RSNA 2012 

Abstract Archives of the RSNA, 2012


'Tsunami' Radiology Notification System: A Low Cost Method in Improving Communication between the Imaging Department and Clinicians

Scientific Informal (Poster) Presentations

Presented on November 28, 2012
Presented as part of LL-INS-WEPM: Informatics Afternoon CME Posters


Marion Dimigen MBBCh, Presenter: Nothing to Disclose
Branimir Zogovic MD,PhD, Abstract Co-Author: Nothing to Disclose
Avigdor Manuel Saks MBBCh, FRANZC, Abstract Co-Author: Nothing to Disclose
Andrew Georgiou PhD, Abstract Co-Author: Nothing to Disclose
Antonia Hordern MSc,BA, Abstract Co-Author: Nothing to Disclose
Glen Schlaphoff MBBCh,FFRAD(D)SA, Abstract Co-Author: Nothing to Disclose


Review of ‘Tsunami’, a radiology notification system, run by a centralised clerk, who on receiving email alerts from reporting radiologists, directly notifies the referring clinical team of the report by phone or fax. The system was set up to provide clinicians with prompt notification of non-urgent unexpected significant findings and to amended reports.


1585 (1.2%) alerts were generated from 129 824 radiology reports completed between March 2010 and February 2012. The alert indication, imaging modality, notification method and notified specialties  were retrospectively analysed from 500 consecutive alerts. The alert time (exam date to email alert ) and notification time (email alert  to notification time) were assessed. Feedback was obtained from interviewing the clinical directors of the 10 most notified hospital specialties.


Of the 500 Tsunami alerts reviewed, 185 (37%) reported possible underlying malignancy (26% suspicious lung nodules). Of the remaining 315 alerts, 44% were probable fractures. The majority of alerts concerned CT (48%) and plain film (43%) reports. Amended reports made up 9% of notifications, of which 94% were changes to trainee’s provisional reports. The average alert time was 2.4±0.2 days and successful notification time was 146±14 minutes (mean± standard error of the mean). Hospital specialists received 57% of all notifications, the majority to the gastroenterology, GI and trauma surgery departments. The ED (emergency department) received 629 (34%) and general practitioners 9%. The ED director preferred to be notified by phone calls or faxes, maintaining that an email alert system would not be feasible with their current set up. Of the 5 surgeons and 4 physicians interviewed, 2/3 felt that an automated email alert system would be difficult to implement or unworkable. This reflected the mix of public or private sector clinicians working in the hospital, resulting in a wide variation in ease of access and supporting administration staff.  


The ’Tsunami’ system effectively communicates non-urgent, significant findings to clinicians and is currently better tolerated than an automated email system. Its efficiency should increase with ongoing improvements in the feed-back mechanism


The Tsunami system is a useful, easily implemented, low cost tool in improving communication of non-urgent but important imaging findings in the setting of a large teaching hospital.

Cite This Abstract

Dimigen, M, Zogovic, B, Saks, A, Georgiou, A, Hordern, A, Schlaphoff, G, 'Tsunami' Radiology Notification System: A Low Cost Method in Improving Communication between the Imaging Department and Clinicians.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL.