RSNA: Promising IT tools may aid in communicating critical results

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CHICAGO—Nabile Safder, MD, of the University of Maryland School of Medicine at Baltimore, addressed the topic of IT solutions in the facilitation of the communication of critical results during the Communicating Results session at the Radiological Society of North America (RSNA) annual conference yesterday.

While Safder spoke about various technologies that can assist communication between physicians and radiologists, he noted that the limitations of the technologies must be understood.

“Our objective is to understand the key building blocks utilized to achieve the functional critical result communication. Technology is not the silver bullet. It requires people, as well as protocol,” said Safder.

Safder broke down the communication of critical findings into three parts – pre-communication, the action of communication and post-communication, or documentation.

Of the three, Safder noted that the action of communication is typically the most simple and suggested that the majority of the problems lie within the pre- and post-communication steps.

As far as reading the reports, Safder estimated that physicians read up to 800 chemistry, 40 radiology and 12 pathology reports a week. This requires time, as well as a system that the physician must put into practice for report reading, he said.

At the same time, however, the radiologist spends time on the delivery of critical results to a referring physician – up to 45 minutes to deliver a critical finding in an outpatient facility and 30 minutes in a hospital setting.  

According to Safder, this is part of the pre-communication stage that utilizes a surplus of the radiologist’s time.

“It’s about finding the potential recipient, making sure you have the right contact info, making sure they respond to that critical result and if they are not there, finding who is responsible for that patient. Then the communication occurs,” said Safder.

Communication modes utilized by practices can include phone and voice mail, fax, paging and text messages, with most practices utilizing phones and pagers. Safder noted the pros and cons of each choice, deeming phones and pagers as a good option due to the sender being assured that the recipient received the critical finding. 

However, these modes of communication take the two parties being available at the same time. Fax and text messages, on the other hand, are a non-disruptive mode, said Sadfer. Both modes have underlying security issues.

In the post-communication steps, the final report is documented. In addition, Sadfer explained that more facilities are additionally documenting message receipts in a separate database from the final report.

“The advantages of this is it creates the potential to obtain accurate information for quality improvement of documentation in compliance with regulations. This is important for the auditing process,” he said.

The future for IT solutions in facilitating critical information communication lie in “master physician indexes,” a form of white pages for physicians providing up-to-date contact information of the physicians, and presence technology, a solution that allows users to post his/her availability status to other users.

Additionally, Safder explained the need for collaboration between the radiology department with other departments in the hospital setting, “To implement IT tools in a hospital, you need partners. We can only advance critical results reporting so far,” he said.

Currently, there are many promising technologies to help with managing critical results, and it is important for physicians to consider critical findings as part of a normal workflow,” said Safder.