Driving with the Digital Dashboard Lights On

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Screen shot source: Carestream Digital Dashboard

Recent requirements from the Joint Commission and the American College of Radiology (ACR) add to the growing number of quality demands being placed upon radiology departments. In an increasingly complex regulatory and financial environment, comprehensive quality management processes are essential. The digital dashboard holds the answers to today’s problems—if you only you dare to fully utilize them.

Fortunately, growing along with these regulations and the increasingly urgent need to closely track economics and operations are dashboard technologies that can assist with the deluge of data constantly streaming within a department. Adopting a digital dashboard in a radiology facility or department can help increase transparency for managers looking to keep up with their practice’s day-to-day operations and be a step ahead in making needed changes. It’s the dashboard’s job to track metrics such as physician productivity, staffing, referrals, scanner utilization, patient volumes and wait times, and much more—and the administrator’s job to change what isn’t working well.

Reduced costs, better resource allocation

Digital dashboarding uses data mining techniques to continuously, automatically process and visually display custom-set key performance indicators (KPIs) that provide operational data for a practices, departments or group facilities. Paul G. Nagy, PhD, associate professor of diagnostic radiology and nuclear medicine in the department of diagnostic imaging at the University of Maryland School of Medicine (UMD) in Baltimore, says dashboards not only give managers a greater holistic view of their practice, but also reduce costs and can improve productivity.

For example, the University of Pittsburgh Medical Center (UPMC), in a study led by Matthew B. Morgan, MD, and colleagues from early 2003 to December 2005, found that the use of an internal, integrated dashboard system decreased the average turnaround time for signing reports from 22.5 hours prior to integration to 17.7 hours after—a reduction of 24 percent. “There’s a challenge that a lot of professionals face in that there’s a lot of information coming in on both the system administrator and the clinical sides. Dashboards can be a relief to that. This is an attempt to get into a clinical picture to the workflow of the radiologist,” says Morgan, now an assistant professor in the department of radiology of the University of Utah School of Medicine in Salt Lake City.

“Using paper-based reporting mechanisms to see how practices are operating is like driving with your rearview mirror,” asserts Nagy. “If you look at existing practices, there’s a lot of time collecting data and not much time looking at that data since people are so exhausted from the actual act of collecting. With use of clinical information systems, we have the opportunity to leverage radiology business architecture.”

Using an in-house, web-based dashboard, Nagy and colleagues at UMD implemented a system they call RadDash three years ago that extracts data tied into patient and physician satisfaction measures from the radiology department’s RIS, PACS, CPOE and speech recognition systems. These KPIs include patient wait time, scanner access time, report turnaround time and modality efficiency among other coupled services across the department.

Nagy and colleagues conducted a 24-month study at UMD—presented at the Radiological Society of North American 2009 annual meeting—that found the average report turnaround time improved from under 10 percent of reports signed within two hours of completion in July 2007 to more than 45 percent of reports in June 2008 after adopting the digital dashboard.

“A lot of the reduction in our turnaround and patient wait times is a result of redistributing existing resources,” says Nagy. For patient wait time, the volume and types of orders were examined in conjunction with the time of day they were ordered and adjusted accordingly to make patient wait times comparable.

“Unless you understand your workflow, you could continually find a backup of patients at a certain time in the workday,” says Nagy. “By looking at what procedures you perform and the resources they require, you can redistribute your resources without spending more or using overtime and be more effective and deliver care without having patients wait as long.”

Jonathan B. Kruskal, MD, PhD, chairman of the department of radiology at Beth Israel Deaconess