Electronic consultation work list enhances radiologist-clinician communication

Many referring physicians believe poor communication between radiologist and clinician to be a common point of failure in patient care.

To address this need, one group of neurosurgeons has designed a remedy by embedding an electronic DICOM consultation work list in their PACS. It enhances image-intensive communication at the point of neurological care where clinician-radiologist consultation is critical.

The consultation work list offers several services, according to Dr. Barton L. Guthrie, a neurosurgeon at the University of Alabama (UAB) School of Medicine at Birmingham:

?generation of consult requests to the radiologist at the point of care (when the clinician is viewing the image)
?notification of the radiologist of the request via e-mail or institutional pager
?generation of the consultant report at the time of interpretation
?notification of the requesting clinician at the time of report generation

The UAB work list, though embedded in the image-viewing component of a DICOM management system, is Web-compatible and has been implemented as a stand-alone Health Insurance Portability and Accountability Act (HIPAA)-compliant, Java-based browser feature.

"The system is standards based, making it scalable and compatible with evolving IT systems," Guthrie said.

While viewing the imaging study, users select a radiologist from the system's menu and enter a specific message or request. The system then transmits the message via standard e-mail. Upon receipt of the message, the radiologist interprets the study and reports to the clinician generating the request.

"With this system, clinicians are able to relay messages to specific radiologists about clinically relevant concerns that were not specifically addressed in the diagnostic report," Guthrie said.

The UAB service also works in reverse, enabling the radiologist to request clinical information not available at the time of interpretation, he said.

The system facilitates a smoother merger of the skills of clinical and radiological experts at the point of patient care without much disruption of productive workflow of either specialty, Guthrie said.