Selection and Pilot Implementation of a Mobile Image Viewer: A Case Study

Abstract

Background: For health care providers, mobile image viewing increases image accessibility, which could lead to faster interpretation/consultations and improved patient outcomes. Objective: We explored the technical requirements and challenges associated with implementing a commercial mobile image viewer and conducted a small study testing the hypothesis that the mobile image viewer would provide faster image access. Methods: A total of 19 clinicians (9 radiologists, 3 surgeons, 4 neurologists, and 3 physician assistants) evaluated (1) a desktop commercial picture archiving and communication system (PACS) viewer, (2) a desktop viewer developed internally over 20 years and deployed throughout the enterprise (ENTERPRISE viewer) and (3) a commercial Food and Drug Administration class II-cleared mobile viewer compatible with Web browsers, tablets, and mobile phones. Data were collected during two separate 7-day periods, before and after mobile image viewer deployment. Data included image viewer chosen, time to view first image, technical issues, diagnostic confidence, and ease of use. Results: For 565 image-viewing events, ease of use was identical for PACS and mobile viewers (mean 3.6 for all scores of a possible 4.0), and significantly worse for the enterprise viewer (mean 2.9, P=.001). Technical issues were highest with the enterprise viewer (26%, 56/215) compared with the mobile (7%,19/259, P=.001) and PACS (8%, 7/91, P=.003) viewers. Mean time to first image for the mobile viewer (2.4 minutes) was significantly faster than PACS (12.5 minutes, P=.001) and the enterprise viewer (4.5 minutes, P=.001). Diagnostic confidence was similar for PACS and mobile viewers and worst for enterprise viewer. Mobile image viewing increased by sixfold, from 14% (37/269, before the deployment) to 88.9% (263/296, after the deployment). Conclusions: A mobile viewer provided faster time to first image, improved technical performance, ease of use, and diagnostic confidence, compared with desktop image viewers.