The primary purpose of this study is to determine if the implementation of an actionable findings communication system (PeerVue) with explicitly defined criteria for the classification of critical results, leads to an increase in the number of actionable findings reported by radiologists. Secondary goals are to 1) analyze the adoption rate of PeerVue and 2) assess the accuracy of the classification of actionable findings within this system. Over a two-year period, 890,204 radiology reports were analyzed retrospectively in order to identify the number of actionable findings communicated before (Year 1) and after the implementation of PeerVue (Year 2) at a tertiary care academic medical center. A sub-sample of 145 actionable findings over a two-month period in Year 2 was further analyzed to assess the degree of concordance with our reporting policy. Before PeerVue, 4623/423,070 (1.09%) of radiology reports contained an actionable finding. After its implementation, this number increased to 6825/467,134 (1.46%) (p < 0.0001). PeerVue was used in 3886/6825 (56.9%) cases with actionable findings. The remaining 2939/6825 (43.1%) were reported using the legacy tagging system. From the sub-sample taken from PeerVue, 104/145 (71.7%) were consistent with the updated reporting policy. A software program (PeerVue) utilized for the communication of actionable findings contributed to a 34% (p < 0.0001) increase in the reporting rate of actionable findings. A sub-analysis within the new system indicated a 56.9% adoption rate and a 71.7% accuracy rate in reporting of actionable findings.

The final product of a diagnostic imaging study is the completed image set on the radiologists’ PACS and radiology information system worklist. Before the case is completed, multiple prior steps are required. The clinical provider must order the imaging study, the radiologist must complete the protocol, the administration must obtain insurance preauthorization, and the schedulers must book the imaging examination. Improving the process of scheduling these examinations has become a priority at our institution.

The purpose of this communication is to share our experience in creating an interventional radiology (IR)-specific peer review process, provide our initial results, and discuss future modifications and refinements to the system so that our institution— and others—can improve on the process of implementing peer review moving forward

In light of the heightened awareness of radiation’s cancer-causing potential and the dramatic increase in the number of CT studies, minimizing radiation exposure is a paramount objective in radiology. An issue that complicates this goal is that image quality is a function of the dose of radiation. In other words, larger doses result in higher quality images. The goal then is to strike a balance to maximize patient safety: reduce radiation without compromising the quality of the image.

PURPOSE: The purpose of this study was to improve the transcription of patient information from imaging study requisitions to the radiology information database at a single institution. METHODS: Five hundred radiology reports from adult outpatient radiographic examinations were chosen randomly from the radiology information system (RIS) and categorized according to their degree of concordance with their corresponding clinical order indications. The number and types of grammatical errors and types of order forms were also recorded. Countermeasures centered on the education of the technical staff and referring physician offices and the implementation of a checklist. Another sample of 500 reports was taken after the implementation of the countermeasures and compared with the baseline data using a chi2 test. RESULTS: The number of RIS indications perfectly concordant with their corresponding clinical order indications increased from 232 (46.4%) to 314 (62.8%) after the implementation of the countermeasures (P < .0001). The number of partially concordant matches due to inadequate RIS indications dropped from 162 (32.4%) to 114 (22.8%) (P < .001), whereas the number of partially concordant matches due to inadequate clinical order indications increased from 22 (4.4%) to 57 (11.4%) (P < .0001). The number of discordant pairings dropped from 84 (16.8%) to 15 (3%) (P < .0001). Technologists began to input additional patient information obtained from the patients (not present in the image requisitions) in the RIS after the implementation of the countermeasures. CONCLUSIONS: The education of technical staff members and the implementation of a checklist markedly improved the information provided to radiologists on image requisitions from referring providers.

Case study in clinical practice management on reducing radiation exposure without compromising image quality for lumbar spine CT.