From the perspective of the practicing radiologist, MyPACS greatly simplifies the task of saving, organizing, and accessing interesting or instructive images. The traditional cut film teaching file required the radiologist to pull images out of the workflow, the file room personnel to take time to make copies, and the department to absorb substantial additional film costs. Most cut film teaching files suffered significant loss of the best images over time. Cut film collections were difficult to store and move, and images could only be viewed at one location at any given time.

When combined with an efficient means of capturing images, MyPACS addresses each of these issues. Image acquisition can be accomplished from a PACS system in seconds, without being removed from the clinical workflow. Case creation in MyPACS takes only a few minutes. Once entered, cases are instantly available from anywhere on the network, and the same images can be viewed simultaneously at multiple sites. The database housing the images is backed up, preventing loss of images. Storage, copying, and distribution of the digital images is quick, efficient, and inexpensive. We have found that MyPACS is far superior to our cut film teaching file for all of these reasons.

We have also expanded the role of MyPACS beyond that of the traditional cut film teaching file. We use MyPACS as a tool during intra- and inter-departmental conferences. Our intradepartmental interesting case conference is given directly from a folder we have created within MyPACS. This encourages presenting residents and fellows to enter cases into the teaching file as they prepare for the conference. It also decreases access time to the images, since even when using PACS we had to spend substantial time finding the best images in each patient's digital folder. When presenting from MyPACS we maintain patient confidentiality - this was difficult to do when presenting from PACS. After each conference, we keep the conference folder in the teaching file, so that those wishing to review cases shown can do so at their leisure, and so that anyone who missed conference can review the images on their own.

At our joint surgery/radiology conference, we include interesting intra-operative digital photographs, so that the radiologists can see the gross pathology as the surgeons see it, and so that surgeons who were not present at a particular case have a better picture of the case's surgical findings. These photographs usually generate lively discussions between the radiologists and the surgeons, enhancing communication between the groups and improving understanding of the cases from both the radiological and the surgical perspective.

We use MyPACS in formal teaching situations. For instance, as medical students rotate through our department, we direct them to a core set of cases on MyPACS which they review on their own and then review again with a staff radiologist asking directed questions and showing additional correlative images and cases, again from MyPACS. There is little preparation time required of staff, since all cases are pre-fetched in teaching folders. Instruction can occur at any computer on the network. This is far preferable to our previous system, wherein we enlisted radiology staff to locate, retrieve, and present cases from cut films, which was far more time consuming for our radiologists and not more educational for the students.

MyPACS is useful in daily informal teaching as well. With a core set of examples of normal studies and common pathologies residing on MyPACS, we can direct residents to look up those cases on MyPACS as they encounter confusing anatomy or pathologic conditions without their having to leave the readout area to conduct a lengthy search through textbooks, cut films, or journal articles. The immediacy of teaching by this method can be highly effective.

We use MyPACS to store, organize, and retrieve cases for upcoming publications and presentations. The flexible text fields, advanced search features, anatomic/pathologic subcategories, folder structuring, and comments fields included with MyPACS simplify the task of locating and copying relevant images and text. This makes lecture and publication preparation far more efficient.

In summary, MyPACS enhances access to useful images in our everyday clinical practice. By making instructive images more accessible, MyPACS enhances our ability to teach, and increases the quality of the images we use to teach while decreasing the time it takes us to locate, organize, and display those images. This enhanced access is invaluable to us as we work to fulfill our educational mission while struggling to keep up with ever-increasing clinical demands.