ECR - MIR@ECR - Managing Radiology

Three presentations were given in this session.

The first one was on the implications for radiology of Imaging and benchmarking by dr. Schouman. Benchmarking is the comparison to best practices based on measurements. She promoted benchmarking to achieve improvement of the productivity and performance of a radiology department. The current situation with EHR, RIS and PACS starts to enable efficient benchmarking. Problems are
- Cumbersome data capture
- Poor data quality
- Lack of standardization
- Reductive analysis
- Meaningless comparisons
One of the key points is the assurance that manual data entry is done correctly. For example the information going into the RIS.

Second was the added value of in-house radiological IT by dr. Jakobsen. He showed, based on examples, that IT is crucial for the operation of a radiology department and that the absence of IT would take down that complete radiology department. The in-house IT support is critical to keep the IT up and running since they can either solve the problem or knows who to contact. Concluding in-house radiology IT can effectively prevent a stop in workflow.

Finally, dr. Senol talked about Risk management in radiology. As definition of risk he gave: The potential that an chosen action or inaction leads to a negative outcome. Risks in radiology are:
- related to reporting
- direct harm to the patient
- related to decision making
Risks related to reporting are:
- delay
- errors in reporting (up to 4% of reports)
- false positive or negative errors
- incorrect diagnosis
When an error occured patient and hospital should be informed and the root cause of the error should be assessed.

ECR 2012 - MIR@ECR - Communication with our Partners

Three presentations were given in this session.

First dr. Kahn talked about computerized physician order entry and decision support. He approached this from the side of the appropriateness criteria. He stated that those criteria are not meant for the radiologist but for the referring physicians. However, delivering it to them in an enormous pdf file is not very efficient. It should be integrated into the exam ordering process using computerized systems inside the electronic health record. By doing this the referring physician can enter the properties of the patients and get decision support on their order. This should reduce the number of wrong diagnostic tests or may even reduce the number of diagnostic tests. Kahn remarked that we should be talking about a radiology examination request and not an order. Furthermore he stated that decision support should be regarded as advise and not the law and that a physician should be able to reject the advice.

Next, dr. Centoze gave a presentation about communication of urgent and unexpected findings. He started to state that efficient and correct communication is crucial. ESR has release guideliness on communication of urgent and unexpected findings published in insights in imaging. Ideally an automatic alert and feedback system should be implemented. Urgent information should always be communicated directly with the referring physician. Unexpected findings could be communicated with other methods like e-mail .

Finally, a presentation on implications of reporting infrastructure - general reading room vs. Individual office was given by dr. Strickland. She presented her personal preference of a general reporting room and discussed pros and cons of that choice against private offices. The pros are:
- less costs because of maximum use of the workstations
- optimized ergonomics in the central reading rooms
- camaraderie: reporting is a social activity/teambuilding
- facilitates clinician access
- enhances inter-radiologist consultation
The perceived cons are
- noise
- personalized workstation settings lost
- pre-existing building architecture
Extra small reporting rooms could be beneficial to have. But they should not be personal.

ECR 2012 - SS505/B0373 - Automated semantic navigation and synchronized alignment

Semantic navigation is used to synchronize baseline and follow-up CT examinations. The algorithm detects words from the radiology report and puts links on it to automatically travel to the proper region in the images. To achieve this the software automatically detects landmarks in the anatomy and connects this to semantic information using rekationships like 'close to', 'above', 'to the right of', etcetera. this method allows matching of non-corresponding exams and provides clinically sufficient automatic alignment of corresponding findings in consecutive examinations.

Nuance launches mobile voice development challenge

Nuance launches mobile voice development challenge

RSNA: Radiology reporting

The RSNA informatics group is standardizing radiology reporting by making a report template library. this uses expert consensus, standard formats, rich functionality and all in XML. Their aim is to provide these templates on a webpage where a radiologist can visit an 'online shop' with macros, select the templates of interest and put them in a shopping cart. Subsequently, the templates can be downloaded and used in the local speach recognition system.

Using this a more consistent reporting can be achieved and reporting speed increases with effective macros.

The full database now contains over 140 templates that are freely available in text and XML.