Tracking Delays in Report Availability Caused by Incorrect Exam Status with Web-Based Issue Tracking: A Quality Initiative

Abstract

Many radiology information systems (RIS) cannot accept a final report from a dictation reporting system before the exam has been completed in the RIS by a technologist. A radiologist can still render a report in a reporting system once images are available, but the RIS and ancillary systems may not get the results because of the study's uncompleted status. This delay in completing the study caused an alarming number of delayed reports and was undetected by conventional RIS reporting techniques. We developed a Web-based reporting tool to monitor uncompleted exams and automatically page section supervisors when a report was being delayed by its incomplete status in the RIS. Institutional Review Board exemption was obtained. At four imaging centers, a Python script was developed to poll the dictation system every 10 min for exams in five different modalities that were signed by the radiologist but could not be sent to the RIS. This script logged the exams into an existing Web-based tracking tool using PHP and a MySQL database. The script also text-paged the modality supervisor. The script logged the time at which the report was finally sent, and statistics were aggregated onto a separate Web-based reporting tool. Over a 1-year period, the average number of uncompleted exams per month and time to problem resolution decreased at every imaging center and in almost every imaging modality. Automated feedback provides a vital link in improving technologist performance and patient care without assigning a human resource to manage report queues.

Study of Radiologic Technologists’ Perceptions of Picture Archiving and Communication System (PACS) Competence and Educational Issues in Western Australia

“…The contents of the questions were based on literature regarding PACS competence and education [1][2][3][4][5][6][7][8][9][10][11][13][14][15][16][17]. Multiple (and including similar) items were used to measure the constructs of PACS competence and education, and the questionnaire was piloted prior to distribution to ensure reliability and validity [18].…”

“…However, this depends on a number of factors and one of the major factors is the PACS competence of radiologic technologists (RTs) [1,4,[6][7][8][9][10]. If the RTs do not have adequate PACS competence, situations such as taking longer to complete radiologic examinations [4,6], mislabeling of images [9], wasting time to fix the mislabeling [7], and delay in reporting will happen [10]. Recently, the registering bodies such as American Society of Radiologic Technologists (ASRT) and Medical Radiation Practice Board of Australia have suggested that RTs need to have adequate PACS competence for their job and the PACS competence has been considered as one of the key competences of RTs [11,12].…”

“…The importance of PACS education has been discussed in the literature [7][8][9][10][11][12][13]. There have been a range of PACS education opportunities including trainings provided by academic institutions [14,15], manufacturers [8,14,15], employers [13], professional bodies [14,15], peer-to-peer learning [11,13], and self-directed, independent study [16] available to RTs for some years.…”

The Future of the Radiology Information System

“…This borrows from established principles in business intelligence and analytics, in which data analysis tools provide the means to make smaller evidence-based adjustments more frequently, providing increased transparency, fewer and smaller systemwide interruptions, and, theoretically, increased efficiency and quality [48]. The available applications are vast, including technologist feedback [46,47], radiologist workflow management [50][51][52], and overall departmental quality metrics [48,49,53]. The reader is referred to the reference material for specific details.…”

“…Morgan et al [49] nicely summarize several factors that can increase the success of a dashboard: interface optimization, where there is concise presentation of only the relevant data at the appropriate time; context sensitivity, which should account for the variability in needs between different users; user customization, to improve user satisfaction and account for interindividual preferences; and workflow integration, because nonintegrated systems have been shown to have a poor impact on end behaviors [52,54]. Perhaps most important, there must be a system in place to drive change on the basis of the information acquired, whether through real-time alert systems [50], individual self-assessment [51], or organized departmental meetings [48].…”