<title>Computer System For Film Repeat Analysis</title>

Abstract

R. Gilbert Jost, Stephen S. Rodewald, Rexford L. Hill, Thomas HansonSharon Albertina, Armand Diaz, Ronald G. EvensMallinckrodt Institute of Radiology, 510 S. Kingshighway, St. Louis, Missouri 63110IntroductionA key measure of any radiology department's efficiency in performing examinations is itspercentage of repeated films. In reliably obtaining high -quality films, some percentage ofrepeats is certain to occur. Human error and equipment malfunction can never be eliminated.Poor patient positioning, patient movement, film artifacts, exposure problems, and process-ing problems are only some of the reasons for performing a certain view more than once.But keeping this repeat percentage to a minimum should enable the department to use lessstaff time and fewer films, and help ensure that patients wait a shorter time and receiveless radiation exposure. In this way, reducing repeats should both lower the cost and im-prove the quality of patient care.A significant decrease in the number of repeated films can be achieved with a good filmmanagement program with accurate collection and analysis of appropriate data. Manualsystems for tabulating repeated film data are time consuming and require a conscientiouscommitment by technologists and supervisors that can be difficult to sustain. In additionto data collection, a successful film management system must provide for a comprehensiveanalysis of the data once it is collected.A computer system, by assuming these data processing chores, can give technologists andsupervisors on- going, in -depth feedback regarding the performance of radiology examinations.A system of this kind has been developed and installed at the Mallinckrodt Institute ofRadiology (MIR) to monitor all diagnostic examinations performed at the Institute.System description and resultsThe MIR computer system for monitoring examination performance has been designed as anindependent module, capable of running on its own minicomputer. The system can also operatein a mode where interaction takes place with a larger, more comprehensive computer patientinformation system. The MIR system, written in BASIC -PLUS, runs on a Digital EquipmentCorporation PDP -11/34 under the RSTS operating system.In the MIR system, a CRT terminal for film data entry is located in each examinationarea of the department. Once an examination is completed and the final set of films hasbeen obtained, the x -ray technologist who performed the exam enters the film data, (eitherby typing at a standard CRT keyboard or by sweeping a hand -held wand across machine -readablelabels.) Through an interactive dialogue at the computer screen, the technologist entersidentification codes for both patient and technologist, and then indicates the type ofexamination, the number and the size of films used, and the room where the examination wasperformed.If it was necessary to repeat any radiographic exposures, additional data is entered.The computer provides a list of the various positions and sizes of films appropriate forthe examination, as well as possible reasons for the repeat (See Figure 1). The technolo-gist makes the appropriate selections, the selections are verified by the technologist andby the computer, and the information is stored.Whenever film or equipment data is entered anywhere in the department the computersimultaneously sends up -dated information to data display terminals located in key super-visory areas.l Thus each of these on -line display terminals provides an up -to- the -minutepicture of room utilization and film utilization throughout the Institute and supervisorsat all levels can make immediate use of this information (See Figure 2).