Richard Earnest Sharpe MD, MBA, Abstract Co-Author: Nothing to Disclose

Ronald Scott Winokur MD, Presenter: Nothing to Disclose

Richard Joseph Thomas Gorniak MD, Abstract Co-Author: Consultant, Bracco Group

Levon N. Nazarian MD, Abstract Co-Author: Nothing to Disclose

Adam E. Flanders MD, Abstract Co-Author: Research Consultant, Geron Corporation

Vijay Madan Rao MD, Abstract Co-Author: Nothing to Disclose

Software that efficiently communicates report discrepancies may improve resident education, particularly for examinations not jointly reviewed by resident and attending radiologist.

Overnight radiology residents draft preliminary interpretations of emergency department studies. As attending radiologists may read these overnight studies at a location away from the resident, notification of report discrepancies is challenging. To facilitate this communication, a plug-in was developed to directly send feedback emails from the PACS. A Javascript and PHPplug-in places a button within PACS on preliminary status cases which launches a window for discrepancy data entry. This information, in addition to RIS metadata, is stored in a mySQL database on the server hosting the plug-in. An email containing the accession number of the case, discrepancy category and attending text is automatically emailed to the resident. 

From 8/3/2008 to 3/29/2011, 2,681 discrepancies were logged. 25 of 48 (72%) attendings logged at least one entry. The modality with the largest number of entries were CT 2,124; MR 330; and XRAY 220. Average attending time required to log an entry was 55 sec. A trainee survey was completed by 35 of 36 (97%) residents. Regarding “the current DL system provides an efficient means for trainees to receive comments regarding cases read during call shifts,” responses were “Somewhat Agree” 9 (37.5%). Results were rated using a 5pt scale from “Strongly Agree” (+2) to “Strongly Disagree” (-2), the average response was +0.94 (95%CI: 0.41-1.47). Trainees state that when there has been a significant DL comment emailed to him, they look back at the case: always 18(82%) or often 3(14%).

Integrating PACS with a resident email feedback tool efficiently and effectively communicates report discrepancies, particularly when there is no resident and attending joint imaging review. Residents respond to significant discrepancies when notified via this tool. This efficient solution may improve communication and education without interrupting workflow in busy imaging departments. Further evaluation is needed to discern whether this tool could assist in evaluating progress and competency.

Sharpe, R, Winokur, R, Gorniak, R, Nazarian, L, Flanders, A, Rao, V, Resident-Attending Communication Is Improved by a PACS Integrated Discrepancy Notification System.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11010608.html