Strategies for radiology reporting and communication : part 4: quality assurance and education. While the digitization of medical imaging practice has brought a number of dramatic changes in technology and workflow, perhaps the most understated change has been the change in physical layout and staff location, which has evolved from a central to distributed model 1. In analog practice, the departmental layout and staff location were centrally and group focused, with both the radiologist reading room and technologist working area created to accommodate large groups of individuals, which routinely interacted with one another for the purposes of peertopeer education, quality assurance, and case review. This naturally created an atmosphere of ongoing communication, collegiality, and mentoring. This trend of group dynamics and interaction extended to the medical staff, which by necessity had to physically travel to the radiology department to review imaging studies ordered on their patients. With the transition to filmless operation, this centralized working model was replaced by a distributed model, in which radiologists and technologists work in relative independence to one another. While this was intended to improve workflow and operational efficiency, the unintended impact has been diminished interpersonal communication, peer review, and education. As access to medical imaging data has become ubiquitous and instantaneous with the adoption of the picture archival and communication system, this distributed practice model has also extended into the referring physician community, resulting in decreased facetoface communications between radiologists and referring physicians 2. This distributed model of radiology practice has become further magnified with teleradiology, with the outsourcing of professional radiologist services to remote locations and independent (i.e., third party) service providers 3,  changes :257,outside of medicine have dramatically changed the manner and speed with which individuals communicate and interact with one another. Direct dialogue has been largely replaced by electronic communication, which can take place through text messaging, instant messaging, and email. While this shift towards electronic communication has had a positive impact on communication workflow and timeliness, it has also led to a diminution in the degree of interpersonal connection between the communicating parties 5, 6. While computerbased facetoface communication options do exist (e.g., Skype), they are relatively impractical in the setting of quick and concise communications which are routinely customary within everyday medical imaging practice. In these situations, it is less important to see one anotheru0027s face than it is to see the imaging dataset, which is the central component of the communication 7. The ideal solution is to, therefore, create a technology which fosters communication in a fast and intuitive manner, incorporates some degree of familiarity and individuality into the communication process, and directly integrates the imaging dataset into the communication platform.

Design of a safe computersupported cooperative environment in radiotherapy: exploratory identification of cooperation strategies Motivation  This research deals with the identification of collective production of a safe radiotherapy treatment and its potential assistance through computersupported environments. It takes place at the beginning of a four years design project involving software companies and and scientific and clinical institutions. Research approach  This work presents an exploratory analysis of cooperation between the four professionals involved in the production of radiotherapy treatment. Our general research objective is to investigate how to support managed safety in the design of a computersupported cooperative environment. Uses and functions of cooperative tools have been outlined through observations and the think aloud technique. FindingsDesign  We identify three types of cooperation tools (computerbased tools, including an existing workflow, unformal verbal exchanges, and the patient body) involved in the production of a safe treatment. Their main functions are : to produce shareable data between professionals, to share the progress in the construction of a treatment and to share procedures and work practices. Research limitationsImplications  This paper aims at contributing to the articulation of two research approaches: CSCW and safety in healthcare. OriginalityValue  Our study reveals informal strategies that participate to a managed healthcare safety performed by professionals. Take away message  Our work may contribute to transform the initial technocentric approach of the design project into a more anthropocentric design project and flexible CSCW tool.