Application of usability testing for improving PACS workstation design

User-centered design is a critical step in the product development cycle. It is an iterative process consisting of product design, implementation, and evaluation stages. Industry-standard usability metrics were employed to evaluate two sequential versions of commercial Picture Archiving and Communications System (PACS) workstation software as part of this process. They were evaluated 6 months apart by five radiologists with varying PACS experience. All radiologists were naive to the specific workstation tested. After a brief workstation overview, they were videotaped as they completed scenarios that closely simulated typical radiological practice. Each scenario consisted of various task categories. The task duration, nature and number of errors, help requests, and operator's manual consultations were recorded. After evaluating the fast software version, areas for improvement were identified and the application design modified. An unexpected result was the rewriting of the software manual to be task- and process-based rather than feature-based. Testing of the second version revealed a 22% improvement in performance time and 30% decrease in the number of errors compared to the first. Usability testing objectively identifies areas for improvement in the PACS workstation software. Additionally, it provides quantitative measures that may be used to prioritize and suggest future design efforts. Performing this evaluation as early as possible results in the rapid evolution of an application that will maximize radiologists' productivity and satisfaction.