Strategies for Radiology Reporting and Communication

Excerpt

While the digitization of medical imaging practice has brought a number of dramatic changes in technology and workflow, perhaps the most understated change has been the change in physical layout and staff location, which has evolved from a central to distributed model [1]. In analog practice, the departmental layout and staff location were centrally and group focused, with both the radiologist reading room and technologist working area created to accommodate large groups of individuals, which routinely interacted with one another for the purposes of peer-to-peer education, quality assurance, and case review. This naturally created an atmosphere of ongoing communication, collegiality, and mentoring. This trend of group dynamics and interaction extended to the medical staff, which by necessity had to physically travel to the radiology department to review imaging studies ordered on their patients. With the transition to filmless operation, this centralized working model was replaced by a distributed model, in which radiologists and technologists work in relative independence to one another. While this was intended to improve workflow and operational efficiency, the unintended impact has been diminished interpersonal communication, peer review, and education. As access to medical imaging data has become ubiquitous and instantaneous with the adoption of the picture archival and communication system, this distributed practice model has also extended into the referring physician community, resulting in decreased face-to-face communications between radiologists and referring physicians [2]. This distributed model of radiology practice has become further magnified with teleradiology, with the outsourcing of professional radiologist services to remote locations and independent (i.e., third party) service providers [3, 4]. …