Radiologists reading on home workstations have become a permanent feature of the post-COVID modern medical landscape. Whether every day or just one or two days a week, the flexibility of working at home is irresistible to many top physicians – and leading radiology groups and imaging facilities should be thinking about the best ways to accommodate and support them.
I can say from experience, having managed the reading environment for vRad’s 500 radiologists over the past 12 years, that supporting work-from-home options can be time consuming for both the radiologists and the IT team. One area where this comes into play is the workstation displays used by the radiologist to view images. It is up to the facility to ensure that radiologists are reading from displays that are appropriately calibrated, lit, cleaned, and maintained. Without the right tools, managing this can be labor intensive, chewing into the radiologists’ productivity, as well as that of the IT support team.
We’re in the middle of rolling out Barco internet-enabled diagnostic displays to all 500 of our radiologists. If you’re a practice employing remote readers or a radiologist considering remote work, I’ll share with you the significant challenges we’re solving with these new monitors.
‘DIY’ solutions can result in radiologist downtime—and lots of headaches
With the rapid shift toward remote reading, tech teams may find themselves using “do-it-yourself” methods in a pinch. Years ago, the vRad team would perform brightness checks, to comply with New York state’s strict display requirements, by having our radiologists use a photometer to measure the light coming out of the monitors. This also burdened the radiologists with keeping track of the measurements.
I still remember a time when a radiologist couldn’t get an accurate reading because there was some light coming in through a curtain in his home office. He tried unsuccessfully over and over. Eventually, the solution was to put a blanket over his head to get the needed measurement.
If you go the DIY route, be forewarned that the process is so onerous there will inevitably be times when radiologists simply put off the evaluation. While it is easy to understand why, if they don’t do it in time to meet mandatory requirements, you’ll be forced to turn their accounts off. Extreme, yes, but monitor calibration is mandatory.
For a large and distributed practice like vRad, the process was incredibly cumbersome and certainly not scalable.
The ‘gold star’ option: internet-connected diagnostic monitors
As vRad grew from 40 to over 200 New York-licensed radiologists, our leadership team decided it was time to upgrade our display technology.
After evaluating options from four different vendors, we found a great solution: workstations with internet-connected diagnostic monitors from Barco. The radiologists and IT team members on the selection committee called them “head and shoulders above the rest.”
The displays are DICOM-calibrated out-of-the-box and continuously monitored in the background. Built-in sensors automatically take care of the brightness and diagnostic checks. And since the displays are connected to the internet via a secure and encrypted connection with no access to patient data, information is communicated directly to the cloud – eliminating nearly all of the work once required of our radiologists. They are even MQSA compliant for mammography, which has more stringent requirements than even the ACR or New York.
Now our radiologists only need to perform a physical check once a year in September, even in New York. That saves each radiologist three to five hours per year. And while they do have to perform an annual check, the software is so much easier for radiologists to use – no blankets necessary. The hardware and software pair together well, and it is now a smooth, intuitive, and user-friendly experience.
Our radiologists are definite fans, saying the displays help improve their overall reading experience in terms of speed, accuracy, intuitiveness and ergonomics. The high-quality medical displays contribute to images loading quickly and being easily manipulated. Automated calibration and QA mean radiologists are always working on monitors that are operating at peak performance.
Our IT team has felt the relief, too. We used to have a full-time employee dedicated entirely to calibration. Everyone on staff had to be trained on it as well. Now, the process is about 10% of one full time employee’s duties. It is also important to us that the data is safely stored on a highly secure cloud-based server without any patient information. That allows us to collect data without lifting a finger. Just as important, our physicist partner is able to access the data at any time – streamlining our collaborative efforts to make sure our fleet is 100% compliant.
A smarter replacement cycle
Another factor to consider is how often you will need to replace your diagnostic displays. Each display contains a specialized backlight that is rated for a certain number of hours. There are two ways to manage the life cycle of the monitors.
The first is to make a generalized estimate of how long it will take a radiologist to reach that magic number of hours. When we were starting out, we replaced all displays every four years, like clockwork. In hindsight, we were likely replacing many prematurely, not being able to accurately take into account the amount of time each display was actually in use.
The second option is to make sure your radiologists’ displays have built-in monitoring tools and treadwear to give an accurate picture of exactly how many hours the backlight has been used and when it needs replacing. Since the Barco displays we chose have this capability, this is the method we use now. During budget season, we just run a report to determine how many monitors will need to be replaced in the upcoming year – with a high degree of accuracy.
Additionally, our new monitors are so much higher quality that they simply last longer; we see this new generation of displays as a decade-long solution.
Better image quality means better reads, happier rads
Even though consumer-grade monitors are acceptable in non-mammography diagnostic applications, “acceptable” does not always equal “optimal.” Our radiologists’ reports depend on the quality of the images they see, which is why we have continued to improve our own standards above and beyond what is required and roll the Barco monitors out to all vRad radiologists.
Our radiologists tell us they are confident in their equipment. Not only are images high resolution, but the automated calibration runs daily performance tests and self-corrects anything that is the slightest bit off, even if it is just one-tenth of a percentage point.
Having state-of-the-art displays also helps our recruitment; radiologists know that our investment in tech is an investment in them. Ultimately, we are getting the noise out of the way so they can focus on what they do best: patient care.