Radiologists bemoan limited access to patient data

Lack of pertinent clinical patient data is a critical element limiting the accuracy of radiologic interpretation.

A recent paper addresses radiologists' perceived need for additional clinical patient data, both at the time of interpretation and in follow-up of imaging examinations (J Digit Imaging 2008 May 6 [Epub ahead of print]).

"The majority of academic radiologists are dissatisfied with their ability to access clinical patient information at the time of interpretation," said Dr. William W. Boonn of the radiology department at the Hospital of the University of Pennsylvania.

Boonn noted that, although most radiologists place a high priority on obtaining this information, a number of factors discourage its widespread use in routine practice. Current mechanisms for monitoring necessary patient follow-up are inadequate, he said.

Boonn surveyed 139 academic radiology attendings, residents, and fellows, 72% of whom reported they frequently needed more clinical information than they received. Over 87% said that this additional information could change or modify their interpretive report.

"In many hospitals, several different information systems may be used to access clinical data, presenting challenges to the radiologist in the form of multiple login requirements and unfamiliar user interfaces," Boonn said.

Legacy systems may challenge information technology staff attempting to integrate these systems due to nonstandard proprietary interfaces.

"Although many hospitals now provide access to patient electronic medical records, often these systems are not readily available to the radiologist at the time of the exam," Boonn said.

Even if this information is available in the reading room, time constraints on the radiologist do not allow efficient review of clinical data, he said.

Boonn's findings suggest that systems could be designed to retrieve and organize patient clinical data from other hospital information systems and then display these data for the radiologist at the time of interpretation.

Specific patient data could be electronically targeted, for example, for retrieval at the time of exam and collected for review along with the study, Boonn said.

"Almost all radiologists indicated they would use this type of system," he said. "The majority felt it would make a significant impact in the quality of their interpretations."

Another deficiency in academic radiology practice exposed in the survey is the lack of ability to follow up on previously interpreted exams.

Most radiologists rely on memory or keep a handwritten log, suggesting that the quality of patient care could be improved by a software mechanism to set flags or reminders that would alert the radiologist later that follow-up is available.

"In the maze of subspecialists who care for a patient, this reminder would help provide additional safeguards that crucial follow-up is addressed," Boonn said.