
JUNE 5, 2012 • VOLUME 5 • NUMBER 3

Communications in Radiology

The Anthropology of Radiology: Building Trust in the Digital Age

By Greg Thompson

High-tech communication in 2012 is undeniably fast and efficient, but does it build trust? Among referring physicians who rely on radiologists, the question transcends the objective nature of science and drifts into the subjective world of personal relationships.

Allison Tillack, MA, a student in the MD/PhD program at the University of California–San Francisco, is not afraid to tackle such topics in her dual role as clinical scientist and medical anthropologist. The fourth-year medical student hopes to be a radiologist one day, and she is determined to integrate technical expertise with a patient-focused approach that belies the solitary-radiologist stereotype.

Tillack, who is now finishing her dissertation, sensed that old-fashioned face-to-face communication would build the most trust, but she needed evidence to back her intuition. Thanks to the 2011 FUJIFILM Medical Systems/RSNA Research Medical Student grant, she had the opportunity to interview and observe a variety of physicians for six months, asking them to reflect on the elusive bonds of trust and how they were formed.

Widely used PACS have revolutionized radiology, but trust and communication have occasionally fallen by the wayside.

“Back in the film days, reading rooms were the information clearinghouses of the hospital. All the teams would be down there talking with the radiologists, and that’s where patient problems were solved. Now, there really is not a space for that.”

—Allison Tillack, MA

Such conversations still occur in patient-care areas, but Tillack laments that radiologists are not usually present. In some cases, patient information might not be adequately relayed via electronic means. “This patient information is critical to how radiologists read the images and construct their differential diagnoses and recommendations,” she says. “The fact that they are not often in on these informal hypothesis-making sessions can be detrimental.”

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What is the greatest obstacle to communications in radiology?

Reality Check: Optimizing Electronic and Human Interactions in Radiology

By Cheryl Proval

The need for improving communications in radiology is well understood, but optimizing interactions with referring physicians is where it gets tricky. In a 772-bed tertiary-care teaching hospital and level I trauma center, the call for increased face time must be balanced, supported, and made optimal through the smart use of electronic tools.

At Einstein Medical Center, Philadelphia, Pennsylvania, where Terence Matalon, MD, FACR, FSIR, is chair of the radiology department, multiple strategies are used to give referrers the information they need, in the format they prefer, in an appropriate time frame.

“Communication is a critical part of the work product of the radiologist. It’s not simply our job to interpret the images, but to ensure that the study that is being done is actually the correct exam, and that the message that we are trying to deliver is actually delivered to the appropriate person.”

—Terence Matalon, MD, FACR, FSIR

The 24-radiologist department reads about 280,000 exams annually—a figure that will jump to 350,000 in September, when the Einstein Healthcare Network (EHN) absorbs a smaller community hospital. Department radiologists currently interact with approximately 600 employed staff physicians and at least another 600 community physicians.

At the center of EHN radiology communications is an electronic system for communicating critical and significant results that has been optimized by referrer and for severity. Other key communications strategies include a movement toward using report templates, participation in hospital committees, and various initiatives by which radiologists insert themselves in the diagnostic evaluation of the patient.

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Feet on the Street: Physician Liaisons Build Referrer Relationships

By Steve Smith

Annmarie Mauro A key referrer had not referred any patients to a New York radiology practice in more than a week. This highly unusual circumstance prompted a visit by the radiology practice’s physician liaison, who left the referrer’s office shaking her head in disbelief at the cause of the downturn: The referrer’s staff members had tried to fax orders to the radiology practice, as they had been doing for years, but had encountered a technical problem on the receiving end—so they faxed the orders to a competitor instead.

Had it not been for the diligence of the liaison, this costly trend could have continued indefinitely. Whether you regard the medical-imaging community as in transition (at best) or under siege (at worst), the physician liaison has assumed a position of greater importance in organizations across the country.

Today, the physician liaison has emerged as a linchpin in the development and maintenance of a healthy medical-imaging enterprise—particularly as some payors have begun to steer patients to locations where costs (and sometimes, quality) are lower. Consequently, the role of the physician liaison has become more vital to the radiology practice.

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ONC Publishes Privacy and Security Guide
The Office of the National Coordinator of Health IT has published a handy guide to help health-care organization comply with the privacy and security requirements of the meaningful-use program, including a 10-step plan for conducting risk analysis, implementing risk-management processes, and documenting compliance.