The Programmable Mouse: A Quality Improvement Project

Mouse Programming Tutorial

Quality means different things to different people.  It changes depending on the context.  For a radiologist, quality typically means utilizing the best and safest imaging practices available for detection, diagnosis, and follow-up of disease.  For an ordering physician, quality frequently means prompt turnaround of an accurate, concise, and actionable final report.  For a patient, quality is often less precise.  The patient often takes it on good faith that the radiologist uses the best practices with prompt, accurate reporting.  With no means to measure this, the basis of quality for the patient is often the entirety of their experience, from finding parking, to registration, to the cleanliness of the waiting room and exam room, and interaction with the support staff, technologists, and radiologists.  It seems for many of us in radiology, ambiguity of quality leads to tribulation over how to satisfy the mandated Practice Quality Improvement (PQI) project for the ABR’s Maintenance of Certification (MOC) Program. 

 A group quality project that was proposed and is currently in progress is to find new technologies  that may improve our effectiveness as radiologists.  Day to day practice centers around three  devices, the Dictaphone, keyboard, and mouse.  In our department, these have not changed in the  last 10 years.  In fact, most PACS computers have the original devices.  This project focuses on  finding a substitute for the current mouse that may improve our productivity. 

 During a 4 year period, over 20 input devices were purchased and evaluated by myself to replace  the traditional mouse.  These devices included wired and wireless mice, tablets and touch pads, programmable boards, and 3D mice.  The companies included were Logitech®, Razer®, Wacom®, IBM®, and 3Dconnexion®.  After evaluation of these devices, a number of essential features were identified.  The device needed to be compatible with the current PACS system, as simple as plugging in a USB with no software installation required, and easily programmable.  Potential programmable mouse buttons include initiate dictation, previous and next series, scout line, localizer, spine labeling, and bone/soft tissue/lung window settings.  A fly-wheel option was preferred over the traditional scroll wheel for large image stacks.  Because of these requirements, the device list narrowed down to products from Logitech®, in particular, the G500 wired mouse and G700 wireless mouse and their successors the G500s/G502s and G700s mice.  Initial evaluation by some of the more technologically savvy faculty was overwhelmingly positive.  As was described by one participant, "it is the difference between starting a fire rubbing two sticks together versus using a lighter.  The cook can focus on cooking, not starting the fire."

The natural conclusion would be improved productivity and speed, but this is an indirect measure of improvement. The purpose of these mice are to simplify the tools we use so we can focus on the study and not be distracted by finding the tools in the menu/submenus.  The largest hurdle noted by this group was the steep learning curve.

The current iteration of the plan-do-study-act (PDSA) cycle includes a diversity of radiologists from those that are technically savvy to those that see themselves as technically challenged.  The goal is to try to reduce the learning curve to encourage a wider adoption of these mice.  Those interested in learning more should contact one of the participants for their feedback and/or email myself at Andrew.Chen@umassmemorial.org.  Trainees are highly encouraged to participate in this and similar future projects as this is a practical skill that is portable to future endeavors.