Pager notification system accelerates report turnaround

As more radiology departments switch from paper to electronic reporting, the use of electronic signatures on radiology reports has become common. Yet the practice of electronic signatures can lead to delays in report turnaround, with potentially calamitous results.

"From a medicolegal standpoint, a single untoward event resulting from a delay in transcription and report verification could lead to a monetary settlement far outweighing the cost of extra transcriptionists or IT solutions," said Dr. David Yousem, director of neuroradiology at Johns Hopkins Medical Institution.

Prior to electronic signatures, transcribed paper reports were placed at the radiologist's location for immediate signature after a transcriptionist concluded a parcel of work. Whether those reports actually were signed immediately, were edited or retyped, or were left for review at another time varied from instance to instance, according to Yousem.

"With electronic radiology reports, however, notification that the report is available for finalization has been increasingly left to the direction of the IT group in the radiology department charged with creating an appropriate notification system," he said.

In many cases, this notification may require the radiologist to be logged into the RIS, a requirement that can lead to further delays in report verification. While verification of reports is but one element of report turnaround time, at Johns Hopkins it constituted 36% of overall process time.

In order to avoid the issue of poor verification times in reports sign-off, Johns Hopkins adopted a pager notification system that periodically scans the RIS and notifies radiologists when they have reports awaiting signature.

A study by Yousem (Acad Radiol 2002 Aug;9(8):954-959) assessed the impact of pager notification on times of verification.

"We found a dramatic and important decrease in report verification times which led to equally impressive improvements in overall report turnaround times," he said. "Physician satisfaction, especially through the emergency room, has increased substantially."

Mean time of verification was 26.75 hours for radiologists before enrollment in the pager system and 14.48 hours after: 23 of the 29 (79%) physicians who used the pager system showed a reduction in report turnaround.

"It's a simple, nearly costless, information technology improvement that can positively impact report turnaround times, physician satisfaction, and accounts receivables," Yousem said.