The goal of this study is to examine workflow and information flow in the emergency department (ED) digital imaging process to identify features of an optimized system. Radiological imaging (x-rays, CT scans, etc) is unique in the ED setting, as the need for fast turn-around time and interactive communication between radiologists and emergency physicians is different than that of most other healthcare settings. The information technology systems which are used by both radiologists and emergency physicians to support these processes have been designed with a focus on the routine workflow of radiologists. We report the results of 14 hours of naturalistic observations of the use of digital imaging systems by a total of 22 ED and radiology staff. A hierarchical task analysis and an information process diagram are presented, and disparate theories that groups in the system have about other groups were discovered, particularly in the communication of clinical information.
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