside the health care facility, is often hampered by limited access.

ResolutionMD, (Calgary Scientific Inc.) is a HIPPA compliant mobile tele-radiology system with FDA and Health Canada clearance, and CE Marking. It provides workstation-class functionality to remote web browsers, iOS and Android devices. Importantly, DICOM images are not transferred or stored on the remote device. The purpose of this study was to compare mobile ResolutionMD to two desktop image-viewing systems widely available at our institution.

Objectives: Compare three image-viewing products in terms of diagnostic quality, access time to images, technical reliability, and clinician satisfaction.

Methods: 20 clinicians participated in this study. Each had an Apple iPad, 3rd generation, 32 MB, 3G or 4G cellular networking, and an installed ResolutionMD application. Participants also had access to two desktop applications, a commercial picture archiving and communication system (GE Centricity) and an in-house developed image viewing system (Qreads). Radiologists had remote access to Centricity from home workstations. All participants used screen-sharing software for remote access to Qreads.

Surveys were performed prior to, and 30 days after, the deployment of ResolutionMD. For 7 consecutive days, participants collected data for each image access event including time, location, device used, access type, image viewing system used, time to view the first image, technical issues, diagnostic confidence, and ease of use. Both diagnostic confidence and ease of use were recorded as continuous values ranging from 0 (worst) to 4 (excellent). An analysis of variance with post-hoc correction was used to evaluate differences in continuous variables.

Results: 17 clinicians (7 radiologists, 4 surgeons, 4 neurologists, 2 oncologists, 2 physician assistants) provided data on 552 image-viewing events. For non-radiologists, most image access occurred during work hours while in the hospital (68%). Radiologists were instructed only to record use when on-call, thus the majority of their data was obtained after hours and when outside the hospital (83%). Diagnostic confidence scores were good-excellent for all 3 systems. Ease of use scores for Centricity, ResolutionMD and Qreads were: 3.7, 3.4 and 2.8, with only the Qreads score rated as significantly different (p < 0.001). Technical issues occurred in: 6%, 12% and 28% of events for Centricity, ResolutionMD, and Qreads, respectively. The times for non-radiologists to access images using Centricity, ResolutionMD and Qreads were: 8.0, 2.1 and 4.4 minutes, respectively (p < 0.001). The times for radiologists to access images using Centricity, ResolutionMD and Qreads were: 12.3, 2.7 and 17.5 minutes, respectively (p < 0.001). 85% of participants expressed a moderate to high desire for permanent implementation ResolutionMD.

Conclusions: A mobile image viewer (ResolutionMD) provides high clinician satisfaction, significantly faster image access, comparable diagnostic confidence and ease of use compared with standard of care image viewers. Mobile access to diagnostic radiology images could result in faster patient throughput, lower health care costs and improved patient outcomes compared with currently available systems.




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