We prospectively compared image and report delivery times in our Urgent Car
e Center (UCC) during a film-based practice (1995) and after complete imple
mentation of an electronic imaging practice in 1997. Before switching to a
totally electronic and filmless practice, multiple time periods were consis
tently measured during a 1-week period in May 1995 and then again in a simi
lar week in May 1997 after implementation of electronic imaging. All practi
ce patterns were the same except for a film-based practice in 1995 versus a
filmless practice in 1997. The following times were measured: (1) waiting
room time, (2) technologist's time of examination, (3) time to quality cont
rol, (4) radiology interpretation times, (5) radiology image and report del
ivery time, (6) total radiology turnaround time, (7) time to room the patie
nt back in the UCC, and (8) time until the ordering physician Views the fil
m. Waiting room time was longer in 1997 (average time, 26:47) versus 1995 (
average time, 15:54). The technologist's examination completion time was ap
proximately the same (1995 average time, 06:12; 1997 average time, 05:41).
There was also a slight increase in the time of the technologist's electron
ic verification or quality control in 1997 (average time, 7:17) versus the
film-based practice in 1995 (average time, 2:35). However, radiology interp
retation times dramatically improved (average time, 49:38 in 1995 versus av
erage time 13:50 in 1997). There was also a decrease in image delivery time
s to the clinicians in 1997 (median, 53 minutes) versus the film based prac
tice of 1995 (1 hour and 40 minutes). Reports were available with the image
s immediately upon completion by the radiologist in 1997, compared with a m
edian time of 27 minutes in 1995. Importantly, patients were roomed back in
to the UCC examination rooms faster after the radiologic procedure in 1997
(average time, 13:36) than they were in 1995 (29:38). Finally, the ordering
physicians viewed the diagnostic images and reports in dramatically less t
ime in 1997 (median, 26 minutes) versus 1995 (median, 1 hour and 5 minutes)
. In conclusion, a filmless electronic imaging practice within our UCC grea
tly improved radiology image and report delivery times, as well as improved
clinical efficiency. Copyright (C) 1999 by W.B. Saunders Company.