Web-Based Digital Radiology Cuts Emergency Head CT Time in Limited-Resource Hospital

Abstract

Rapid neuroimaging is critical in acute neurological emergencies, but film-based workflows in resource-limited hospitals often cause delays. This study evaluated a web-Based digital radiology system embedded in EMR on emergency head CT turnaround times (TAT). A quasi-experimental pre-post study with independent samples was conducted at a private class C non-teaching hospital in East Java, Indonesia, comparing two six-month periods: pre-implementation (January–June 2023) and post-implementation (January–June 2025), separated by a 12-month stabilization period. Technical TAT (scan completion to digital upload) was assessed in 200 cases (100 pre, 100 post); clinical TAT (scan completion to final  report) in 990 cases (485 pre, 505 post) using a census approach. Normality was tested using Shapiro-Wilk, followed by Mann-Whitney U test and chi-square test for quality standard achievement (≤15 minutes for technical TAT, ≤90 minutes for clinical TAT), with effect sizes (r, Phi) reported. Median technical TAT decreased from 19:04 to 11:12 minutes (41.3% reduction, U=2.000, p<.001, r=0.864), with ≤15-minute achievement rising from 0% to 98% (χ2=192.157, p<.001, Phi=0.980). Median clinical TAT decreased from 1:49:00 to 1:09:00 hours (39.6% reduction, U=79,576.000, p<.001, r=0.303), with ≤90-minute achievement improving from 45.8% to 76.0% (χ2=95.452, p<.001, Phi=0.311). This study shows that web-based digital radiology enhances emergency neuroimaging efficiency in limited-resource hospitals.