Beyond the Basics: Next-generation Radiology Reports

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At Shields Health Care Group (SHCG), an outpatient high-end imaging provider headquartered in Quincy, Massachusetts, staying ahead of the technology curve has been a clearly defined business initiative from the beginning. It is paying off handsomely. According to the company, one in every three MRI patients in the state is imaged at an SHCG center.

imageSHCG has leveraged the capabilities of its RIS to create customized radiology reports that are popular with referrers. “One of the biggest things we’re doing is something we call e-protocols,” Patricia Whelan, MHA, vice president of IT at SHCG, explains. “In our RIS, this allows the physician who views the images for the referrer to select the protocols used to view images. This feature is really important for a RIS because it allows you to tailor the exam specifically to what it is that your referrer would like.”

Whelan adds that there are multiple imaging options: “Everything from slice thickness to flip angles—all kinds of techniques that could be used—and the RIS that we have allows the radiologists to select the protocols that best meet the needs of the referrer. We can also set up a specific protocol with that referrer’s name, and it pops up for the technologists before they begin the exam. Not every RIS has the ability to do that. If physicians know that you are going to do that for their special patients, they know that all those patients are going to get that same protocol. It allows us to give those referrers exactly what they’re looking for,” she says.

SHCG, which uses a RIS from Sectra Medical Systems, Linkoping, Sweden, also customizes reports by specialty. Whelan says, “We are customizing at the procedure level. For example, all of our cardiac CT exams will have certain images in them, with this table and that narrative. They will always be in the same order.”

In the near term, SHCG might take customization by specialty a step further. “We’re thinking about reorganizing our website and having landing pages by specialty,” Whelan says, “so that when you come to, you’re not getting all the general messages; as an orthopedist, you would get a landing page where everything was oriented to orthopedics—maybe all the national news or what’s hot in the field. Then you could also log in to get the radiology reports.”

Express Link

One way that referrers currently get their SHCG reports is by signing onto a Web portal. SHCG’s website hosts a portal called Shields Express Link that lets referrers gain access to reports and other data based in the RIS, Whelan explains. Through Express Link, referrers can check the status of their patients, order more exams, review finalized reports, and (through a DICOM viewer) look at patient images on SHCG’s PACS. Referring physicians can also listen to an audio version of the report while multitasking. Many quick-reference tools allow referrers to understand the key elements in a report at a glance, Whelan says, and more RIS-based reporting advances are on the way.

“What we have coming out very soon, for our referring physicians, is a chat-with-the-radiologist-now feature, along with some instant-messaging capability,” Whelan says. This will allow referring physicians to see immediately whether the radiologist who interpreted the exam is available. Then, a telephone conference can take place, or there can be text messaging between the physicians.

The referrer can also request a Web conference so that the referrer and the radiologist can view images and discuss them. Charts, graphs, measurements, and grids can be referenced. This is a big upgrade to the left-margin, book-report style of traditional radiology reports, Whelan notes. She says that referrers can’t wait for the interactive features to be implemented.

In one instance, there already is immediate interaction. Whenever an imaging exam results in critical findings, the referring physician gets a phone call from the radiologist, Whelan says. “If there is a positive finding for a critical result, it is a physician-to-physician phone call,” she says. “We don’t believe in sending an email. You’ve got to have questions answered. It’s a tremendous relationship builder, and it definitely affects referrer satisfaction.”

Tracking Outcomes and Preauthorizations

The information that SHCG imports to its RIS does more for referrers—and, potentially, for insurers—than pure reporting. The RIS data provide referrers with a way to track outcomes, Whelan says. This