Sanjeev Katyal MD, Presenter: Nothing to Disclose

Shaina Robinson, Abstract Co-Author: Nothing to Disclose

Brian Scott Kuszyk MD, Abstract Co-Author: Nothing to Disclose

Susanj S. Patel MD, Abstract Co-Author: Nothing to Disclose

Eric Richter MD, Abstract Co-Author: Nothing to Disclose

Mark Brown MD, Abstract Co-Author: Nothing to Disclose

Suzanne Shullman MD, Abstract Co-Author: Nothing to Disclose

James Wilbert Backstrom MD, Abstract Co-Author: Nothing to Disclose

The purpose of this prospective study is to investigate the effects of self-editing on radiologist productivity, report quality, fatigue levels, and overall cost effectiveness of care.  

Approximately 10,000 CT chest and CT abdomen and pelvis interpreted by four body imagers will be assessed over a 6 month period. Outpatient, inpatient and emergency exams will be included in the scope of this study. For each working week, one of two predetermined reading methods will be used by each radiologist: utilizing a medical transcriptionist with findings only dictation style or self-editing with templates. Effects on fatigue levels with and without the use of a medical transcriptionist will be monitored. Each radiologist will complete daily fatigue surveys on a scale ranging from 1 (little) to 4 (significant fatigue). All final reports will be reviewed for reporting errors to determine overall quality outcomes with and without the use of a medical transcriptionist. 

A 1,400 representative sampling of our self-editing study data population was preliminarily reviewed. On average, the overall time/case was decreased by approximately two minutes when utilizing a medical transcriptionist than with self-editing. Overall, the four radiologists in our study were approximately 47% more efficient when transferring editing to a lower cost FTE. More importantly, they achieved this increased efficiency with lower fatigue levels. The average fatigue score for the sent to editor workflow was 2.1 and the average score for the self-edited workflow was 3.4. Through the preliminary analysis, there have been no differences in clinically significant accuracy rates between the two reading methods. The entire data set of 10,000 CT scans will be reviewed for both typographical and quality errors.

By sending to an editor instead of self-editing CT reports, our radiologists have decreased the overall time/report by an average of 47% with associated lower fatigue levels. These gains in clinical efficiency can be traded for reading more cases, performing imaging appropriateness and physician outreach, and spending more time viewing each case.

The use of voice recognition (VR) has decreased costs by eliminating medical transcriptionists but for most practicing radiologists, VR may have the unforeseen consequence of decreasing overall productivity and report quality.

Katyal, S, Robinson, S, Kuszyk, B, Patel, S, Richter, E, Brown, M, Shullman, S, Backstrom, J, The Effects of Self-Editing on Radiologist Productivity, Fatigue and Quality.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014668.html