Radiology reports allow referring physicians to decide patient management and provide appropriate and timely care. Voice recognition (VR) is widely used by radiologists to create radiology study reports. Nevertheless, many radiologists still rely on radiology transcription services to proofread and correct VR generated reports. The reason for this is the high rate of transcription errors in associated with VR diagnostic radiology reports (www.radiologykey.com). The performance of a radiology department is measured in terms of its capability to deliver error-free reports rapidly.
The availability of patient data is key aspect in information-based decision-making by physicians. Interoperability of various healthcare systems is necessary to make patient data available for effective decision-making. Radiology images and reports are key elements of a patient’s medical history. All care providers need to have easy access to radiology information to diagnose illnesses and assess treatment outcomes.
The integration of Picture Archiving and Communication Systems (PACS) with electronic medical records (EMRs) provides clinicians with easy access to radiology information. It can also help reduce costs by minimizing duplicative scans and redundant image and report distribution. PAC-EMR integration also saves radiologists time, improves workflow, and helps them access clinical data in the EMR more often, according to a study published in the Journal of Digital Imaging in 2018 (www.radiologybusiness.com).
The research team gathered EHR access data on 37 users covering a period from 180 days before the PAC integration to 240 days after. Following PACS integration it was found that:
- EHR access time reduced to 6 seconds from 52 seconds (which amounts to an average of more than a working day (8.26 h) per radiologist per year)
- Radiologist-initiated EMR access increased from more than 36 percent before integration to more than 44 percent after integration
- EMR use increased over time following integration
The authors concluded that, much more than being “a matter of convenience”, the interface between EMR and PACS truly improves patient care and helps specialists demonstrate their value.
“There is substantial aggregate time savings provided by integration,” the authors wrote. “More importantly, these time savings organically drive changes in radiologist practice projected to change diagnosis in 1 out of every 200 cases read. We believe that in light of these results, PACS-EMR patient context integration should be considered an essential component of every PACS environment.”
How can PACS-EMR be achieved? According to an article in Imaging Technology, successful integration depends on the following considerations:
- Plan for best-of-breed solution architecture – For integration to be effective, the architectural design would need to account for multivendor, multisystem integration. The departmental PACS and information systems, such as RIS, cardiovascular information systems (CVIS) should interface with the EHR in the hospital as well as outpatient clinics and referring practice.
- Minimize downtime – In effective integration, there would be minimal impact on workflow and care delivery. For instance, workflow in the emergency department (ED) is time critical and cardiology departments have highly specific needs. PACS-EMR integration should cause minimal disruption to these processes.
- Optimize the patient experience: Effective integration would allow various stakeholders involved in the patient’s care to make quick and informed decisions. This is essential to optimize patient care and enable cost-effective healthcare delivery. It will also streamline information and save radiologists’ time by preventing repeat order verification, duplicate screening forms, and redundant insurance validation.
- Leverage current standards compliance: Interfacing based on DICOM (digital imaging and communications) and HL7 standards will allow quick sharing of information across the care continuum. It will facilitate quick integration of various systems and allows information to be shared without the need for costly and time-consuming integration project.
- Hosting of PACS: Organizations considering PACS options must first identify how their system will be used and where it will be hosted. PACS can be hosted in-house, at a remote hosting facility, or in the cloud (as Software as a Service). Organizations must choose the vendor that can meet their needs. The Internet is the best system for health data exchange. Internet-connected medical devices and systems are necessary elements of an ideal data exchange. Integration via the Internet can combine information from numerous systems and provide data as an element of a portal, a mobile application, or as part of any system.
Error-free and timely medical and radiology reports are crucial for successfully PACS-EMR integration. With the improvements in speech recognition systems, many groups are moving this mode. One of the main benefits of voice recognition is that clinicians can use structured templates to send finalized reports to the referring physician in quick turnaround time. According to a new study by Reaction Data (www.healthcareitnews.com), today 85 percent of radiologists use a speech recognition system to record their reports while 15 percent continue use the traditional dictation method and send it to a radiology transcription service provider. The study also found that of the 15 percent of provider organizations that have not yet adopted speech recognition and 41 percent said they have no plans to ever adopt the technology. This shows that medical transcription outsourcing is still relevant to ensure accurate patient data for effective decision-making.