CHICAGO – While radiologists and ER physicians at the University of Pittsburgh Medical Center generally agree on their final assessments of patient x-rays, there is considerable disparity in their reporting times. In a presentation at the RSNA meeting on Tuesday, Dr. Jeffrey Towers delineated the case-reporting behavior by both groups using an electronic report generator.
Designed at the university, a system integrated with a Web-based PACS system is used to generate the reports. A preliminary author field is filled out by the ER doctor, and the final author field by the radiologist.
"[Our system] forces document agreement between reports," Towers said. Clinicians and radiologists must hit one of three buttons before their report is accepted: "Agree," "Minor discordance," or "Major discordance."
For this study, 31,229 case reports, filed over one year, were used. Cases were studied in aggregate and in specific shifts: 8 am to 5 pm, 5 pm to 11 pm, and 11 pm to 8 am. Radiology staffing differed based on these shifts, Towers explained.
According to the results, 53% of the cases had only a radiology report, while 23% consisted only of the clinical report. In 20% of the cases, the radiology report was entered first into the system. During the day shift, radiologists were better at putting in their reports within an hour of the preliminary clinical findings, Towers said.
In terms of agreement, the radiologists agreed with the clinical information 84% of the time. Minor or significant discordance was found in 16% of the cases.
However, delays in radiology reporting time varied widely depending on the shift. From 8 am to 11 pm, there was an average delay of 50 minutes between the time the clinical information was submitted and the radiologist entered his assessment. From 5 pm to 11 pm, the delay averaged 81 minutes, and jumped to 341 minutes from 11 pm to 8 am because there were fewer radiology staff available, Towers said.
In some cases, the radiology report was never filed because of overlapping shifts, he added. If a case was submitted in-between shifts, the radiologist for the later shift may have assumed his predecessor submitted the report.
Despite this time delay, Towers said his institution was pleased with the reporting system because it facilitated rapid communication between doctors and remote coverage of the ER, and offered documentation of reports. Most importantly, it cut down significantly on paperwork, he said.
By Shalmali Pal
AuntMinnie.com staff writer
November 28, 2001
For the rest of our coverage of the 2001 RSNA meeting, go to our RADCast@RSNA 2001.
Copyright © 2001 AuntMinnie.com
