Keep it simple: Complicated path to patient data can slow workflow

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Click. Click. Click. An excessive number of mouse clicks—and subsequent ticking of the clock—is not something radiologists want to hear when interpreting an image.

Unfortunately, that has become the name of the game for many radiologists who need to go searching the information systems at their workstation to gather the data needed for an interpretation. If a user interface is not optimized, it can definitely slow down workflow.

“It’s so easy to get lost in all that extra stuff,” says Arun Krishnaraj, MD, MPH, of the department of radiology and medical imaging at the University of Virginia Health System. “Extra button clicks, the number of hyperlinks, and the number of options that you are accosted with when you deal with the electronic health record.”

Krishnaraj is the director of the division of body imaging at his institution, and recently spoke at the annual meeting of the Radiological Society of North America on the issue of streamlining workflow through efficient display of patient data.

Time is of the essence during an interpretation, and time is exactly what is too often wasted searching the medical record. Krishnaraj points to a study from Abraham Lin, of the department of radiology at Massachusetts General Hospital, and colleagues that appeared in a 2010 edition of the American Journal of Roentgenology. Lin et al. sought to determine how much time radiologists spend digging for information in the record, and in a sample of nearly 400 cases from more than 30 radiologists, they determined that 14 – 21 percent of a radiologist’s diagnostic effort during an interpretation is spent searching the EHR.

“What we need is the appropriate patient context, and all that information can be gleaned from the electronic health record,” says Krishnaraj. “The problem is that most interfaces that a radiologist deals with are not optimized for the radiologist workflow.”

Think of an Apple iPhone screen, suggests Krishnaraj. Over the years since the first generation of the iPhone, the number of features has increased, yet the basic home screen has hardly changed. The interface is slick and easy to navigate, not bogged down like typical clinical information systems.

Because of the complicated manner in which information must be navigated, Krishnaraj says patient information doesn’t get leveraged to the fullest extent.

However, things may be changing. Vendors are listening and the market is gravitating toward features that improve the radiologist’s workflow. This can come in the form of new search tools on existing systems, or workflow optimization tools that can be added to a given process to easily search and display pertinent patient information.

Krishnaraj credits campaigns emphasizing patient-centeredness launched by the American College of Radiology for helping boost appreciation for this additional patient context. These initiatives come from the viewpoint that getting to know a patient as specifically as possible is key to providing valuable care.

The country has done a good job of adopting health information systems and capturing data, now is the time to put them to optimal use.

“[These databases] contain a vast amount of information, some of which is helpful, some of which is superfluous and some of it, if you’re not aware of it, could lead to potential complications,” says Krishnaraj.