Roentgen WorkFlow - WORKFLOW AND COMMUNICATIONS

The Roentgen Works Flow implements workflow rules for studies and relevant study information to flow from multiple, local sites to radiologists who are authorized to read for that site and modality type. Roentgen Works also handles the communication between radiologists, referring physicians and local technologists, and it can support the radiologists’ reporting process as well.

Workflow diagram

Workflow diagram

Upon receipt of a study, the RWF creates an order ticket. The “order” can trigger a DICOM request for relevant comparison studies from a server. A site coordinator accesses The RWF Server over a secure web connection and views a page of “incomplete” studies. They indicate the study status, the requested service (such as final, wet read or over-read request) on each study and enter any missing information, such as referring physician contact numbers. Once a study has been “completed” in this manner, it is automatically assigned to the appropriate radiologist based on their credentials and their current workload / availability. The study goes into a Queued status once it has been assigned and the study starts being sent to the assigned radiologist. Each radiologist is associated with an AE Title and the study is stored to that device. This allows radiologists to use their DICOM workstation of choice.

Once the entire study has been stored, the status changes to “delivered”.

Sample Radiologist’s Delivered Screen

Sample Radiologist’s Delivered Screen

Radiologists select studies from a “delivered” list, opening the study into integrated workstations and launching the dictation process. BRIT provides integration to both BRIT and Osirix workstations. On the dictation screen, there is also a timeline showing comparison studies for this patient from integrated PACS. With integration, it can utilize an IHE Patient Discovery process to access patients from outside system, even if the patient has a different ID. These studies may be selected for viewing as well. Next, the radiologist can put a study on hold and select the reason from a site customizable list. The study then shows up on an Actions Needed List at the local site. The radiologist may also call out an urgent finding using the browser-based tools, tools integrated with the workstation or via parsing of a radiologist’s report. This initiates BRIT’s urgent finding workflow, which may include the optional auto-phoning of contacts and reading of the finding. The urgent findings can be acknowledged via the phone or via the web interface. All steps are documented.

Sample Result of Urgent Calling Panel

Sample Result of Urgent Calling Panel

The radiologist may use BRIT’s voice dictation solution, an integrated Dragon Voice Recognition Solution or their dictation solution of choice. Once a report is available to Roentgen Works via one of these tools or via an HL-7 report message, Roentgen Works can email a link of the report to the referring physician / location or optionally, fax it. The reports are available via the zero foot-print browser to users with permissions to view that patient. Permission is automatically granted to the referring physician of order, physicians in the same physician group, users associated with the ordering location or those manually selected.

Management tools include workload tools for radiology managers to gauge the current workload for each doctor. Managers can also reassign studies. All management tools can view statistics from individual sites or for all sites and the statistics can be downloaded into excel for further analysis.

Sample Radiologists’ Workload Screen

Sample Radiologists’ Workload Screen

Doctors and technologists from referring sites can access the web server and view the images and reports. The reports can be downloaded as pdfs. The timeline of older studies can be made available to them same as the radiologists. Radiologists always have access to the viewer, as well and they can sign reports from the application.

Sample Browser Screen with timeline and report, not yet signed-off

Sample Browser Screen with timeline and report, not yet signed-off