Evaluation of a filmless radiology pilot--a preliminary report.

The development of the Multimedia Electronic Medical Record System (MEMRS) promises new opportunities to significantly reduce the routine use of film as the medium for viewing radiological medical images. The effect of this change to digital media on physician workflow and the perceived value and utility of medical images is an area of ongoing investigation. In this study we examined oncology clinicians use of medical images in a MEMRS. We conducted observational studies of clinicians during a filmless radiology pilot study in which a filmless environment was simulated but the actual film was available on request. This observational study was the first step in a comprehensive evaluation designed to elucidate the issues surrounding the implementation of a filmless radiology environment. We identified and examined several of these issues, including physician concern regarding the utility of digital images for clinical use and comparison with film, the need to address the effects of image compression with clinicians, and the workflow changes necessary to incorporate digital image use into a clinical practice.