From this survey it becomes clear that most Dutch radiology departments are well digitised. In most PACS the RIS is fully integrated, only in one quarter (25%) the PACS is linked to the EPR.

In most radiology groups usage of teleradiology is limited to the ability to view images from the hospital at home or elsewhere, mostly for on-call situations. Therefore teleradiology is mostly of the intra-mural type [1, 3]. Currently there is only very limited secured networking between hospitals enabling digital transmission radiological images, and outsourcing is currently only being used in one academic centre. Most radiological examinations are still distributed using CD’s or DVD’s. From this survey it becomes obvious that there is a very strong need and demand for a digital image distribution network between Dutch hospitals. Moreover, this DVD-based image exchange system no longer meets the current legal requirements, stipulating that privacy-sensitive data should be transferred using a state-of-the-art method, i.e. digitally and appropriately secured. Therefore the radiologists’ rightly demand for digital image exchange is currently insufficiently answered.

The management of PACS- and IT-systems in the radiology department doesn’t seem to be organised in a seamless manner: usage of SLA’s is insufficiently known and should therefore be encouraged. The involvement of radiologists in the management of these systems is waning, some respondents even stated that the leading position of radiologists is lost and that the role of radiologists has become rather formal and passive. This is especially true once the PACS is installed; radiologists are insufficiently steering further optimisation of the workflow with the system.

A majority thinks that the knowledge of PACS and radiology related IT-systems is lagging behind among radiologists and that postgraduate training and support in these issues should be increased within the radiological society.

Although most hospitals are already using “standard reports” for various examinations, the usage of Structured Reporting (SR) is currently not well established in the Netherlands [3]. This is mainly for technical reasons and due to the lack of commercially available software allowing efficient integration of structured reporting in the daily workflow. For the same reason integration of coding systems such as RadLex and SNOMED-CT with structured reporting is not yet widely implemented.

Based upon the results of this survey we can conclude that Dutch radiologists want the following:

• Facilitation of image distribution between hospitals using a secured digital network,
• Further implementation of SLA’s between radiologists and IT-departments,
• Additional training and support of radiologists in IT-related issues,
• Software developments enabling easy implementation of structured reporting and
• Creation of a nation-wide teaching database

These topics therefore deserve further attention of the Radiological Society of the Netherlands.