SIIM: Chang acts out rad dept woes, reinforcing need for better reporting
MINNEAPOLIS—Imaging informatics luminary Paul Chang, MD, PhD, medical director of enterprise imaging at University of Chicago Hospitals, may have missed his real calling; he and his colleagues presented a SIIM conference first—a play starring Chang as the cranky radiology chair. The plot replicated standard operating procedures and challenges in many departments.

During a department meeting, the chair gloats over the department’s glowing business. Slowly, various stakeholders unload their problems. The finance manager insists the department is in a deficit, and revenue doesn’t cover expenses despite increasing study volume. The chief technologist shares complaints from clinicians who are unhappy because it takes them too long to schedule their patients’ CT studies. Many are threatening to refer patients to the competition, said the technologist. His solution to the backlog is to buy another scanner and hire more techs. Then the medical director chimes in with his issues; referring physicians claim report turnaround time is too long. He suggests the hospital hire another radiologist.

In the play, the infuriated, yet comical, Chang explodes, demanding that the staff identify the causes of the department’s woes. One by one, staff trickles into the IT department, begging for reports. The sole IT staffer takes more than a week to compile the reactive reports before quitting his job.

“Radiology can’t fly blind,” stated Chang. Running an imaging department without critical data like report turnaround time, scanner utilization and revenue and expenses not only embodies inefficiency but invites failure.

Chang concluded the performance with a process for achieving imaging informatics nirvana, which included these steps:
  • Start with formal sustainable methodology including people, process and governance;
  • Collect and validate data;
  • Integrate multiple databases into a consistent format in a data warehouse;
  • Enable data mining; and
  • Present dashboards and reports.

Ramin Khorasani, MD, vice chair of the department of radiology at Brigham and Women’s Hospital in Boston, added to Chang’s list, insisting that dashboard-driven performance improvement requires more than IT. He stressed that the essential ingredients are leadership, change management skills, quality and process improvement measures and performance improvement metrics.