RSNA: Practical informatics for the practicing radiologist

CHICAGO--Information technology is essential to radiology practices because of their complex data and workflow. In addition, the use of IT improves efficiency and quality, reduces costs and opens doors to new services, according to Keith Dreyer, DO, PhD, vice chair of radiology and informatics at Massachusetts General Hospital (MGH) of Boston, who spoke at the annual Radiological Society of North America (RSNA) meeting on Monday.

Dreyer's lecture was part of the RSNA's annual crash course in imaging informatics, presented in partnership with the Society for Imaging Informatics in Medicine (SIIM).

Prior to the rise of the IT-rich department, the typical radiology process from order to results communication took about five days. Today, images are available within minutes of the exam in the IT-invested practice, Dreyer said.

Still, the process of transitioning from paper-based radiology to a digital department is complex and confusing. Dreyer advocated for the best of breed approach to IT investments, arguing that no single vendor provides a comprehensive radiology IT solution set. To help guide departments and imaging centers, he offered a 10-step model for splitting IT investments among vendors.

Dreyer’s Top Ten IT Investments:

  • DICOM modalities to acquire digital images
  • RIS to manage the text of radiology including registration, scheduling, reporting and billing, and to manage workflow
  • PACS to manage images, enable soft copy interpretation and provide an image archive and disaster recovery
  • Teleradiology to extend imaging throughout and beyond the enterprise
  • Voice recognition software to instantly convert speech to text
  • Advanced visualization to deliver 3D imaging
  • Electronic result reporting to provide web-based text and image results and distribute images beyond radiology
  • Electronic order entry for remote ordering and to capture indication and protocol information
  • Clinical decision support, which uses American College of Radiology (ACR) appropriateness criteria to guide ordering physicians toward higher yield, or more appropriate exams
  • Business intelligence data analysis dashboards to provide role-based presentation of mined data
  • Cross enterprise imaging to manage extra-enterprise digital images on CD/DVD and push them into PACS

IT investments do save time and improve care. Dreyer shared that MGH has saved over $1 million annually since implementing voice recognition. In addition, its advanced visualization business has grown to more than 50,000 studies annually.

Finally, the impact of clinical decision support software is significant. In 2004, about 25 percent of MGH radiology orders were classified as low yield. Today, only 2 percent of exams ordered are low yield.

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