Development of COVID-19 Screening Process with Mobile Chest Radiography Service in Integration with the Online PACs

Abstract

Chest radiography is crucial for the diagnosis and treatment of COVID-19-induced pneumonia. This action research aimed at examining the situation and factors impacting the chest X-ray screening service. The study involves three phases: phase 1: identification of factors and problems in radiology service; phase 2: development and administration of the framework with digital radiography mobile (DR) system, combined with online film reading on the ‘Radio Volunteer’ digital platform; and phase 3: evaluation of screening process performance. In the epidemiological scenario of Kosum Phisai district, the daily infection rate has surpassed 40 cases (6.25%), the conventional computed radiography (CR) manifested tardiness in coping with escalated number of patients, necessitating the engagement of two personnel per screening cycle. Furthermore, certain cases encountered delays due to radiologist interpretation requirement. After implementing the new framework, we reached the maximum screening capacity up to 116 cases per round, equivalent to 14.5 cases per hour. This not only diminished the delay of the acquisition but also demonstrated the operational efficiency with a singular operator. The radio volunteer online film interpretation system processed a maximum of 98 images within 12.25 minutes, reflecting a velocity of 8 images per minute, before quick interpretation the severity of pneumonia by the volunteer radiologists. In July and August, category 4 and 5 patients totaled 36 (18.94%) and 74 (15.10%), respectively. This intervention enhanced the efficiency of the chest X-ray screening process for medical emergency responsiveness accommodating the escalating caseload.