Transmission failure rate for computed tomography examinations in a filmless imaging department.

The purpose of the study was to determine the frequency and causes of unsuccessful computed tomography (CT) transmissions in a filmless imaging department and to determine the added efficiency gains provided by the sequential addition of modality worklist software and a major network upgrade. Prospective data on CT transmission error rates were recorded over an 18-month period. During the study interval, modality worklist functionality was added, followed by a network upgrade. Failed transmissions were categorized as to the source of the error (human v technical), and the specific problem encountered. Prior to the introduction of modality worklist software, the initial CT transmission failure rate was 7.6%, which was primarily the result of human error (69%), in the form of data entry error. Upon the introduction of modality worklist software, the transmission failure rate decreased to 3.5%, with human error accounting for only 16% of all failed transmissions. The subsequent addition of a network upgrade from shared Ethernet to switched Ethernet further reduced the transmission failure rate to 2.0%, which was believed to be the result of a reduction in the number of network collisions. Other sources of failed transmission occur at the levels of the CT scanner (network interface card), picture archiving and communication system (PACS)/hospital information system (HIS) interface, and modality gateway. When planning the transmission from film-based to filmless operation, one should consider various hardware, software, and infrastructural requirements to ensure successful PACS implementation. Software upgrades, in the form of modality worklist software, serve to improve technologist productivity by minimizing data entry error. Infrastructural changes, in the form of network upgrading, ensure proper dissemination of electronic data with decreased frequency of network collisions. Collectively, these improvements lead to enhanced transmission of digital images, resulting in productivity gains within the filmless CT department.