Do clinicians read our reports? Integrating the radiology information system with the electronic patient record: experiences from the first 2 years

Hurlen, Petter; Østbye, Truls; Borthne, Arne; Dahl, Fredrik A.; Gulbrandsen, Pål

doi:10.1007/s00330-008-1098-3

Cited by 8 publications

(7 citation statements)

References 20 publications

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“…These systems are evolving to meet people's needs by implementing larger networks, allowing patient access and integration of ever more items of patient data [8]. Although great advances have been made over the years, on-demand access to clinical information is still inadequate in many settings, contributing to duplication of effort, excess costs, adverse events, reduced efficiency [9] and inability to take full advantage of existing IS [10]. Although it is widely accepted that full access to integrated electronic patient records and instant access to up-to-date medical knowledge significantly reduces faulty decision making resulting from lack of information [5,11,12], there is still very little evidence that life-long EHR improve patient care [13].…”

Section: Introductionmentioning

confidence: 99%

Determinants of frequency and longevity of hospital encounters' data use

Cruz‐Correia

Wyatt

Dinis-Ribeiro

et al. 2010

BMC Med Inform Decis Mak

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BackgroundThe identification of clinically relevant information enables improvement in user interfaces and in data management. However, it is difficult to identify what information is important in daily clinical care, and what is used occasionally. This study aims to determine for how long clinical documents are used in a Hospital Information System (HIS).MethodsThe access logs of 3 years of usage of a HIS were analysed concerning report departmental source, type of hospital encounter, and inpatient encounter ICD-9-CM main diagnosis. Reports median life indicates the median time elapsed between information creation and its usage. The models that better explains report views over time were explored.ResultsThe number of report views in the study period was 656 583. Fifty two percent of the reports viewed by medical doctors in emergency encounters were from previous encounters - 21% at outpatient attendance, 19% in inpatient (wards) and 12% during emergency encounters. In an inpatient setting, 20% of the reports viewed were produced in previous encounters. The median life of information in documents is 1.5 days for emergency, 4.8 days for inpatient and 37.8 days for outpatient encounters. Immune-haemotherapy reports reach their median lives faster (7 days) than clinical pathology (15 days), gastroenterology (80 days) and pathology (118 days). The median life of reports produced in inpatient encounters varied from 36 days for neoplasms as the main diagnosis to 0.7 days for injury and poisoning. The model with the best fit (R2 > 0.9) was the exponential.ConclusionsThe usage of past patient information varied significantly according to patient age, type of information, type of hospital encounter and medical cause (main diagnosis) for the encounter. The exponential model is a good fit to model how the reports are seen over time, so the design of user interfaces and repository management algorithms should take it in consideration.

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Section: Introductionmentioning

confidence: 99%

Determinants of frequency and longevity of hospital encounters' data use

Cruz‐Correia

Wyatt

Dinis-Ribeiro

et al. 2010

BMC Med Inform Decis Mak

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“…In previous studies of the ICT introduction [11,12] we found a RTAT reduction from 13.4 to 2.7 hours for preliminary, and from 22.6 to 15.1 hours for final reports. We also observed faster and more comprehensive clinical access to the results of diagnostic imaging after the introduction of RIS and PACS, and the integration of these with the EMR system.…”

Section: Discussionmentioning

confidence: 54%

“…In a study of clinicians' use of the reports in the EMR, we observed that clinicians read reports soon after they were available [12]. The median time from a preliminary report becoming available in the EMR until it was opened was 0.8 hours for Computed Tomography (CT) reports, and 1.1 hours for Computed Radiography (CR) reports.…”

Section: Introductionmentioning

confidence: 99%

Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study

Hurlen

Østbye

Borthne

et al. 2010

BMC Health Serv Res

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BackgroundOne year after the introduction of Information and Communication Technology (ICT) to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT) reports in the Electronic Medical Record (EMR) was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS).MethodsData describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups.ResultsThere was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence.ConclusionOur results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction.

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“…There is no doubt that the radiologist has a responsibility to patient care 17 and although they are expected to call with urgent findings, the definition of urgent is open to interpretation. Studies have also shown that many reports are never read 4–6,18,19 and so important but non‐urgent findings that are not verbally notified may go unmanaged by the referring doctor.…”

Section: Discussionmentioning

confidence: 99%

Verbal notification of radiology results: are radiologists meeting expectations?

Preece

Whitchurch

Sutherland

2022

Internal Medicine Journal

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Background Delayed communication of radiographic findings is associated with poor patient outcomes and significant medicolegal risk. Radiologists verbally contact referring practitioners with urgent findings, although practitioner's expectations regarding notification have rarely been examined. Aim To assess differences in preferred practice between radiologists and referring practitioners in the verbal communication of urgent radiology findings. Methods For 33 clinical stems, respondents were asked if they would issue (radiologists) or expect to receive (referring practitioners) verbal notification of results or routine written communication only. Surveys were emailed to radiologists and referring practitioners of varying experience at a tertiary referral hospital in Melbourne, Victoria. Results A total of 97 survey responses was received. Eighty responses were from referring practitioners and 17 from radiologists. Referring practitioners were seen to slightly prefer verbal notification more often than issued by radiologists overall (61%; 95% confidence interval (CI) 57–66% verbal notification expected vs 58%; 95% CI 52–64% issued). More senior referring practitioners with greater than 10 years' experience expected verbal notification more often (67%; 95% CI 59–75%), and more senior radiologists issued verbal reports less often (54%; 95% CI 39–69%). More junior referring practitioners, for example, registrars or fellows, expected notification less often overall (59%; 95% CI 43–76%). Subgroup analysis demonstrated statistically significant differences in notification preferences for certain clinical scenarios. Conclusions Overall results show fair correlation between referrer's expectations of verbal notification and the provision of verbal notification by radiologists. However, there were discrepancies in the practice and preferences of more junior and senior practitioners in certain clinical scenarios.

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Do clinicians read our reports? Integrating the radiology information system with the electronic patient record: experiences from the first 2 years

Cited by 8 publications

References 20 publications

Determinants of frequency and longevity of hospital encounters' data use

Determinants of frequency and longevity of hospital encounters' data use

Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study

Verbal notification of radiology results: are radiologists meeting expectations?

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