Radiologists are an integral part of the healthcare team because they help move the patient towards a diagnosis and therefore treatment.

And all of this happens in radiology reading rooms, which are busy places, handling thousands of images and hosting a horde of referring physicians wishing to consult with radiologists.

In the ‘80s, the Picture and Archiving Communications System (PACS) was introduced. The focus became increasing radiologist productivity, which was often tied to reimbursement. After that, radiologists gradually disappeared into a reading cubicle, churning out imaging cases.


Soon after, PACS with voice recognition (VR) took off and drastically impacted the design of medical imaging reading environments. The perception of radiology as a cost center caused many a reading room to be relegated to a dark corner of the hospital, often away from the main radiology department.


PACS did more than eliminate film, the system took away collaboration and camaraderie and we lost ergonomic workspaces designed around view boxes because of bulky CRT displays.


Poor ergonomics create a sedentary workplace and are now widely accepted as contributing factors to radiologist fatigue and burnout. Imaging and radiologists will thrive if they can adapt and step out from behind their reading stations to become integral members of the healthcare team.


The focus must change from only productivity to properly designed ergonomic workstations and reading room environments that can increase accessibility while maintaining productivity.


Ergonomic Room Design



Ergonomic design ensures that reading rooms support the operational, clinical, and educational needs of the department, while minimizing distractions, improving efficiency and providing a comfortable working environment to protect the long-term health of the staff.


A proper reading room location can significantly enhance communication between radiologists and physicians. This leads to improved quality of care and customer service, increasing long-term value of radiology.

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Eliminating repetitive strain injuries (RSIs) and minimizing interpreter fatigue should be the primary goal of any reading environment optimization effort.


Radiologists in particular have been found to be at high risk of neck, back, shoulder and wrist injuries as well as visual fatigue. These risks arise from a sedentary work environment and accumulate over time. They can significantly impact productivity, personal health, and diagnostic accuracy.


Training in the proper use and adjustment of all ergonomic equipment and design features should be included in any reading environment optimization effort, to ensure equipment is properly adjusted and utilized so their benefits are realized.

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Seating is one of the most critical components of proper ergonomics and comfort. Seats must be fully adjustable to accommodate individuals of different heights and body types. Alternating positions between sitting and standing is the best way to avoid back pain and other discomforts due to sitting for extended periods.

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Input Devices

While adoption of ergonomic mice and keyboards is important, radiologist adoption of voice recognition has made the speech microphone the primary input device. Use of hands-free devices, including headsets, should be considered.

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Poor acoustics can adversely affect both the performance of the software as well as the performance of the radiologist. Reading room design needs to minimize noise resulting from radiologist dictations, as well as surrounding noise. Acoustic issues are most prevalent in shared reading environments, which are common in large teaching hospitals and can also be seen in smaller community-based hospitals.


Additionally, many other ambient sound pollutants, such as HVAC and computer fan noise, ringing phones (landline and cellular) all need to considered and minimized in the final design.


A combination of passive noise reduction methods (i.e., acoustical treatments on walls, ceilings and floors) and active noise cancellation options are part of RedRick’s design process.

Work Surfaces

Work surface designs (desktops) should allow horizontal re-positioning of monitors for optimal viewing by multiple users, in both sitting and standing positions. There must also be enough depth and width for books and support materials, particularly in academic environments.

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Display Management

Displays should be height adjustable in relation to the main work/input device surface to ensure they are viewed at a slight downward angle. To minimize eye fatigue and strain, additional adjustments and placement in the horizontal plane (forward/backward, side-to-side) are required. Monitors should be arranged in a single row and in a semi-circle to ensure all are equidistant from the viewer’s eyes. To further relax the eyes and reduce eye strain, radiologists should be trained to look at an object 20 feet from their displays, every 20 minutes, for 20 seconds.

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Ambient lighting intensity must equal monitor illumination intensity to reduce eye fatigue. In general, lighting design should aim to minimize eye strain and associated fatigue and maximize viewing of multiple workstations.

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Environmental Control

The introduction of multiple monitors, CPU’s, dictation equipment, and other heat-generating electronic devices requires paying special attention to the design of the air conditioning system. Reading room HVAC must be dedicated and highly adjustable to ensure that personal preferences can be met. Airflow controls should be available for the overall room common spaces but should be adjustable in individual reading areas.

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All finish materials (flooring, ceiling, and walls) should be sound and light-absorbing. The use of carpeting, sound-absorbing ceiling tiles, and acoustical wall panels is a good idea. Where carpeting may not be allowed, due to infection control, use alternative flooring materials, such as recycled rubber to provide both acoustical properties as well as easy cleaning.

