Radiology can’t live without PACS, but will relationships survive the isolation?

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PACS technology has worked wonders improving efficiency in radiology, but it’s doing a number on radiologists’ relationships with people whose work falls within, or reaches into, the imaging circle.

There’s no time like the present to grapple with this hard reality, before the “high-tech, high-touch” ideal crumbles into all tech and no touch.

That’s the gist of a wakeup call issued by four Indiana University radiologists and published online May 10 in  Academic Radiology.

Darel Heitkamp, MD, and colleagues look at the effect PACS has been having on rads’ relationships with technologists, radiology trainees, referring physicians—and one another.

“Gone are the days of turning to get second opinions from subspecialty colleagues on the other side of the room,” they write of the latter. “And the same fragmentation is apparent in other aspects of academic radiology practice, such as research and educational interests, professional development needs, and even casual discussions of personal matters. It is difficult to learn and grow when radiologists are walled off from such important sources of learning and collegiality.”

The authors lay out several suggestions for mitigating the grinding down of professional relationships due to PACS.

Residents and fellows “need to be better educated regarding the downsides of PACS,” they write. “Just as we educate trainees about the strategies that add value to radiology, programs should also alert them to the forces that threaten to erode them. Today's residents and fellows have no memory of the far more personal way radiology was practiced just 20 years ago, and they may simply take for granted that there is no other way to practice.”

Practicing radiologists would do the field a favor if they would seek out ways to build and maintain better relationships, write Heitkamp et al.

“In-person interaction with technologists, radiology colleagues and referring health professionals should rank as a higher priority, and opportunities should be sought to promote it, such as technologist-radiologist meetings, in-services and grand rounds, and multidisciplinary conferences,” they add.

Further, radiologists “should make an effort to visit control rooms, reading rooms, and patient care areas on a regular basis.”

Where circumstances preclude in-person interaction, they write, more communication could be done by telephone, texting and live video conferencing.

“Increasing efficiency and improving metrics such as turnaround time are not the Holy Grails of radiology practice, especially not if they can only be purchased at the price of a severe erosion of relationships,” the authors write. “Eventually, this erosion can progress so far that it undermines the core of what makes the radiologist useful in the first place.”

In this, the volume-to-value transition era in healthcare, they conclude, “the time is ripe for radiologists and radiologic practices to reexamine and respond more effectively to the PACS-related erosion of human relationships.”