By Greg Patrick, BS
Prior to the development of Picture and Archiving Communications Systems (PACS), the radiologist was an integral member of the healthcare team because he/she had the one thing everyone needed – the X-ray. The radiology reading room was a busy place that was constantly visited by referring physicians wishing to consult with the radiologist. As the use of PACS and imaging IT systems were adopted throughout the 1990’s and 2000’s, the radiology profession shifted its focus from the radiology consult to radiologist productivity and timely report turnaround, which was often tied to reimbursement.
During this period, the hardware that supports these systems has not always kept up, and the ergonomic consequences have been disastrous. Until flat panel, high resolution, grey scale displays were developed, the ergonomic adjustment of an early medical grade CRT display was limited. During these early years, PACS furniture often consisted of any table strong enough to hold a couple of CRTs. The large size of the CPU needed to run the PACS software also occupied floorspace, created the ubiquitous ‘rats nest’ of wires under the table, and generated copious amounts of heat and noise.
As PACS and imaging IT hardware and software technology matured, reading room and PACS workstation design opportunities have evolved from supporting technology to supporting how the radiologist interacts with technology and with other clinical staff. While the initial conversion from film to digital drove early PACS furniture and reading room design and location decisions, modern considerations must enable the radiologist to perform a multitude of tasks, read more studies, and integrate more information, all within the same amount of time. The long-term, repetitive actions required to support these goals has been shown to increase the radiologist’s risk of burnout, visual fatigue, and repetitive stress injury (RSI) to the neck, back, shoulders, and wrists. In addition, hours of sitting at a PACS workstation has been shown to be detrimental. It is widely accepted that sitting is the new smoking!
Recent scientific literature has documented the prevalence of these afflictions and their impact, and presented recommendations for reducing their risk with proper PACS workstation and reading room ergonomics. A recent article highlighted the findings from the 2017 ACR Human Resources Commission Workforce survey, including the importance of adjustable monitors and adjustable sit-stand desks that provide individualized controls for lighting and monitor angle as critical components to reducing RSI’s.1 A full collection of research articles about the relationship between good PACS workstation ergonomics and the risk of RSIs can be found here.
Other reading room ergonomic factors such as acoustics, lighting, and environmental controls can reduce visual fatigue and distractions that limit the radiologist’s ability to work efficiently while further reducing the risk from burnout and RSI’s. My AHRA Fall Virtual Conference talk, “How to Improve the Radiologist Workplace by Reducing the Risk of Work Related Repetitive Stress Injuries and Visual Fatigue,” will review these issues in detail and present specific opportunities for reducing the risk of RSI and visual fatigue.
- Parikh J, MD et al. Musculoskeletal Injuries Affecting Radiologists According to the 2017 ACR Human Resources Commission Workforce Survey. J Am Coll Radiol. 2018;15:803-808.
Greg Patrick, BS is the president of RedRick Technologies. He can be reached at Gpatrick@redricktech.com.