Adam Randolph Travis MD, Presenter: Nothing to Disclose

Stephen Thomas MD, Abstract Co-Author: Nothing to Disclose

Divya Mukta, Abstract Co-Author: Nothing to Disclose

Paul J. Chang MD, Abstract Co-Author: Co-founder, Stentor/Koninklijke Philips Electronics NV Medical Advisory Board, Amirsys, Inc Medical Advisory Board, Koninklijke Philips Electronics NV Medical Advisory Board, Poiesis Informatics Medical Advisory Board, lifeIMAGE Technical Advisory Board, Merge Healthcare Incorporated

Previously in our institution, the approval process for requested percutaneous imaged-guided biopsies was paper-based and decentralized, requiring the radiologist to access multiple systems in collecting necessary information. Furthermore, no structured follow-up process existed, representing a neglected opportunity to track performance data such as false negatives and complication rates. To address these concerns, PACS-integrated software tools were developed to centralize and streamline the approval process and provide automated monitoring of results and complications.

Design and implementation of biopsy management tools occurred in two phases.  In phase one, an approval tool was created to replace the paper-based approval process, and linked to an online schedule with integrated imaging information.  A biopsy log tool was also created to enable structured tracking of complications and performance data, with a follow-up tool to provide user-logged biopsies. In phase two, approval and follow-up tools were augmented to incorporate recent lab and pathology information, respectively, reducing the number of steps involved in approval and follow-up. The approval tool was also modified to allow specification of the radiologist performing the biopsy, in order to assign special procedures to those with appropriate expertise.  A report generator was created to track and analyze each radiologist's performance and outcomes.

Use of these tools significantly reduced time spent approving biopsies, with an associated 22% increase in approved biopsies per month over the course of implementation. Additionally, these tools improved workflow by facilitating rapid retrieval of relevant clinical information and by allowing assignment of challenging procedures to those with appropriate expertise. Most importantly, collection of biopsy follow-up data was significantly improved with use of these tools, increasing from 45% of performed biopsies to 91%.

PACS-integrated biopsy management software tools designed and implemented at our institution have improved workflow and increased collection of follow-up data on percutaneous image-guided biopsies. The reports of individual radiologist outcomes also serve as a PQI project to comply with MOC guidelines of the ABR.

PACS-Integrated biopsy scheduling and outcome tracking allows for quality control and compliance in a busy work environment.

Travis, A, Thomas, S, Mukta, D, Chang, P, PACS-integrated Biopsy Management Tools: Towards Automated Quality Measurement and Improved Workflow.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034611.html