CHICAGO, Nov. 29—One of life’s great frustrations is to discover, after the fact, that work or a service requested was not only unnecessary, but also went completely unused. Thanks to research conducted by Petter Hurlen, MD, and colleagues at Akershus University Hospital in Lørenskog, Norway, radiologists at the facility know that approximately 10 percent of their final report output falls into the unread/unused bin.
Hurlen presented results of a study that monitored the clinical use of radiology reports over time after the integration of radiology services with an EMR at the 93rd annual meeting of the Radiological Society of North America (RSNA).
In 2004, both a RIS (MagicSAS, Siemens Medical Solutions) and a hospital-wide EMR (DIPS, a Bodø, Norway-based healthcare IT developer) was introduced at Akershus. At Hurlen’s hospital, all radiology reports undergo a preliminary read and a final read by different radiologists.
In January 2005, the RIS was integrated with the EMR and both the preliminary report from the first reading and the final report were available to clinical users of the system. The facility deployed Siemens’ MagicView PACS in May 2005, and it was integrated with the EMR, making images available from the patient record, Hurlen reported.
Data sets describing the availability and use of different categories of radiology reports for in-patients were retrieved from the EMR and RIS in March 2005, and then four more times, in four month intervals from Oct. 2005 to Oct. 2006, Hurlen said, providing the research team with five data sets comprising 8,225 examinations.
Hurlen displayed photographs of the traditional manner in which clinicians at Akershus received the results of radiology examinations, which were film and light box didactic presentations to clinical colleagues—typically conducted the morning after the exam was performed.
“Even though available in the EMR from Jan. 2005, in March, the median time from an examination was performed until a report was viewed in the EMR, was 2 days 9 hours and 36 minutes,” Hurlen said. “After the technology shift in May 2005, this dropped to 4 hours 59 minutes, then to 2 hours 20 minutes, and finally to 1 hour 37 minutes and 1 hour 36 minutes for the next two four month periods. Most final reports were read, although approximately 10 percent weren’t looked at, at all.”
It took the clinicians a year to adapt to the technology shift that made radiology reports available both faster and easier, and from that point on the usage of the system to read final reports seemed stable, he noted.
“Most preliminary reports are also viewed, but the percentage is higher for CT examinations than for other categories, possibly indicating that CT images are more difficult to interpret for most clinicians than plain x-rays, and the preliminary reports (for this modality) are thus of greater demand,” Hurlen observed.
Integrating radiology information systems with the EMR gives clinician faster and easier access to radiology reports, but an adaptation period of one year should be expected, Hurlen said.