Human Factors and Human-Computer Considerations in Teleradiology and Telepathology

Abstract

Radiology and pathology are unique among other clinical specialties that incorporate telemedicine technologies into clinical practice, as, for the most part in traditional practice, there are few or no direct patient encounters. The majority of teleradiology and telepathology involves viewing images, which is exactly what occurs without the “tele” component. The images used are generally quite large, require dedicated displays and software for viewing, and present challenges to the clinician who must navigate through the presented data to render a diagnostic decision or interpretation. This digital viewing environment is very different from the more traditional reading environment (i.e., film and microscopy), necessitating a new look at how to optimize reading environments and address human factors issues. This paper will review some of the key components that need to be optimized for effective and efficient practice of teleradiology and telepathology using traditional workstations as well as some of the newer mobile viewing applications.

Effect of color visualization and display hardware on the visual assessment of pseudocolor medical images

“…However, the ad hoc manner for handling color and the lack of standardization and common methodologies used to display medical images are often cited as contributing to suboptimal medical decisions with direct impact on patient treatment and prognosis. [3][4][5][6] In this topic, a recent expert consensus paper concluded that more research is needed to quantify the associated variability and to develop standards and common practices. 7 In addition, the advent of wide-scale implementations of easily accessed picture archive and communication systems (PACS) as well as the availability of wireless connectivity has increased the presence of telemedicine applications opening a range of new image reading options complementing dedicated clinical workstations.…”

“…7 In addition, the advent of wide-scale implementations of easily accessed picture archive and communication systems (PACS) as well as the availability of wireless connectivity has increased the presence of telemedicine applications opening a range of new image reading options complementing dedicated clinical workstations. 4,8,9 This has in turn created the need for understanding the suitability of handheld devices including laptops, tablets, and phones, which are gaining popularity in everyday consultation workup of medical professionals. 3,4,[10][11][12][13][14] Most current mobile phones and tablet devices have pixel densities and spatial resolution similar to the characteristics of medical-grade displays, 15 while not being limited by memory or computational power connected to high bandwidth networks.…”

“…4,8,9 This has in turn created the need for understanding the suitability of handheld devices including laptops, tablets, and phones, which are gaining popularity in everyday consultation workup of medical professionals. 3,4,[10][11][12][13][14] Most current mobile phones and tablet devices have pixel densities and spatial resolution similar to the characteristics of medical-grade displays, 15 while not being limited by memory or computational power connected to high bandwidth networks. 4 However, consumer-grade devices and handheld image readers have several limitations.…”

“…3,4,[10][11][12][13][14] Most current mobile phones and tablet devices have pixel densities and spatial resolution similar to the characteristics of medical-grade displays, 15 while not being limited by memory or computational power connected to high bandwidth networks. 4 However, consumer-grade devices and handheld image readers have several limitations. Among them, recent work has demonstrated limited primary stability leading to color gamut shrinkage 16 underlining that proper calibration is necessary to guarantee stability of display characteristics over time and to ensure similar and consistent behavior between different devices.…”

“…Currently, color management methods for characterizing and calibrating color displays for medical image interpretation are not common resulting in inconsistent presentation. [3][4][5][6] Moreover, tablet and phone calibration methods bring about additional difficulties since most of these devices do not currently support ICC profiling or calibration tools and, most importantly, are typically used in environments with widely variable illumination. 4,7,[17][18][19] Although there has been no clinical evidence that color calibration increases diagnostic efficacy, some studies have demonstrated significant improvements in practitioner reading time.…”