Although film processing in the pre-digital era could take days, most people considered the wait for pictures of a birthday party or trip to the Grand Canyon a minor inconvenience at most.

But for some, the inherent delays in film processing had serious ramifications — for example, when the images in question were X-rays of a broken vertebra or of a suspected cancerous lung tumor.

Delays could mean late diagnosis or inadequate treatment.

Rasu Shrestha, research associate in the department of radiology in the Keck School of Medicine of USC, said that while such delays were unavoidable in the past, new digital technology now in use at the Healthcare Consultation Center II (HCC II) has decreased the wait for medical images to mere minutes.

As part of a $10 million system that went online in July 2004, USC physicians can now review their patients’ medical images within minutes after the scans are completed.

“The patients love it because it saves them a lot of time. Before, they would have to wait for films to be printed, then stored while awaiting a radiologist’s examination and annotation, and then sent by courier to their referring physicians,” Shrestha said.

The new system is faster, more efficient and less vulnerable to errors because it combines three separate components of the imaging process into a single, streamlined workflow.

The Imaging Center at HCC II uses what is called a Picture Archiving and Communications in Medicine combined with a Radiology Information System with integrated voice recognition.

Previously, medical images would need to be transported to the radiologist, who would analyze the images and file a verbal report that would then need to be transcribed and attached to the image — a time-consuming process that required data to be entered multiple times — with a corresponding increase in the opportunity for errors.

Shrestha said that under the new system, CT scans, MRIs, X-rays and other images are never recorded on film, but rather shot digitally and imprinted with the patient’s personal identification data.

The files are stored in a secure computer archive that is immediately accessible to radiologists who can quickly report on the studies using a computerized voice-recognition system.

The instant the radiologist signs off on the study, the referring physician is sent a fax of the full report, which also instantly becomes available online via a password-protected site.

“This is extremely beneficial for patients and physicians because it eliminates the sources of a lot of errors,” Shrestha said.

“It eliminates the possibility that someone will physically misplace films or reports. And there is no data-entry duplication, saving the need to repeatedly type in a patient’s name and record numbers. You enter the data once, and they become a permanent part of the file.”

Because all the images are digital, patients are subjected to less radiation in cases when technicians err in making the image, he said.

“Before everything was digital, if a scan was overexposed or underexposed, the patient would need to be scanned again. But with digital imaging, those kinds of errors can be fixed on the computer,” he added.

The system, housed in the HCC II, can be accessed from dozens of exam rooms, which include computers and displays linked via the Internet. As a result, a physician can immediately call up a patient’s medical imagery, which automatically includes digital images from previous visits for comparison. These include images that were originally done on film.

As an additional benefit, the image files contain pre-calibrated measurement tools so that potential errors in scale and orientation of the images are eliminated.

To protect patient confidentiality, the entire system meets federally mandated requirements for security and tracks which files users have been accessed and how and when changes are made to individual records.

“All of these things translate into better patient care,” Shrestha said. “But right now only a few hospitals in the country have adopted this kind of fully integrated system. We foresee the HCC II as being a role model for others; we’re definitely at the leading edge of the curve.”