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In digital radiography, computed radiography (CR) technology is based on latent image capture by storage phosphors whereas direct radiography (DR) technology is based either on indirect conversion using a scintillator or direct conversion using a photoconductor. DR-based portable imaging systems may enhance workflow efficiency. The purpose of this work was to investigate changes in workflow efficiency at a tertiary healthcare center after transitioning from CR to DR technology for imaging with portable x-ray units. An IRB exemption was obtained. Data for all inpatient-radiographs acquired with portable x-ray units from July-2014 till June-2015 (period 1) with CR technology (AMX4 or AMX4+ portable unit from GE Healthcare, NX workstation from Agfa Healthcare for digitization), from July-2015 till June-2016 (period 2) with DR technology (Carestream DRX-Revolution x-ray units and DRX-1C image receptors) and from July-2016 till January-2017 (period 3; same DR technology) were extracted using Centricity RIS-IC (GE Healthcare). Duration between the imaging-examination scheduled time and completed time (timesch-com) was calculated and compared using non-parametric tests (between the three time periods with corrections for multiple comparisons; three time periods were used to identify if there were any other potential temporal trends not related to transitioning from CR to DR). IBM's SPSS package was used for statistical analysis. Overall data was obtained from 33131, 32194, and 18015 cases in periods 1, 2 and 3, respectively. Independent-Samples Kruskal-Wallis test revealed a statistically significant difference in timesch-com across the three time periods (χ2(2, n= 83,340) = 2053, p < 0.001). The timesch-com was highest for period 1 i.e., radiographs acquired with CR technology (median: 64 minutes) and it decreased significantly for radiographs acquired with DR technology in periods 2 (median: 49 minutes; p < 0.001) and 3 (median∶ 44 minutes; p < 0.001). Overall, adoption of DR technology resulted in a drop in timesch-com by 27% relative to the use of CR technology. Transitioning from CR to DR was associated with improved workflow efficiency for radiographic imaging with portable x-ray units.
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