Comparison of Radiology Apps

The usage of mobile devices for radiology purposes increased in the last few years with the availability of smartphones. The first mobile app used for radiology purposes was approved by FDA in 2011 after an initial rejection in 2010.

A mobile device with smart phone capabilities can be used as an alternative medical device with limited features that can accessed from anywhere without depending on a desktop client. However, it’s not a complete replacement for desktop pc but still need a desktop pc to perform some complex tasks.

A Radiology information system (RIS) is an integrated suite of various software components responsible for patient management, workflows, reports, orders and billing, authorisation, image storage (PACS) etc. The main purpose of RIS is to manage radiology activities from referral request to scanning to report. The patient management module is either internal or external integrating with hospital information system or EHR.

image

In this comparison study, range of functionalities implemented in mobile apps to access radiology based information by each RIS vendor will be compared and discussed. The scope of comparison was limited to 3 Australian based RIS vendors namely Kestral karisma, GE Centricity, I-MED.

Kestral computing is an Australian operated organisation developing radiology and pathology solutions. Its flagship product karisma is a web based RIS application with features accounting, reporting, dictation etc. It developed a mobile app Karisma mobile to access its RIS server from iOS and Android platforms based devices.

GE healthcare is a unit of GE Australia providing medical technologies and services. GE centricity RIS-IC is RIS web application developed by GE healthcare. It’s integrated with GE Centricity PACS solution to implement patient centric workflow management in radiology. It developed a mobile app AccessNow to enable limited functionality of its integrated RIS server accessed on iOS and Android platform based mobile devices.

I-MED Network radiology, an Australian network of medical imaging clinics providing radiology services. It developed I-MED mobile app to access its RIS/PACS server on iOS and Android based devices.

Criteria

The purpose of any radiology mobile app is to share the reports and images and to perform complex radiology tasks with an easy interface on a range of mobile devices. The following criteria were used for comparison as most of the mobile RIS functionalities falls in one of this criteria.

Usability

This criteria discusses the functionalities specific to usability. It measures the easiness of interaction to perform an action on a mobile device when compared to that of a desktop pc.

Usability is more important and is a key efficiency factor when interacting with a complex system. For example adding annotations in image areas with hand writing or sketching. This enables the user to use this functionality instead of writing detailed descriptions in the report and can be quickly completed and easy to interpret by others.

Sharing

This criteria discusses the functionalities that enable data sharing and workflows. Sharing is a key data quality factor. For example in radiology, patient reports and images are shared among the users as part of the workflow for documenting first or second opinion.

Mobility

This criteria discusses the functionalities that can be accessed from various types of mobile platforms. Most of the vendors were having mobile apps specific to one or two mobile platform(s) I.e. IPhone and Android. Mobility may be possible indirectly with a mobile web browser for other platforms if RIS application is a web based.

The following is table listing the range of functionalities categorized by the above criteria that are possible in every mobile RIS/PACS app at minimum

 

No. Functionality Criteria

1. Search for patient with demographic details Usability
2. View Images from radiology server Sharing
3. View Reports from radiology server Sharing
4. Image activities (Zoom, Pan, Rotate etc.), annotation Usability
5. Report dictation with voice recognition Usability
6. Access from web, cloud, smart phones and tablets of various platforms Mobility
7. Search for patient history and reports Usability
8. Comparing with prior images/studies Usability
9. Upload images Usability, Sharing

Findings from comparison

  The following table shows range of functionalities available in the compared mobile apps categorised by criteria.

Criteria Kestral Karisma GE Centricity AccessNow I-MED
Mobility Available on iPhone, iPad, but not on android and windows phone. Web based system with limited features can be accessed from tablets. Available on Android and IPhone phones.

A Web based system. Accessed from any mobile web browser.

If accessed from web, dependent native functionality like sensors may not be possible.

Available on Android and IPhone apps, IPad, A web based system. Accessed from any mobile web browser in other platforms.

If accessed from web, dependent native functionality like sensors may not be possible.

