Hello!

We redesigned the Radiology Information System using user-centered design methods.

We delivered a prototype design solution which will be integrated into an existing international product.

Scroll down to learn more about our process.

Radiologists Save Lives

Despite having less direct interaction with patients, radiologists are just as responsible for their care as other physicians. Their mostly-digital workflow revolves around tying together data points that come from different sources: the patient images, scanned requisition sheets

from doctors within and outside of their facility, and patient records stored on different databases. Behind a computer screen and phone, their presence around the hospital is measured in the text of their dictations and their voice on calls. They are one with the computer.

Existing software is not well-designed

The introduction of digital workflow in the radiology department has improved patient care and throughput significantly. [1] As a surrogate for many roles in the department, the software requires the radiologist to take on many roles that s/he had not performed traditionally. Radiologists often struggle to track down

pieces of information across databases, with unreliable software that requires second-guessing, and with poor design decisions. Furthermore, radiologists are often required to read more exams on the software than their predecessors, and the software does not sufficiently aid their need to make quick diagnoses. [2]

Our team dove deep for insights

The Glasswing team set out to perform a thorough analysis of radiologist workflow to identify areas of opportunity for RIS software.We travelled to nine hospitals worldwide to watch radiologists as they interacted with and and became frustrated

with their software. Out of hundreds of data points, we distilled key themes to carry with us as we designed and prototyped software solutions. By and large, we found that radiologists need to be able to access information more easily.

Partnering with GE Healthcare

GE Healthcare is interested in applying our research and design work to a web browser adaptation of a current software product, Rad Cockpit.The updated version, eRad Cockpit, will be used internationally, which adds another twist to the design

challenge.With eRad Cockpit, GE Healthcare aims to take a significant jump toward data integration and improved interactivity with radiologists and RIS / PACS administrators in mind.

Our goal is to research and design a unified flow of information to improve efficiency and adaptability in radiology departments.

Research

Over four months, we performed contextual inquiries with 19 radiologists, technologists, and RIS / PACS administrators

Scope Setting and Research Goals

Over four months, we researched workflow in the radiology department using a variety of user centered methods. Research began with an initial kick-off meeting with stakeholders from GE Healthcare. From there, we crafted a research methodology that would allow us to dive deep into radiologist workflow

and information sources. Through our research, we needed to gauge a functional, realistic view of the contextual requirements while remaining sympathetic to the radiologists. Primarily, we used Interviews and Contextual Inquiry to learn more about the field.

Interviews with Stakeholders

By the nature of their job, radiologists are pressed for time. They have a specialized knowledge set which requires years of training.We aimed to maximize the value of our time with radiologists by learning as much as possible beforehand. To do this, we met with stakeholders from GE Healthcare and with several RIS / PACS administrators. These 3-on-1 interviews provided an initial dive into department workflow and allowed us to uncover how radiologists fit into the larger context

Contextual Inquiry

With an initial idea of the workflow dynamic in the radiology department, we performed nineteen contextual inquiries to provide more information on work context and workflow breakdowns. This method involves entering the radiologists workspace to observe in a master-apprentice relationship; we carefully watched the radiologist move through their RIS & PACS, pulling many data points and synthesizing on the fly.

Occasionally, we asked questions to elucidate the reason behind an unexpected action; through this questioning, we heard stories of frustration and incomprehensible system requirements. We compared the results of our US-based Contextual Inquiries to workflow observations in Switzerland, Denmark, and Ireland because eRad Cockpit will have international users.

Research Synthesis

Compiling our research notes into one file, we printed them to create physical artifacts that represent the data. In paper, the data points can be easily organized, grouped, and analyzed. Our data yielded ten large themes about radiologists, radiology workflow, and the software that supports radiologists. We distilled these ten themes into four crucial findings for our research and future software prototype. Unfortunately, we cannot share these findings publicly

Design

Using an interative design process, we created Facet, an interactive prototype which solves many of the issues seen in our spring research

Process Overview

Fresh from our research, we generated over 250+ design solutions for radiology software. We had several group, individual, and improvisational brainstorming sessions which yielded a broad spectrum of solutions. We gradually selected and refined ideas to develop storyboards for concept validation.

Using a process of iterative design, we turned feedback at each stage into better design solutions at higher levels of fidelity. Twenty-seven storyboards turned into nine paper-prototypes, which were brought to Texas and Europe.These were refined into five interactive prototypes, which we combined into 1 high-fidelity prototype.

Concept Validation

Storyboarding and Paper Prototyping
We paired back 250 ideas into 27 concepts which we sketched out into storyboards that communicate the use case and the software solution without focusing on fine-grained detail. By showing our storyboards to radiologists in the US and abroad, we discovered new insights about our concepts and how they would or would not improve radiologist workflow. Several solutions would have encountered insurmountable obstacles in development, and were let go of quickly. Others were validated, and the feedback was used to refine the concept in later iterations. This inexpensive and easy feedback allowed Glasswing to focus only on the highest potential ideas which could realistically be implemented.

Interaction Design

Prototyping in Axure + JavaScript
We developed nine paper prototypes from the storyboards which received positive feedback. These low-fidelity implementations were also rapidly and inexpensively created. Testing the interactivity of these ideas through a scenario-and task-based protocol, we eliminated two lower potential ideas and combined a few others based on their goal. Afterwards, we developed five mid-fidelity interactive prototypes using Axure. Again, these solutions were put in front of radiologists and stakeholders to gain feedback. Small tweaks were made along the way, and larger pieces of feedback were taken into account for the final, high-fidelity prototype. We were careful to collect quantitative feedback at this stage to feel more confident in our design selections.

Constructing a High-Fidelity Prototype

Our fourth design iteration involved constructing a high-fidelity prototype using Javascript and a few associated libraries. Initial visual design elements were created in Adobe Illustrator and brought over to HTML and CSS. We designed the interactivity metaphor details on the whiteboard based on feedback from radiologists.

The final design solution involves porting over some common design patterns from consumer products. It leverages well-known metaphors with some necessary changes to work in the context of the radiology department. The work is proprietary, and unfortunately cannot be displayed publicly.

About us

We are an interdisciplinary team of Researchers, Designers, and Engineers