Greasing radiologist/referring physician communication leads to better reads

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Smoothing barriers impeding radiologist/referring physician communication can better care through improved timeliness and more nuanced interpretations, according to a study published in the Journal of the American College of Radiology. For the University of Texas Health Science Center, this meant building a communication tool within PACS and assigning clerical staff to troubleshoot the system, rather than leaving radiologists to figure it out on their own.

Difficulties in reaching referring physicians are among the most common workflow disruptions cited by radiologists, according to a 2015 study. Telephone communication is especially problematic on a large scale: that same study found more than 10,000 after-hours calls directed towards a single resident over a 3-month period.

“Most radiologists would like to communicate findings as quickly and directly as possible. Nevertheless, the delays and disruptions associated with making phone calls are a significant disincentive to communicating verbally with ordering physicians,” wrote lead author and Assistant Professor Eduardo J. Matta, MD, et al, of the McGovern Medical School at the University of Texas. “This is especially the case with non-urgent findings that may not require immediate communication but would still be better relayed through a conversation.”

Compounding the problem was a poorly updated physician directory, causing radiologists to call the wrong physician or one who was no longer responsible for the patient. This sometimes forced the radiologist to spend valuable time searching through directories or patient records to find the correct doctor.

Matta and colleagues sought to iron out this process with a software-based solution, settling on a PACS-integrated communications package from Primordial Design. They enlisted a multidisciplinary committee to determine wants and needs for the software, including radiologists, referring physician’s information technology representatives, developers, and administrative staff.

They determined five goals for the new software:

  • Updated physician catalog
  • Using clerical staff for troubleshooting, rather than radiologists
  • Parallel workflow, keeping track of all interactions
  • Physician training
  • Interface occurs at the PACS station

Once the software was installed, there was a 5-month data gap until the analytics package had accumulated enough data, but the researchers were greeted with terrific results once the probationary period was over.

“The number of calls to referring physicians and their teams had increased for all levels of urgency: critical calls almost tripled (from 12.2 to 34.1 calls per month), whereas nonurgent calls increased more than 10-fold (from 9.0 to 115.5 calls per month),” wrote Matta et al.

Plucking administrative tasks from the radiology workload meant more reads and higher physician satisfaction, according to the article, but proper training and preparation are vital.

“Previously, finding the responsible physician was left to the radiologists, which was inefficient,” wrote Matta et al. “We showed that well-trained clerical staff members can perform this task effectively, while radiologists efficiently continue their work uninterrupted.”

Radiologists are using their added time to provide more detailed explanations of all reads, including non-urgent ones, according to the article.

“Now that this new process is in place, radiologists frequently call to discuss issues that may not be urgent but that still benefit from more immediate or direct communication,” wrote Matta er al. “This not only improves the timeliness of care but also allows better, more nuanced interpretations.”