Two immediate measurable benefits to optimizing picture archiving and communications system, PACS and radiology protocols is the ability for radiologists to make an accurate diagnosis and to reduce unnecessary follow-up exams.
According to Ramin Khorasani, M.D., M.P.H., department of radiology at Brigham and Women’s Hospital in Boston, it is not uncommon for important clinical information to be discovered at the time a patient arrives for a scheduled procedure. These late discoveries result in much inefficiency if the protocols then have to change based on the needs of the patient.
Ways to Improve RIS
- Creating protocol work lists integrated into the workflow using the imaging request time, rather than the scheduled procedure time, can help improve efficiency. With the work list being dynamically generated throughout the day and available on PACS work stations, critical clinical information would be available in real time eliminating redundant procedures.
- Providing a summary of relevant electronic medical record (EMR) data to radiologists at the time of protocolling can improve quality, safety and efficiency.
- Offering clinical decision support can help to reduce inappropriate use of imaging when used by ordering physicians, wrote Dr. Khorasani.
- Using a medication order entry integrated with EMR data can help to reduce the risk of medication errors.
- Creating a radiologist-centric interface, combining only the relevant data from the EMR and RIS, can help to deliver a more efficient process overall.
Avoid Critical Communication Breakdowns
An issue that was not included in Dr. Khorasani’s article but bears noting is that the communication breakdown between referring physicians and radiologists can lead to critical errors in reporting resulting in litigation due to negative patient outcomes.
An American College of Radiology (ACR) survey revealed that 25% of respondents acknowledged being involved in at least one malpractice lawsuit involving failure of communication, with awards to the plaintiff averaging $2 million. The number of malpractice lawsuits involving failed communication and naming radiologists as either a defendant or a codefendant is increasing; and the size of payouts has grown substantially.
When we consider the sheer volume of reports the typical primary-care physician receives in one week, it’s no surprise that communications can, and do, break down. Establishing radiology protocols encourages a radiology “chain of command” that would work toward identifying crucial clinical information that will improve diagnoses and patient efficacy.