Interview with Dr. Robyn Cairns, pediatric radiologist at British Columbia’s Children’s Hospital and vice chair of medical informatics for the Department of Radiology at University of British Columbia
With the rapid expansion of radiology comes a corresponding need for advances in radiology peer review. Dr. Robyn Cairns, pediatric radiologist at BC Children’s Hospital in British Columbia and vice chair of medical informatics for the Department of Radiology, University of British Columbia, puts it this way, “The busy pace of a radiology practice demands an efficient solution to integrate peer review into radiologist workflow.”
Cairns has long observed the duality of radiology peer review — everyone agrees it’s important and beneficial, but it adds a significant burden to radiologists already struggling to complete their daily tasks. “It’s time consuming for me to stop my dictation workflow, fill in a piece of paper, and file it somewhere,” she says. “Sometimes it’s difficult to get to QA rounds, which are in turn frustrating because they capture such a small amount of data.”
The effort to keep up with peer review programs is running smack into an even greater need for them. “Peer review is key to making sure we’re doing the best job for patients,” says Cairns, adding that it’s critical for the public to know there are systems, such as Qualitative Intelligence Communication Systems (QICS) in place to protect them against people who aren’t keeping their skills up or aren’t capable of doing the work.
As worldwide pressures to improve the quality of healthcare continue to build, radiology peer review will also play a greater role in demonstrating care quality. “I think the pressure is on all physicians to be more accountable. In radiology, unlike other forms of medicine, the images are there, so they can be reviewed by another person to assess quality,” says Cairns, who helped evaluate products for a peer review pilot involving Vancouver Island Health Authority radiologists. The British Columbia program will eventually be the largest cross-facility initiative of its kind in North America, encompassing hundreds of radiologists. Approximately 3.5 million medical imaging studies are interpreted across BC each year and once complete this project will be applied to assess the quality of some of those studies.
Cairns notes that automated peer review systems (provided they are user friendly and seamlessly integrated with an organization’s PACS) not only solve these issues, but provide tremendous opportunities.
“The technology itself is a huge enabler because it pushes reviews to radiologists with clear instructions on how many they need to do and the indications for the review,” she said.
Even more exciting is its potential to provide departmental data to aid in quality initiatives and population data to aid in care improvement. “Right now in peer review, there is limited meaningful data collection over time. If we miss something, it gets noted but it is difficult to consolidate this data to apply it to quality improvement initiatives,” explains Cairns.
Another potential benefit of automated radiology peer review is increased use of in-progress peer consultation reviews, reviews performed prior to distribution of a final report, which is currently constrained by logistics. If making an in-progress peer consultation request was as easy as clicking a button, more radiologists might take advantage of a second opinion, says Cairns. “Right now, peer review is all about what’s mandated, but I think there are many opportunities to take technology that’s already in place and extend it to add more value to patient care.”
Learn about how McKesson’s QICS for Radiologist Peer Review can help your team improve workflow and improve patient safety.