SUNDAY, 11/28/99 ~ EVENING EDITION
Clinician-driven reporting tool relies on point-and-click efficiency

By Brenda Tilke

Imaging technology has changed dramatically over the decades, but the method of generating radiology reports has not. The conventional narrative description technique used to create reports has several drawbacks that need to be addressed, said Dr. David J. Vining, head of the Virtual Endoscopy Center in the department of radiology at Wake Forest University in Winston-Salem, NC.

In his InfoRad presentation at the RSNA meeting Sunday morning, Vining described the problems as lack of standard terminology, inconsistency, poor accountability, and inefficiency -- especially inefficiency.

"This point of service is where our clinical colleagues hate us the most," he said.


Attendees stream toward the just-opened technical exhibits at the RSNA meeting Sunday morning.

Vining and partners at the Virtual Endoscopy Center have developed an alternative reporting method that they characterize as the "Quicken of radiology reporting," referring to the popular do-it-yourself income tax software. Instead of extensive narratives, the new system works on a point-and-click basis to provide concise, bulleted reports.

"We have developed a Web-based multimedia report that can be accessed by the Internet and offers instantaneous delivery to referring physicians," Vining said. "It eliminates the need for transcription and also for voice recognition programs."

The typical report first contains the demographic information, then shows a relevant clinical image with the anatomy and pathology identified.

"Instead of a descriptive technique, we're showing where it is and what it is," Vining said. "By using the ACR Index of Radiologic Diagnoses, we have a standardized reporting mechanism. We show a bulleted statement of findings. Normal structures are simply listed as normal."

For pathologies, the referring physician simply clicks onto the marked image to enlarge it for a close-up three-dimensional view of the area in question. Secondary findings can be accessed for more in-depth descriptions.

Vining believes this new "paradigm for digital image reporting" has the potential to revolutionize the practice of radiology.

"It can record information on how long it takes radiologists to read certain types of studies to generate more accurate RVUs," he said. "Because we're using standardized ACR terminology, it can easily be translated into virtually any foreign language, and you can tie the report into billing at the front end. Also, it has training applications, and it's possible this type of reporting could replace the oral boards."

The new method needs more testing and has several challenges to overcome. These include integrating with RIS/HIS and PACS and revisions to the ACR codes, which have not been updated since 1992.