Web-based questionnaire enhances radiology safety

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Notes on paper have a way of getting lost or misplaced. In the world of healthcare, lost or misplaced paper-based notes or instructions can critically impact patient care and safety. In addition, paper-based instructions hinder the efficient and timely transfer of information from department to department within a healthcare enterprise.

A team of developers from the radiology department at the University of Utah in Salt Lake City sought to reduce the use of paper-based patient information collection in their department through the deployment of a web-based questionnaire prior to the performance of radiologic studies. Their work was presented earlier this year in a scientific poster presentation at the 2008 Society for Imaging Informatics in Medicine (SIIM) conference in Seattle.

Tracy Robinson, MD, Scott DuVall and Richard Wiggins, MD, crafted their system in an effort to positively impact patient care at their facility. As they noted in their presentation, paper-based patient information collected at the point of care in the radiology department was not part of the patient’s medical record.

“This important information is currently being stored separate from the patient’s medical record, and then being shredded approximately six weeks after the image acquisition,” they wrote.

They modeled their system on a similar implementation currently deployed in the preoperative surgery waiting area at Eccles Critical Care Pavilion at the university.

“The significance of this project is that the important information which is currently being discarded would be incorporated in the patient’s electronic medical record, and would be available to the radiologist at the time of the interpretations, positively affecting outcome,” the authors wrote.

The team developed a system for both pre-procedure patient questionnaires and patient history and safety screening sheets for MRI and CT exams.

They tested the usability of their system utilizing a tablet-based PC with stylus as an input tool. Securing the system for patient privacy entailed dedicating a server used only for storing of the web files and database tables. In addition, IP tables and TCP wrappers were used to limit access to networked computers only. Wireless network access in the department includes security certificates, such as Wi-Fi Protected Access and Temporal Key Integrity Protocol, which are required to log onto the system.

Patient demographic information is pulled from the department’s RIS where it is transferred from the university’s EMR at the time of order. This information, including study modality and description, are used to determine which questionnaire a patient is to fill out.

As a result of usability testing conducted during the development phase of the system, the team has constructed a page-based format that allows users to easily navigate the questionnaire without having to scroll through windows. Also, screen font and input elements (radio buttons and check boxes) were adjusted to a larger size to better suit the age range of the department’s patients.

The team is set to deploy their questionnaire into the health sciences system at the University of Utah and is optimistic about its impact on patient care and safety at the institution.

“There will also be additional positive outcomes, in that the protocol for the study could be modified at the time of the study, to better address the clinical information often lacking on the request sheet system currently in use,” the authors wrote.