Operating data and unsolved problems of the DICOM modality worklist: an indispensable tool in an electronic archiving environment.

PURPOSE: We evaluated the efficacy of DICOM worklist software for radiological modalities from the viewpoint of risk management, to reduce mislabeled image data in an electronic archiving environment. We focused on the following five points: 1) the effectiveness of the DICOM modality worklist, 2) problems involving incorrect patient and image data, 3) the presence of incorrect profiles despite the transfer of patient profiles online via the DICOM worklist, 4) ways to eliminate entry failure, and 5) further examination even if data entry were correct. MATERIALS AND METHODS: Retrospective data of patient profiles with image data were evaluated both before and after installation of DICOM modality worklist management software at Sakai Municipal Hospital. All radiology modalities were connected to RIS terminals in which DICOM modality worklist software was installed. Patient profiles were transferred online from RIS terminals to the modalities. It was not necessary for technologists to type patient profiles in usual examinations. RESULTS: Before installing the DICOM modality worklist software, the number of data entry errors was 31 and the rate was 6.4% of 487 examinations. After installation, manual data entry occurred in 80 of 1,994 examinations. The number of data entry errors for patient profiles was two, and the rate was 0.1% of the total examinations (p < 0.0001). Before installing the DICOM modality worklist, two wrong patient IDs that corresponded to other existing patient IDs were typed into the modality. No patient IDs were mixed up after installation of the DICOM modality worklist (p = 0.0385). CONCLUSION: The DICOM worklist was indispensable to electronic archiving because it decreased incorrect patient profiles that corresponded to image data loss. This was effective in decreasing patient mix-ups that could lead to serious malpractice. Despite the DICOM worklist, however, some incorrect patient profiles remained as a result of manual typing errors. The reasons for manual typing included emergency examinations, paper-based operations, and system shutdown. Furthermore, the risk of patient mix-ups remained even if the patient profile was correct. To eliminate or decrease medical accidents, determining why accidents happen and ensuring better data confirmation are necessary.