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NYMISS: PACS needs to get smarter

by Brendon Nafziger, DOTmed News Associate Editor | September 14, 2012

"I have no idea if people are following those recommendations. I want that in the next-gen systems," he said.

"Brain dead" speech recognition

Siegel would also like voice recognition programs, which transcribe the radiologist's reports, to take a smarter approach in order to avoid some of the hilarious misunderstandings he and his colleagues have had to put up with.

For instance, he said software has rendered the finding "fibroids of the uterus" as "fireballs of the Eucharist," the measurement "4.8" as "foreplay," and the phrase "if clinically indicated" as "death clinically indicated."

"Speech recognition systems are brain dead," he said.

In the same way a Mrs. McGillicuddy, a skilled and experienced human transcriptionist, might question the use of an unusual word, Siegel would like the system to call attention to one-of-a-kind words ("Eucharist"), or at least leave them blank, so the physician could correct the system's errors in review.

Better interfaces

Siegel also hopes radiologists are able to, eventually, move past the dominant PACS interface for the past two decades: the computer mouse.

"I want some more degrees of freedom to do more complex navigation through datasets," he said.

One immediate alternative is a roller mouse. Siegel said when his department turned to using a roller mouse, they achieved a 40 percent reduction in CT reading time, because they could drag images continuously with the roller.

Touch screens offer another way to achieve some workflow shortcuts. The drawback is that radiologists probably don't want to be getting fingerprints on a monitor they have to make clinical diagnoses off of. That's why another soon-to-be-released product, the Leap Motion, could be interesting, Siegel said. The $70 gadget, about the size of the iPod, helps transform screens into "no-touch" touch screens by capturing fine hand movements. An early version of the device could ship as early as February, according to the company's website.

A possibly more sci-fi future interface brought up by Siegel is a $299 EEG headset produced by Emotiv, called the Epoc, that lets users control a computer by reading changes in brain signals. Reviews online suggest it has a few kinks to work out, at the very least, and Siegel also suggested it looked like it needed some work. But the idea holds promise.

"I don't think we're ready for this in 2012, but the idea of being able to refine this seems interesting for the future," he said.

App store

Another problem with PACS is that no software developer provides the "best of breed" product in every category, but it's hard to get the systems to work with programs designed by other vendors.

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