When radiologists drive to and from work, they can control the position of the car seat, the airflow, the lighting and the sound. But when they arrive at work, where they spend the majority of their day, the conditions are dramatically different.
- Eliot Siegel, M.D. First Filmless Reading Room Gets MakeoverThough perhaps not as provocative as the transformations people and homes undergo on reality TV, the world’s first filmless radiology reading room recently got a makeover of its own. The reading room at the Baltimore Veterans Affairs (VA) Medical Center now boasts a prototype showcase for interpreting images on a Picture Archiving and Communication System (PACS).
“We wanted to create an environment for radiologists that would simultaneously facilitate image interpretation and lower stress,” said Eliot Siegel, M.D., a professor and vice-chair of the Diagnostic Radiology Department at the University of Maryland School of Medicine and chief of imaging at the Baltimore VA.
Dr. Siegel’s research into radiology ergonomics has shown that as radiology departments began to move from film to PACS—and hospitals took out viewboxes and replaced them with computer workstations—radiologists started suffering more physical problems such as eye strain, neck strain, carpal tunnel syndrome and other repetitive stress injuries. “When radiologists drive to and from work, they can control the position of the car seat, the airflow, the lighting and the sound,” Dr. Siegel said. “But when they arrive at work, where they spend the majority of their day, the conditions are dramatically different. The seating is bad, there is no ventilation or temperature controls and the lighting is often abysmal.” Dr. Siegel’s research led to a grant from GE Healthcare, culminating in the planning and construction of the futuristic reading room. “I believe that it is possible to markedly improve our working environment and consequently increase productivity and accuracy for a relatively modest outlay of funds,” he added. GE Healthcare Marketing Manager Mark Morita, who works with doctors on emerging technologies, said Dr. Siegel came to mind immediately in the ergonomics area. “Millions of dollars have been spent on PACS and other technology without much being spent on the doctors who use PACS,” Morita said. Morita said GE Healthcare pulled together research leaders from a variety of perspectives about three and a half years ago to brainstorm ideas for optimizing a reading room. Design firms and architects created pictures of an ideal room with four to six pods. Different ideas and designs ranged from the kind of space a community hospital might require to a larger room to be used in a major metropolitan teaching hospital. Building the room at the Baltimore VA took about two and a half years, due to some unique constraints. “The reading room is centrally located in the radiology department, next door to the MR scanner,” said Morita. “We needed to soundproof the reading room to minimize the vibrations from the scanner.” Researchers also delayed opening the room in order to test and deploy components that feature innovative approaches to security, acoustics, lighting and computer-based environmental control. Virtual TourWhile functioning as the day-to-day work environment for radiologists, the Baltimore VA reading room is also a demonstration showcase. It has five separate mini-environments and six PACS workstations and features a variety of solutions for lighting, furniture, ergonomics and other new ideas in room design. Visitors can check out each workstation and select the lighting, acoustics and ergonomics they prefer. The reading room also was showcased at RSNA 2005, where Morita said it received a huge response. “Radiologists said they loved it but couldn’t get their hospitals to do something like this,” he said. “But I think there is going to be a groundswell of movement toward improving working conditions now that Dr. Siegel and his colleagues are proving, through research, the need for workstation improvements.” Futuristic items in the reading room include a biometric security code activated via fingerprint and LCD glass on the workstations that changes from transparent to opaque, depending upon whether or not the doctor wants to consult with colleagues or view images privately. Beamed-in or focused sound lets one radiologist listen to classical music while another listens to white noise, and computer monitors self-assess for quality and report the results to a central server and database. Desks and chairs can be raised and lowered for the comfort of the individual radiologist, and aromatherapy may be introduced too, said Dr. Siegel. The Baltimore VA reading room serves another important role as a laboratory for ergonomics research. “We can collect data to further our work on room design,” Dr. Siegel said. “To date, our research on monitor and background lighting has shown a significant impact on radiologists and their levels of stress, fatigue and eye strain. The new room allows us to monitor the number of cases read and the number of breaks taken to help improve overall productivity while maintaining our diagnostic accuracy.” Remaining on the Cutting EdgeDr. Siegel said he and his colleagues want to guard against the room becoming antiquated. “When we opened our reading room in 1993, it was the first of its kind. But without improvements and changes, it still could become obsolete quickly,” he said. Consequently, the new reading room will continually be refreshed with new systems as the technology changes. Companies are clamoring to showcase their products, Dr. Siegel said. To view take a virtual tour of the kind of radiology reading room built at the Baltimore VA, please visit the RSNA News Extras page at RSNA.org/Publications/rsnanews/extras.cfm. RSNA Extras
To document their reading room makeover, Eliot Siegel, M.D., and his radiology colleagues at the Baltimore VA put on their best “geek wear” to create the “Digital Eye for the Analog Guy” video. Following the format of Bravo television’s “Queer Eye for the Straight Guy” series, one doctor focused on sound, the others on furniture, lighting, ventilation and technology.
The video is available on the new RSNA News Extras page at RSNA.org/Publications/rsnanews/extras.cfm. Also available is a virtual tour of the kind of radiology reading room built at the Baltimore VA, as well as a presentation by Dr. Siegel to the UK Radiological Congress.
This rendering depicts an ideal, customizable "luxury" reading room, including a 6-way adjustable chair and adjustable work surfaces, controllable ambient lighting and an air circulation system. The unit also rotates completely. Similar to a luxury car, the unit allows users to set their individual preferences on an electronic security key device so the unit can be reset immediately for each physician.
Rendering courtesy of GE Healthcare.
RSNA 2006 to Feature Courses on Reading TechnologyRefresher courses at RSNA 2006 will look at designing reading rooms into the future. To register for these or any other courses, go to rsna2006.rsna.org and click on Registration, Housing and Courses. RC126
(Re)Designing Your Department (Basic Imaging Informatics)- Changes in the radiologist workstation and reading room for transition from film to filmless practice
- Optimizations for task-focused workstation design including ergonomic furniture, input devices, proper room and task lighting, noise abatement, ventilation and temperature controls
- How workstation and environment affect efficiency, fatigue and stress-related injuries
- How key drivers of architectural design and planning are changing in the digital department
- How to plan flexible imaging environments that can better accommodate the currently unknown medical technology that may be available in the future
- Design for multi-disciplinary collaboration among various specialists
RC130
Workstation Design (Advanced Imaging Informatics) (In Conjunction with the Society for Imaging Informatics in Medicine)- The most frequent complaints about workstations and why they occur
- Other industries and professions that have similar information-intensive and image-driven workflow
- Steps users can take to improve interaction with the workstation and software changes could to make the experience less fatiguing
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