The process of evaluating new technology has quickened its pace, but that does not make it any less challenging for a busy radiology practice, Ted Best says. Best is acting director of IT for Carolina Regional Radiology (CRR), Fayetteville, North Carolina, and is president of Xodus Technology Professionals. “The process flow hasn’t changed; what have changed are the tools that we use,” he notes. “One of the key factors in making these projects a success is communication, and using advanced tools such as group exchange servers, instant messaging, and video conferencing have helped us communicate more effictively and move the decisions forward at a faster pace.”
He adds, however, that radiology practices can still succumb to indecision when evaluating new technologies if project best practices are not followed. Best helped shepherd CRR in its selection of a voice-recognition solution, in a project aimed at enabling the practice’s 21 radiologists to use a unified system, as opposed to the disparate voice-recognition systems in use by CRR’s hospital partners.
“We desired a robust PACS that would give our radiologists the functionality to deliver patient care in the most efficient manner possible,” says Harry Ameredes, president of CRR. “Serving several different imaging centers and hospitals, we needed a PACS solution which would allow us to integrate multiple modalities from several different facilities into a single workflow. With regard to voice recognition, we desired an embedded platform over an integrated platform. An embedded platform is part of the PACS, not a stand-alone application; an integrated solution allows the radiologist to toggle patients with partial dictations open on each patient.”
Naming the Team
There are, Best notes, “so many different ways to keep these projects from being a success.” In a democratic governance structure like that of many radiology practices, he observes, “You find a lot of people who have ample opinions regarding a subject, but don’t really want the responsibility of making the final call.”
Best recommends that practices choose both their evaluation teams and their final decision makers from the start. The evaluation team should include “anyone who uses the product or maintains the product,” Best says, along with “at least one person who completely understands it or has process-flow knowledge. On a voice-recognition project, you need someone who understands the reporting workflow from start to finish.” There should also be a handful of named decision makers. He adds, “When you don’t have named decision makers, things go out to committee and never get decided upon; everyone has input, but there has to be a decision maker (or two or three) who makes the final call.”
In CRR’s case, this process was significantly streamlined because most of its radiologists had experience in working with several voice-recognition products—and by the fact that its PACS provider, Intelerad ® Medical Systems, could offer the M*Modal voice-recognition solution as an embedded part of its InteleOne ® PACS Multi-Method Reporting Module TM.
“Intelerad has provided us a solution that combines all our disparate systems into a single workflow,” Ameredes notes. “We set up a test environment—a test workflow—and we liked what we saw. As a radiologist, it’s important to have an intuitive, robust, efficient workflow; the more quickly we can get a report out to the referring physician, the more value we will have in the patient-care process.”
Trying the Product
CRR’s input team included a handful of radiologists representing the practice’s various subspecialty areas. Ameredes says, “We took a sampling of the practice’s subspecialties.” Orthopedic radiology (the subspecialty of Ameredes) and mammography were two areas of the practice that embraced the solution early.
Sheryl Jordan, MD, a breast imager with CRR, reports that today, the practice’s average work RVUs per breast-imaging radiologist are 85.17—a remarkably high figure, given the additional responsibilities of breast imagers, beyond reading. “It’s nothing short of remarkable, and that is solely because of the use of voice recognition and templates,” she says.
CRR’s orthopedic radiologists have also seen benefits from the use of voice recognition and templates; Ameredes says, “We have built standardized templates which allow our radiologists to be more efficient, while providing the referring physician a consistent report across our practice—regardless