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Layout and Location

Layout should group individuals, who need to communicate with each other, more closely (i.e., radiologists in a specific subspecialty). Similarly, radiologists in the same specialty should be grouped closely to facilitate efficient communication.


The reading room design should ensure that staff and clinicians can find a specific radiologist or reading zone with the least amount of disruption or distraction to others within the environment.


Teaching rooms should be placed near main entrances to minimize groups of individuals walking through the entire reading area.


Furthermore, room location should encourage and facilitate communications by minimizing the distance between the reading room, technologists, and referring physicians.


The reading room layout should be forward-looking, keeping in mind that technology is ever-changing and devices might need to be added or subtracted from the mix.


A reading room can be divided into three environment zones, all of which have different ergonomic needs.

Primary Zone

This is the work zone immediately in front of the radiologists where they interact with primary viewing technologies, including monitors and input devices. This is the area that is most impacted by ergonomics.


  • Seats should be fully adjustable and move with the individual to encourage good posture, head, neck, back, and arm support.

  • Multiple seating options should be provided, with each seat properly adjusted for every individual.

  • A routine of alternating between sitting and standing throughout the day should be adopted.

  • Workstations should support the weight of PACS systems, which can include multiple CPUs, as well as four or more medical-grade monitors.

  • To minimize distraction, the work surface should be made from a non-reflective (matte finish) material, neutral in color and hue.

  • The main work area should be a single surface that is not split or divided.

  • The size of the work surface should be large enough to accommodate the daily tools of the radiologist and fit two or more specialists, residents or fellows who may need to review cases together.

  • The workstation must provide the ability to adjust the monitors in the vertical, horizontal and lateral planes relative to a radiologist’s eyes. To minimize eye strain, all monitors should be 18”- 24” away and should be viewed downward at a 14-degree angle.

  • All adjustments must be easy and quick to perform, preferably with one hand.

  • The monitor mounting solution must be robust enough to securely hold the monitors in place once it has been fitted to individual needs.

  • Ergonomic keyboards and mice should be used to avoid injury caused from wrist deviation.

  • Hands-free devices should be adopted, particularly headsets for dictation and/or talking on the phone.

  • Individually adjustable task lighting should be incorporated into each reading workstation to illuminate items on the desktop yet not create glare on the monitor.

  • (White) light should be on a dimmer that is controlled by the user, allowing the eyes to adjust to lower ambient light intensity.

Secondary Zone

This zone is immediately outside the primary zone, immediately surrounding the radiologist. The key environmental issues in this zone include organizational factors such as clutter control, paper, and cable management.


  • The entire workstation should be height adjustable to facilitate sitting and standing, while maintaining proper ergonomics for individuals of all heights.

  • Space permitting, spread out the work surface beyond the Primary Zone to accommodate peripheral materials, such as documents, resources and device management.

  • Extra desktop power outlets and USB ports should be available to organize personal cell phones and tablets, as well as enable efficient connection to local computers and printers.

  • A telephone support arm that allows a radiologist to position the telephone in the most convenient location also frees-up valuable desk space.

  • Local storage of necessary office supplies, such as pens, pencils, paper clips, should be provided to avoid clutter and ensure supplies are easily found.

  • All ambient lighting used during business hours should be indirect and the intensity should be adjustable, to match the brightness of the PACS monitors.

  • Attempts should be made to divide individual reading areas using moveable panels with sound-absorbing and sound-blocking properties.

  • HVAC systems should not generate excessive noise and active and passive acoustic controls designed exclusively for the Tertiary Zone should extend into the Secondary Zone, since they are contiguous spaces.

  • Accommodations should be made so reading room visitors can have conversations with staff without creating a disruption.

  • Providing ample space for two or three people to meet, at each reading station, eliminates groups congregating in common areas.

  • Temperature and fan speed in each reading area should be individually controlled.

  • The use of directionally adjustable ceiling diffusers is highly recommended to minimize noise from airflow and ensure uniform temperature control.

Tertiary Zone

This zone is immediately outside the secondary zone and encompasses the remaining aspects of the entire reading environment as well as location of the reading environment.


  • Walls and partitions should be finished with neutral colours that harmonize with ambient light systems.

  • Where possible, sound absorbing wall and ceiling surfaces should be used to reduce ambient noise.

  • Floor finishes should be appropriate for high traffic, use of chairs, standing for prolonged periods and sound absorbing.

  • To minimize noise from outside the reading room, ensure that common exterior walls are well insulated.

  • Install an active sound masking system with controls located inside the reading area.

  • Consider the proximity of entry points (doors) in relation to individual reading areas and meeting rooms. Doors should not be immediately adjacent to individual staff.


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