Region Skåne
In light of the COVID-19 virus pandemic, the work situation for many radiologists has changed. Many have taken on new work tasks, workloads have suddenly changed, and what is perhaps most apparent is that many now need to perform their daily work from home. We have interviewed—virtually, of course—Mattias Mjöman, a radiologist at Region Skåne, who describes how the COVID-19 situation has quickly changed his daily work and how he manages to work from home.
One of Sweden’s biggest healthcare regions with a population of over one million people. Region Skåne has eight hospitals where radiologists are working toward one central enterprise imaging system with a PACS and VNA managing production of approximately one million radiology exams per year.
Mattias: Me and many of my colleagues now must review exams from home, which is working very well. The recommendation to work from home as much as possible is partly to minimize the risk of being infected when commuting to work, but also to prevent us being exposed to each other. For the past two weeks, I’ve been working from a room in my basement.
Some of my colleagues still have to work at the hospitals, but they have taken several actions to minimize the risk of being infected. Lunch breaks have been redistributed, meetings are taking place in larger rooms or via Skype, and training of residents is no longer taking place at workstations but in MDT rooms, for example.
Well, the schedule has changed quite a bit. Many patients scheduled for radiology exams don’t want to come to the hospital due to the risk of infection. Also, we are not seeing as many acute cases coming in, which indicates a tendency among people to delay seeking medical care until the crisis has abated. We are also being affected as a result of more radiologists on sick leave because of enforcements to remain at home even with the mildest of symptoms.
All in all, we have noted a decrease in workload so far, but we have been able to fill cancellations in most cases. This will most likely change over the coming weeks as we get more pneumonia to diagnose due to COVID-19 infected patients.
Yes, we have received cases in order to confirm pneumonia, both CT and CR examinations. The intensive care unit and the temporary care stations built contain mobile modalities for COVID-19 diagnostic purposes. These images are imported into the centralized image archive and diagnosed by us.
Furthermore, the Swedish Society of Radiology (Svensk Förening för Medicinsk Radiologi) has sent out guidelines on how we should work, which has been very good. Of course, we also read international guidelines.
So far, no radiologists here have been reassigned to take direct care of COVID-19 patients, as we have seen, for example, in Italy.
I really like my home workplace. I have my laptop connected to two larger external monitors and use the laptop screen for worklists and patient information. This gives me the same three-screen setup as I have at the hospital, so display protocols will work exactly the same.
In February this year, we started with a PACS-driven workflow, which considerably facilitates the review since there is no RIS that I need to log into anymore. That used to take quite some time. Thank God we did that transition before the COVID-19 outbreak! In addition, speech recognition is completely integrated into the PACS, which makes it very convenient to dictate.
My workstation is connected to the central system via a secure VPN tunnel administered by Region Skåne. The Internet I use is a regular home fiber connection, with a 100 Mbps download speed and 10 Mbps upload speed. With the VPN connected, the download speed is approximately 35 Mbps. This set-up works very well for me, and my review performance is as good as it is onsite at the hospital.
I also have a special mouse and keyboard that I have configured to be able to steer the dictaphone and use keyboard shortcuts. It makes me more efficient. Altogether, the ergonomics are good—however, I do miss my height-adjustable desk and the possibility to work while standing.
It’s also worth mentioning that our radiology department is currently preparing home-working kits for a broader roll-out to enable even more radiologists to work from home should the situation worsen.
Mattias by his three-screen workstation at home.
A close-up of Mattias’ workstation at home, with a special mouse and keyboard that he has configured.
The biggest drawback is the lack of spontaneous discussions with colleagues that normally occur at work, like the small informal meetings. Otherwise, there are not many disadvantages, as I see it. I am more productive working from home, as I don’t experience the same level of disturbance, big or small.
One possible disadvantage is the effect on my colleagues still working onsite. They now have a higher workload as they must perform the examinations that require onsite presence. Having to maintain contact with colleauges working from home also increases their workloads to some extent.
I use the integrated chat functionality in PACS a lot to communicate with my colleagues. It allows us to create groups so we can share and discuss cases, to see where everyone is physically located, and if they are active or offline. It has proven particularly beneficial in these special times—so beneficial, in fact, that even the technologists and radiology nurses now have started to use the chat functionality.
As I mentioned, the chat functionality is great. And it is also really convenient to work with shared worklists driven from the PACS, where I can see which cases other radiologists are working on and we have the possibility to easily share the workload.
Many radiologists have the luxury of actually being able to be flexible in their work situation—in contrast to many other specialties. I encourage everyone to really utilize the technology, to embrace it and turn it into an advantage. For example, a colleague got stuck in Germany due to travel restrictions, but he could still continue working remotely because of the home-reading option. That’s just great, isn’t it?
