Kevin William McEnery MD, Presenter: Nothing to Disclose

Charles T Suitor MS, Abstract Co-Author: Nothing to Disclose

Jay Patel, Abstract Co-Author: Nothing to Disclose

With PACS enabled paperless interpretation workflow, it standard procedure for radiologists to interpret cases in "first in – first out" (FIFO) priority. However, in our clinical practice, there are times when outpatients have imaging studies performed and then immediately visit their physician to discuss the results of imaging studies. A “Just in Time (JIT)” interpretation model permits timely interpretation of these clinical examinations. A competing workflow prioritization is a transition the multidisciplinary workflow - interpretation of diagnostic studies based upon sub-specialty rather than modality case grouping cases (e.g. musculoskeletal, genitourinary, etc.) rather that modality specific work lists.

A customized worklist engine was developed to enable JIT interpretation. The system aggregates data from several sources: PACS (images available), RIS (cases without reports), EMR (clinical service, current clinical status), and HIS (next appointment). We implemented work lists creation capabilities which allow aggregation of out-patient interpretation studies based upon specific clinical service criteria –aggregated all modalities which fulfill the service criteria. The system also accommodates the needs of radiologist residents in assignment of cases for interpretation of cases only after review by staff radiologist.

The workflow engine was able to effectively manage the interpretation of over 1,000 imaging studies on a daily basis. Radiologists note a general satisfaction with the system which eliminates interruptions for ad hoc prioritization with the prioritization processes being entirely automated. It is possible for patient care coordinators to override the prioritization at the specific request of a clinician or clinic if there is a clinical reason to do so. In-patient studies and STAT ordered cases receive higher priority and the aggregation rules are not applied.

JIT interpretation work lists are able to successfully manage the worklist of a large, tertiary care clinical practice. The implementation of the worklist engine requires integration of PAC, RIS, EMR and hospital scheduling systems.

McEnery, K, Suitor, C, Patel, J, Enabling “Just in Time” and Multidisciplinary Interpretation with Intelligent Interpretation Worklists.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4418946.html