RSNA2023 Leading Through Change
Daily Bulletin

Powerup Your PACS Game Using Gaming Devices

Thursday, Nov. 30, 2023

By Nick Klenske

Not only is your standard PACS setup of a mouse, keyboard and dictaphone 'old school', it's grossly inefficient. In fact, a study conducted by the University Hospital Basel estimated that the average radiologist mouse travels nearly 1.5 miles in a single eight-hour shift!


"From changing windows to measuring a lesion or region of interest and toggling between image sets, many PACS functions involve multiple clicks or movements of the opposite hand to engage keyboard shortcuts," explained Puneet Bhargava, MD, director, Gastrointestinal Radiology at the University of Washington (UW), Seattle.

But more than being inefficient, today's PACS setups are also bad for your wrists.

"All those repeated mouse tasks require radiologists to shift their focus away from the diagnostic image and impose cognitive and physical strain, as well as result in fatigue and a higher probability for errors," added Nitin Venugopal, MD, a radiology resident at UW.

Drs. Bhargava and Venugopal decided it was high time to rethink the PACS paradigm, and to do so, they drew inspiration from today's gaming devices.

"Computer gamers and video editors have all kinds of interesting devices that they use to augment their workflow and make it more efficient," Dr. Bhargava said.

According to Dr. Venugopal, the radiology workflow is similar to that of video editors and graphic designers. "Whether they know it or not, many radiologists already have a gaming mouse and keyboard at their workstation, they're just not using these devices' advanced features," he said.

Hacked for PACS

The two colleagues showcased some of these devices—and what they can do—as part of an Imaging Informatics Education Exhibit.

"We want radiologists to know how easy it is to program a gaming mouse, keyboard or macro pad and instantly boost its efficiency," Dr. Bhargava remarked.

Take for example the gaming mouse. Although designed for playing video games, these high-end devices are customizable—meaning they can be easily hacked for PACS.

Dr. Bhargava also recommended investing in a 'hyper-scroll' enabled mouse. "This allows the mouse to move freely and can make it easier to review cross sectional imaging," he said.

Time to Take Advantage of Advanced Peripheral Devices

Drs. Venugopal and Bhargava say their goal is to see peripheral devices designed specifically for radiologists on the market.

Until then, the two encourage radiologists to discover how easy it is to program shortcuts onto their own devices and try it out for themselves.

"I feel like we're leaving a lot of efficiency on the table by not taking advantage of advanced peripheral devices," Dr. Venugopal said.

"Don't limit yourself to the traditional mouse, keyboard and dictaphone set up," Dr. Bhargava added. "There are plenty of interesting and useful peripheral devices out there that can fit your individual needs as a radiologist."

Dr. Bhargava has a website where radiologists can learn more about select alternative tech tools.

Access the presentation, "Improving Workstation Ergonomics and Productivity with Input Devices: Saving Time and Your Wrists," (INEE-17) on demand at