[Note: an update to this has been posted]

A while back Intelerad put a bug in our Radiologist’s ear about a mammo viewer they were working on. We had been using Threepalm’s offering, which was a fairly nascent offering as it was. The biggest gripe we had with 3palm was that it worked off a separate worklist, which is far from an ideal workflow. Feature wise it was adequate, and after getting some bugs ironed out, it was working. Not to our liking per say, but it was working.

The mammo viewer built into Inteleviewer also works. However to say it is not meeting our expectations would be an understatement. At least we are back to a single worklist workflow.

Let’s touch on some of the good points:

Single worklist. Yes I had already mentioned this, but this is definitely the best “feature”. At the same time that we went to the Inteleviewer mammo viewer, we also got their new worklist. Aside from some quirks, it has been well received. It really is a significant leap forward from Intelerads old Reporting Worklist tool.

The interface. It isn’t so much that the interface is good, rather, since it is essentially Inteleviewer, it is familiar. Threepalm’s layout was quite unique and somewhat non-traditional. It made it difficult for our Rads to learn their way around. MG in IV plays to IV’s strength, it is laid out logically, and features are fairly easy to find.

Administration. Managing the Intelerad world is actually quite easy. Granted, this may be more a case of being liking what you are familiar with, but to me and my team, it lessens the burden. Not to mention having two dicom applications fighting for disk space is never a good thing.

Unfortunately, at the moment that is all I can come up with for positive things to say about Intelerads mammo viewer. I feel it prudent to stop and clarify that the software is not classified as finished yet. Intelerad openly admits they have much to learn about the mammo world. Yes they do.

Now I will touch on some of the not so good aspects.

The first item is not actually a flaw of the mammo viewer at all, but it is directly tied to our mammo workflow. The new worklist function that I previously stated was a significant improvement, has one troubling flaw. It is SLOW. Specifically, whereas the previous version made a case available immediately to the Rad once completed by a Tech, this version has a background process that needs to run, and until it does, the Rad will not be presented with the case, regardless of how frantically (s)he press the refresh button. Initially this was set to several minutes. Intelerad fairly quickly responded to our complaints and lowered the cycle to 60 seconds. However, given our workflow, this is still much too long. Our Techs will mark the case complete, ready for dictation, and then step directly into the reading room to have the Rads confirm everything is in order before sending the patient on their way. Each time they do his, there is the potential for up to a minute of lost productivity while everyone waits for the worklist to present the case on the screen for selection. If you work in radiology you likely understand that over the course of a working day, this results in a very significant loss of productivity, and as such is the bane of the Rads. The part of this that is so odd is that Intelerad seems to find it hard to believe this “little” delay is such a big problem. Perhaps we have an entirely unique workflow… but I don’t expect such to be the case.

Once Rads get the case open, Things don’t improve much. Ok, maybe that is a little harsh. While the mammo viewer does not yet have many modality specific tools (we are assured those are coming in later releases), the fact that it leverages existing Inteleviewer tools means it is certainly adequate. The hanging protocols, while not yet user editable, cover the basics well enough.

The other major gripe we have is around the ability (or inability as the case may be) to handle priors. There are two distinct issues. First of all, frequently the system doesn’t realize there are priors, so they are not displayed automatically for the Rad. We are still going back and forth with support trying to convince them there is a problem. When the software does decide to play nice and show priors, or when the Rad manually pulls them up, it has trouble aligning the priors. Most of the time, the issue has to do with extra issue captured in the scan, which the viewer faithfully tries to display, at the cost of pushing the image all over the view port. Our previous Threepalm software did suffer from this as well, but to a much less significant degree. There are times however when the software just throws reason out the window and essentially hides the breast image outside of the viewable region of the screen. When his happens, you are lucky if part of the marker is still viewable to give some indication that the breast is there somewhere. The image can be panned around so that it comes back into view, but a whole lot of panning is required, and it really does not leave a positive impression with the Radiologist.

Here is hoping that Intelerad can come through and address our major complaints. If so I will gladly post an update.

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