AutoHotkey for Radiologists: One Key for the Things You Do a Hundred Times a Day

Radiologists press the same keys thousands of times a day. Next field, sign, window preset, copy, paste, next case. AutoHotkey is a free, open-source Windows scripting tool that lets you bind any of those sequences to a single key, and it is the reason the first RadPro helper was a text file rather than an installer. Here is what it is, why it suits a reading room, and where its limits are.

What AutoHotkey does

You write a small script that says "when this key is pressed, do these things," save it with an .ahk extension, and double-click it. From then on the key does what you told it to, in every program, until you close the script. The things it can do are the things you would do by hand: type text, press key combinations, click, switch windows, read and write the clipboard. Version 2 of the language is the one to learn; the syntax is cleaner than the old version and it is still actively maintained under the GPL.

; Ctrl+Alt+S: sign the report and advance to the next case
^!s::
{
    Send "{F15}"      ; the editor's sign key
    Sleep 300
    Send "^{F12}"     ; advance the PACS
}

The modifier symbols are the whole vocabulary: a caret for Ctrl, an exclamation mark for Alt, a plus sign for Shift, a hash for the Windows key. Everything after the double colon runs when the chord is pressed.

Why it suits a reading room

• It works on top of whatever you have. PowerScribe, Fluency, Dragon, a RIS module, a browser editor: AutoHotkey only sees a window and a keyboard, so it does not care which vendor is behind them. No integration, no IT project.
• It is free and it is a text file. You can read every line of what it does, which is more than can be said for most reading-room software, and your local IT can read it too before it goes near a clinical workstation.
• Microphones and macro pads speak its language. A programmable button on a dictation microphone typically sends a function key. Map that key in AutoHotkey and the button does anything you like. The companion posts on a duckyPad Pro and a Razer Naga V2 HyperSpeed take the same idea further.

How it connects to RadPro AI

The original RadPro helper, RadProHotkey.ahk, was exactly this: a script that copied the open report, switched to the RadPro AI tab, and pasted it in, with the reverse on Ctrl+Backtick. It still downloads from the download page. Its replacement, RadPro Hub, does the same job as a small Windows program with the things a script cannot easily give you: clipboard wiping after each transfer, a refusal to run while cloud clipboard sync is on, and a local audit trail. If you already run AutoHotkey, the two coexist. The Hub listens for Backtick, Shift+Backtick, Ctrl+Backtick, Alt+Backtick and Ctrl+Shift+Backtick, plus F13 to F24 for editor and PACS actions, and your own scripts can send any of those keys to it.

; Ctrl+Alt+R: send the open report to RadPro AI with a template
; (a doubled backtick is how AutoHotkey writes a literal backtick)
^!r::Send "+``"         ; Shift+Backtick, handled by RadPro Hub

Where the limits are

AutoHotkey sends synthetic keystrokes, so it is only as safe as the window in front of it. A paste that lands in the wrong field is undone with Ctrl+Z, but it is still a paste into a clinical record, and a script has no idea what it just typed. Keep the scripts short, keep the report editor in front when you press a key, and do not let a script run unattended. And read your institution's policy on unmanaged software before installing anything on a hospital workstation; a script you can read is easier to get approved than a black box, but it still needs approving.

A sensible first script

Bind one thing you do fifty times a day to one key you never use. For most radiologists that is "sign and next." Live with it for a week. Then add a second. The people who get the most out of AutoHotkey are not the ones with the longest scripts; they are the ones who removed the two or three keystrokes that were breaking their rhythm.