How Should You Control Peer Review and Peer Feedback Workflows?

2016-07-22
 

Clinicians giving peer feedback in a hospitalClearly defining the differences between peer review and peer feedback can be difficult, because these two concepts often overlap, and Radiology departments have unique workflows and standards that govern quality and collaboration.

A question to the UK Imaging Informatics Group about the differences between the two sparked a lively internal discussion. This particular discussion thread defined Peer Feedback as “the process to provide feedback for radiologists when an addendum is added to a previously dictated report, and Peer Review as “a review of a reported exam, whether or not an addendum was added.

We understand the importance of facilitating, communicating and tracking both peer review and peer feedback. Because sites have different and often unique needs, it’s hard to be successful with a one-size-fits-all solution, which is why our product teams at Change Healthcare designed Conserus Workflow Intelligence™ as a flexible rules engine that can be configured according to your needs.

Handling Peer Feedback with and without an Addendum Workflow

As the question thread describes, peer feedback has tremendous educational value; capturing teaching opportunities every time they occur is the key to creating a culture of continuous learning. In order to automate this process, Conserus Workflow Intelligence can be configured to recognize occasions where a peer feedback addendum is created. Rules can be created that trigger an alert for the reporting radiologist when an addendum is added to the original report so that no learning opportunities are missed.

The discussion thread also noted the various opportunities for peer review throughout the radiology workflow. These include multidisciplinary team meetings, ad hoc clinical review and more structured quality assurance and credentialing processes. In order to facilitate each of these opportunities as they arise, Conserus Workflow Intelligence is integrated directly within a PACS system and can initiate a peer review with little negative impact on productivity.

Sites can configure the system to meet standards as they evolve. For example, if a site wants to comply with the RCR Quality assurance in radiology reporting: peer feedback (which recommends systematic review of 5% of reports by December 2018) or the Bupa insurance requirement that 10% of cases be peer-reviewed, they simply use these rules as the baseline during the creation of the workflows. Once configured, the system will automatically select and distribute the appropriate number of peer review cases to meet these guidelines.

Change Healthcare’s solutions allow customers to choose from several best-practice peer review models and monitor the process. They have the flexibility to offer unique workflows that combine peer feedback with ongoing peer review. Other features include site-determined random selection of exams, sophisticated and flexible assignment and communication capabilities, escalation rules and reminders that help prevent cases from slipping through the cracks, as well as robust results tracking for statistical and benchmarking analysis.

This flexibility allows departments to choose from several best-practice models, including: Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE); proctoring; and on-the-fly and blind peer review, which can incorporate anonymous, real-time chat with the reviewing radiologist. But at the end of the day, we work with each site to design the workflow that makes sense and reflects the priorities and realities of individual departments.

You choose how to notify your users and whether or not you want to include a link to the study and the report to make things easy for those receiving the alert. You decide what information is included in the message and whether or not you need escalation rules that will help close the communication loop.

Based on how the rules are set up, the feedback can be sent directly to the radiologist, to a QA committee for follow-up, stored as a learning case or any combination of those.

We know how important peer feedback and peer review are. If you are having trouble managing these kinds of communication, we hope you check out Conserus Workflow Intelligence, Change Healthcare’s solution for workflow orchestration. Send us your questions or ask us for a demonstration to learn more.

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