Usability Simple to use, Minimum UI and features.

Notifications, Badge numbers, Report lists navigation

No image viewing

No search functionality, users work on only notified reports.

Dictation and Authorisation support.

Simple to operate, Minimum UI and features.

Search functionality with patient demographics. Supports imaging activities zoom, pan, scroll, W/L

No dictation support, split screen comparison with prior images, No Authorisation.

Simple to use, Minimum UI and features.

Search functionality with in the history of visits.

Image functions zoom, pan.

No dictation support or compare with prior images or reports, functionality, No authorisation.

Sharing Reports and Images shared between users, Workflows

Users can view and edit reports, dictate, and send voice files to server. Ability to authorise reports

Reports and images shared between users

No specific workflows

Users can view reports and images.

Reports and Images sharing.

Retrieve reports and images of referred patients.

Retrieve recent examination requests.

The following table shows range of functionalities available in the compared mobile without any categorisation.

 

Functionality Kestral karisma GE centricity AccessNow I-MED

Retrieve images from server No Yes Yes
Image functions( zoom ,pan, scroll) No Yes, supports zoom, pan, and scroll. Yes, supports zoom and pan only
2D/3D, MIPR capabilities No Yes No
Retrieve reports from server Yes Yes Yes
Retrieve tasks from server Yes, with the help of push notifications of reports to work No Yes, only examination requests
Workflow support Yes No No
Report dictation Yes No No
Search No functionality offered Yes, Search referred patients with demographic details Yes, Search only visited histories.
Comparison No comparison offered. Yes, comparison with prior images No comparison

Discussion

In all the compared apps, it was observed that the minimum functionality implemented was reporting (with or without imaging).

Karisma notifications is a good usability feature which informs a user about the reports that requires user authorisation without opening the app and display badge numbers on top of mobile app icon. Without this, the user has to open the app, manual check for new reports and close the app. On opening app, reports that require authorisation are displayed in a list view and users can quickly open a report and edit and send back to radiology clinic. Users were able to dictate using mobile integrate voice system.

Karisma mobile supports work flow management from referral to report generation. The limitations are there was no support for images and search functionality in the mobile apps. Users need to work only the notified reports (work list) but a web based system available that can accessed from any web browser.

GE Centricity AccessNow has some good usability features around images. Users can view images with 2D, 3D, MIP/MPR capabilities and perform image related functions like zoom, pan, scroll etc. The most interesting feature was split screen comparison with prior images. It helps users a lot in decision making. The other feature is search functionality with patient demographics (Patient Id, name, access number, modality, date range). Everyone who has access to this mobile app can search for any patient and not sure how the privacy concerns were addressed.

I-Med radiology app has some good usability features similar to that of GE Centricity AccessNow app. Users can view images without 2D/3D but can perform image functions zoom and pan. It has different view styles (screen orientation, resolution) in iPad when compared on iPhone. It’s a good usability feature of adjusting to surroundings (responsive design). Users can search their visit history, retrieve referred reports and access recent examination requests.

Karisma mobile app adopts task based approach with modalities. It enables the users to perform pre allocated tasks only and a search for referral patient is not possible. However, GE centricity Accessnow and I-Med adopts query based approaches. It includes querying the patient information and reports with image analysis.

There’s a scope for providing more functionality and improvement in these mobile apps as outlined below.

Karisma GE Centricity AccessNow I-Med
Imaging functionality

Retrieve, Zoom, Pan.

Search functionality patient and reports

Comparison

Workflow based approach.

Modalities(Work lists), Dictation

Work flow

Dictation,

Search functionality,

Comparison

Conclusion

All the compared mobile apps were not close to each other in terms of functionalities and their functionalities were dependent on the vendor and were restricted to specific needs. There were no specific design guidelines that specifies what a RIS mobile app is and what features it should contain at minimum. The range of functionality varied from vendor to vendor. Some vendors implemented workflows and others implemented image related extra activities such as panning, zooming etc. However most of the vendors developed apps for IOS and Android platforms only but not for Windows phone.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.