HealthManagement, Volume 20 - Issue 9, 2020


The role of a radiologist is becoming more central to healthcare. Radiology departments are overloaded with work. Demand for fast imaging results and 24/7 availability are also consistently increasing. Agfa HealthCare has developed a shared reading workflow within its Enterprise Imaging platform, which allows radiologists to share tasks and expertise beyond the hospital walls. spoke to Johan Hendrickx of Agfa HealthCare to find out how the shared workflow feature works and how it can benefit both radiologists and patients.

Key Points

  • Shared workflow refers to the possibility of organising the acquisition of images and their reporting across different sites.
  • A shared workflow solution includes access to the entire medical imaging record and reports. 
  • A shared workflow allows radiologists at different sites and facilities to receive reading tasks based on their expertise.
  • A shared workflow is an efficient way to organise the available resources available within a region.

Can you please tell us something about Enterprise Imaging and the shared workflow feature?

Shared workflow refers to the possibility of organising the acquisition of images and their reporting across different sites. Radiologists can get tasks assigned to them irrespective of where images have been acquired within the region. A shared workflow solution includes access to the entire medical imaging record and reports. Therefore, you have very easy access to all priors, wherever they have been acquired in the region you have set up for collaboration. A shared workflow allows radiologists at different sites and facilities to receive reading tasks based on their expertise. 

What is the difference between shared workflow and teleradiology? 

Teleradiology is often used when there are not enough radiologists available to manage the workflow. In this situation, some of the work is outsourced to a third party. Studies are sent to outsourced radiologists, and you wait for them to provide a report. Teleradiology is more of an external collaboration: you push studies to outside radiologists for them to be read or report. One wants to avoid using too much teleradiology because these services tend to be quite expensive. 

On the other hand, a shared workflow is a more efficient way to organise the available resources you have within your region. It allows hospitals to set up cluster sites and collaborate with them so that the work can be more efficiently organised. Unlike teleradiology, it offers a much closer collaboration, as if you’re sharing with a colleague sitting next to you. But in this case, they may be in another hospital altogether. Also, with a shared workflow, the process of reading and reporting is faster because if one radiologist is busy or unavailable, another radiologist within that network can handle the reading. Therefore, it allows a facility to have an efficient radiology department 24/7. 

Many countries are facing a shortage of radiologists, and it is becoming difficult to manage increased workload. How can shared workflow help solve this problem?

That is one of the main reasons we built this feature - to allow radiologists to collaborate more efficiently. Shared workflow allows you to share the workload with multiple sites, and you can build workflows around that. Even if there is a need for specific subspecialties, you don’t necessarily need such a radiologist on site. You can group that work and push it out towards other sites of your collaboration. Someone with that particular expertise on the other site can pick up that study, read and prepare the report, which will go back to the site of origin. This is all done automatically, allowing the process to become much more efficient. Specifically, for countries where there is a shortage of available radiologists, work can be organised in a much more efficient way. Not only can you share expertise, but you can also reduce the cost of having to outsource some of this work elsewhere. Hence, shared workflow allows you to use the available resources in a more efficient way.

Radiologists are also faced with the challenge of controlling costs. Can a shared workflow facilitate this goal? If yes, how?

Absolutely. With a shared workflow, you do not have to outsource work to external companies that will do the reading for you. It allows you to become more efficient as an organisation, and thus, you drive down the overall cost of that outsourced work.

If you were to list the key advantages of a shared workflow, what would those be? 

The biggest advantage of a shared workflow is the ease with which you can create and share tasks. Enterprise Imaging is the backend solution. It allows you to create task lists and assign them to specific radiologists or specific groups of radiologists. Radiologists within the network can automatically see tasks assigned to them locally. 

Another big advantage is how data is managed within the system. Data is never copied from one site to the other. It is always streamed. If a radiologist wants to open a study for reading, the images of this study will be streamed to them. As soon as they make the report and sign it off, the report is automatically stored back into the site of origin, so there is no duplication of data. 

To summarise, with a shared workflow, no data is moved around, you have full control of the workload, even when it’s made accessible remotely, and given distribution of workload is fully automatic, you don’t need to have additional workers in place to be able to share. 

Can shared workflow help patients in remote areas? 

Yes, patients can go to the nearest hospital, and even if the radiologist that has the experience to report that particular case is not on site, images can still be acquired in the remote sites. By putting in place a shared workflow, the request can automatically be routed towards the site that has the experience set. The reporting is done there, and the result is forwarded back to the remote or rural side. Hence, with shared workflow, patients do not have to travel to the more specialised centres to get better service. 

How does this feature ensure that there is no duplication of effort and images are not read or shared by multiple people within the network? 

This is actually an advantage that we also implement already with the Agfa HealthCare XERO Exchange Network. All radiologists within the region always have full access to the entire medical imaging record of the patient. If the patient was in another site where a specific study was already acquired, you don’t have to redo that acquisition. The fact that you have such easy access to the entire medical imaging records can help avoid duplication. 

Is this a standardised solution, or can hospitals and radiology departments customise the shared workflow feature according to their needs? 

The Agfa HealthCare shared workflow solution is highly customisable. You can design it to match your needs, whether you want to be able to share studies after hours, or during weekends, or weekend days, or for a specific specialty or a combination. You can also ensure quality control by initiating a multi-author workflow for studies that are more difficult. There’s a whole range of possibilities that can be put in place. You have total control over the workflow. 

It is clear that radiologists can benefit from a shared workflow. How does it help patients? 

First of all, by making the entire region more efficient, a shared workflow ensures that a particular study is reported faster. Based on this, patient follow-up can be organised at a quicker pace. Shared workflow also increases the flexibility for patients to go into the local hospital, have their images or study acquired there, and benefit from the knowledge and the specialisation over the entire region. After all, this is why we do this – to provide better patient care. 

Disclosure of conflict of interest: Point-of-View articles are the sole opinion of the author(s) and they are part of the Corporate Engagement or Educational Community Programme.