Radiologue: Whole-system Communications for Radiology
Kris Kyes

The San Francisco General Hospital/University of California–San Francisco Department of Radiology has created a groundbreaking communications tool called Radiologue. Alexander V. Rybkin, MD, a radiologist in that department, described the system in “A Web-based Flexible Communication System in Radiology,” which he presented in Minneapolis, Minnesota, on June 5, 2010, at the annual meeting of the Society for Imaging Informatics in Medicine.

Radiologue shows great promise not only in improving communications within radiology departments and practices, but in untangling knotted workflows and enhancing patient care. By giving all parties involved in imaging access to user-annotated information on studies and patients in real time, it replaces whiteboards and logbooks, both of which are often illegible or inaccessible. Based on the operations of a typical department, one must assume that Radiologue also does away with a number of exasperating, ineffective, or frantic phone calls.

The starting point, Rybkin says, was a busy department’s chaotic communications routine, which employed procedure logbooks and whiteboards. Since San Francisco General Hospital handles 50,000 emergency-department visits, 18,000 admissions, and 25,000 CT exams per year, the potential for poor communications (and poorer consequences) was immense. Although the hospital had addressed many potential problem areas using quality-improvement and workflow-enhancement techniques, bottlenecks could still be created by failed communications in radiology.

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Fail-safe: Automating Critical-results Notification
Cheryl Proval

The radiology department at Brigham and Women’s Hospital (BWH), Boston, Massachusetts, developed a policy for communicating critical and discrepant results after the Joint Commission made communications among caregivers a national priority for health-care providers. When the goal was expanded in 2007, the department took the next step and used IT to automate the process and to embed it into radiologist and referring-physician workflow.

Nonetheless, the journey begins with a policy based on strict definitions of critical and discrepant findings, according to Luciano Prevedello, MD, a neuroradiology and informatics fellow in BWH’s radiology department. He described the solution in “Methods for Effective Communication and Reporting,” presented on June 4, 2010, at the annual Society for Imaging Informatics in Medicine meeting in Minneapolis, Minnesota. Noting that it is common, in the reading room, to hear radiologists question whether a particular result is critical, he says, “If you don’t have strict definitions of what a critical or discrepant finding is, then it is going to be a problem for people to use the policy and be compliant.”

BWH must have gotten it right. Since February 2006, the department’s compliance has moved from 30% to almost 95% in 2010. This is how they did it.

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Debunking the Primary Myths of PACS
Cat Vasko

The road to PACS perfection is paved with distractions and pitfalls, Paul Chang, MD, FSIIM, says. Chang is professor of radiology, vice chair of radiology informatics, and medical director of enterprise imaging at University of Chicago Medical Center in Illinois. During the 2010 Dwyer Lecture, “The Role of Imaging Informatics in the Next Generation of EMR/EHR,” presented June 4, 2010, at the meeting of the Society for Imaging Informatics in Medicine in Minneapolis, Minnesota, Chang used the experiences of other industries to debunk common PACS myths—and to illuminate next-generation requirements for imaging.

“We need to address the real threats and challenges facing not only radiology, but health care in general. We can learn a heck of a lot more from outside this industry. We’re 10 years behind. We need to spend some time outside our own zone to see how to leverage IT better.”

—Paul Chang, MD

The first PACS myth that Chang cites is the consternation over PACS-driven versus RIS-driven workflow. “This is a meaningless concept,” Chang says. He brings up the example of Amazon, where 25 systems (ordering, inventory, billing, credit card, shipping, and so on) work together in a way that appears seamless to the end user: “It is a workflow engine optimized to address a workflow requirement,” he says. “The fact that we concentrate on PACS-driven workflow versus RIS-driven workflow is such a dangerous oversimplification of what we really need to accomplish: helping our patients.”

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Red Hats and Flat Panels
What do 1980s rock band Devo and FUJIFILM Medical Systems USA, Inc, Stamford, Connecticut, have in common? The two teamed up to launch the company's new portable digital flat-panel detector, just cleared by the FDA. Check out the hybrid product-launch/music video at the link below.

[Music Video]

Is ARRA IT's Cash for Clunkers?
The difference between a government boondoggle and an effective pay-for-performance program hinges on the definition of two words: meaningful use.

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CIOs: How Not to Be Last Among Equals
An article in the Wall Street Journal outlines for CIOs the skill sets that they need to acquire before they can be considered peers in the executive suite, rather than IT specialists.

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Report on HIE Activity Released
Significant progress has been made by the health information exchange movement according to a new report from the eHealth Initiative called, The State of Health Information Exchange in 2010: Connecting the Nation to Achieve Meaningful Use. In 2010, surveyors identified 73 operational HIEs, compared to 57 in 2009.

[Access Report [PDF]]

SEPTEMBER

Webcast: Extreme RIS: Breaking Down Communications Barriers
Sponsored by FUJIFILM Medical Systems USA, Inc

September 21, 2 PM Eastern
Save the date.

NOVEMBER

Improving Health and Healthcare Through Meaningful Use of Health IT
Sponsored by the Healthcare Information and Management Systems Society

November 3–4

This virtual conference will feature two learning tracks—Health Information Exchanges: Facilitating the Adoption of HIT, and The Fundamentals of Achieving Meaningful Use: Real World Approaches.

[More Info]

RSNA 2010: Personalized Medicine: In Pursuit of Excellence
Sponsored by the RSNA

November 28–December 3
Chicago, Illinois

A wide variety of informatics topics will be covered, from analytics to quality to radiation-safety tools, along with the implications of meaningful use for radiology. Former President Bill Clinton and Harvard physician Atul Gawande, MD, both will address the meeting.

[Register]

PUBLISHER
Curtis Kauffman-Pickelle

EDITORIAL DIRECTOR
Cheryl Proval

EDITOR
Cat Vasko

ADVERTISING DIRECTOR
Sharon Fitzgerald

PRODUCTION COORDINATOR
Jean Lavich

TECHNICAL EDITOR
Kris Kyes

WEB MASTER
Robert Elmquist