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Roshan MP, Garcia J, Cury AB, Lamy C, Souza F, Sidani C, Cury RC. Eye tracking validation: Improving radiologist reporting and interpretation. Eur J Radiol 2023; 168:111134. [PMID: 37806192 DOI: 10.1016/j.ejrad.2023.111134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/03/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
RATIONALE AND OBJECTIVES This study aims to validate a new radiology reporting style using eye tracking to maximize radiologist interpretation time, increase accuracy, and minimize dictation time, ultimately providing a clinically relevant, concise, and accurate reporting style. MATERIALS AND METHODS The positive findings only dictation style using a podcast stand-alone microphone (n = 76) was compared with the standard check-list dictation style using a handheld microphone (n = 81). Experienced board-certified radiologists used each style for various imaging modalities. The number of voice recognition corrections per case was tracked. Eye-tracking glasses captured eye movement to document dictation, interpretation, and total examination times. This device also generated thermal heat maps for each style. The statistical difference between the two methods was assessed via descriptive analysis and inferential statistics. RESULTS Eye tracking revealed that the new positive findings dictation style led to a noteworthy shift in radiologists' visual attention, with reduced heat map overlaying the reporting software compared to the standard check-list style, indicating greater focus on medical images. Cases with at least one voice recognition correction significantly decreased using the positive findings dictation style versus the standard check-list style (5.26 % vs. 14.81 %; p = 0.0240). The positive findings dictation style significantly decreased average dictation time (16.54 s [s] vs. 29.39 s; p = 0.0003) without impacting interpretation time (70.90 s vs. 64.30 s; p = 0.7799) or total examination time (87.45 s vs. 93.69 s; p = 0.3756) compared to the standard style. CONCLUSION Positive findings only dictation style significantly decreased dictation time and enhanced accuracy without compromising total interpretation time.
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Affiliation(s)
- Mona P Roshan
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA.
| | - Jacklyn Garcia
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA.
| | - Ana B Cury
- Baptist Health of South Florida and Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL 33176, USA.
| | - Chrisnel Lamy
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA.
| | - Frederico Souza
- Baptist Health of South Florida and Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL 33176, USA.
| | - Charif Sidani
- Baptist Health of South Florida and Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL 33176, USA.
| | - Ricardo C Cury
- Baptist Health of South Florida and Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL 33176, USA.
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Jorg T, Kämpgen B, Feiler D, Müller L, Düber C, Mildenberger P, Jungmann F. Efficient structured reporting in radiology using an intelligent dialogue system based on speech recognition and natural language processing. Insights Imaging 2023; 14:47. [PMID: 36929101 PMCID: PMC10019433 DOI: 10.1186/s13244-023-01392-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Structured reporting (SR) is recommended in radiology, due to its advantages over free-text reporting (FTR). However, SR use is hindered by insufficient integration of speech recognition, which is well accepted among radiologists and commonly used for unstructured FTR. SR templates must be laboriously completed using a mouse and keyboard, which may explain why SR use remains limited in clinical routine, despite its advantages. Artificial intelligence and related fields, like natural language processing (NLP), offer enormous possibilities to facilitate the imaging workflow. Here, we aimed to use the potential of NLP to combine the advantages of SR and speech recognition. RESULTS We developed a reporting tool that uses NLP to automatically convert dictated free text into a structured report. The tool comprises a task-oriented dialogue system, which assists the radiologist by sending visual feedback if relevant findings are missed. The system was developed on top of several NLP components and speech recognition. It extracts structured content from dictated free text and uses it to complete an SR template in RadLex terms, which is displayed in its user interface. The tool was evaluated for reporting of urolithiasis CTs, as a use case. It was tested using fictitious text samples about urolithiasis, and 50 original reports of CTs from patients with urolithiasis. The NLP recognition worked well for both, with an F1 score of 0.98 (precision: 0.99; recall: 0.96) for the test with fictitious samples and an F1 score of 0.90 (precision: 0.96; recall: 0.83) for the test with original reports. CONCLUSION Due to its unique ability to integrate speech into SR, this novel tool could represent a major contribution to the future of reporting.
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Affiliation(s)
- Tobias Jorg
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131, Mainz, Germany.
| | | | | | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131, Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131, Mainz, Germany
| | - Peter Mildenberger
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131, Mainz, Germany
| | - Florian Jungmann
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131, Mainz, Germany
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Alarifi M, Patrick T, Jabour A, Wu M, Luo J. Full Radiology Report through Patient Web Portal: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103673. [PMID: 32456099 PMCID: PMC7277373 DOI: 10.3390/ijerph17103673] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 12/23/2022]
Abstract
The aim of this study discusses the gap between the patient web portal and providing a full radiology report. A literature review was conducted to examine radiologists, physicians, and patients’ opinions and preferences of providing patients with online access radiology reports. The databases searched were Pubmed and Google Scholar and the initial search included 927 studies. After review, 47 studies were included in the study. We identified several themes, including patients’ understanding of radiology reports and radiological images, as well as the need for decreasing the turnaround time for reports availability. The existing radiology reports written for physicians are not suited for patients. Further studies are needed to guide and inform the design of patient friendly radiology reports. One of the ways that can be used to fill the gap between patients and radiology reports is using social media sites.
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Affiliation(s)
- Mohammad Alarifi
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
- College of Medical Applied Sciences, King Saud University, Riyadh, SA 11451, USA
| | - Timothy Patrick
- College of Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Abdulrahman Jabour
- Health Informatics Department, Faculty of Public Health and Tropical Medicine at Jazan University, Jazan, SA 45142, USA;
| | - Min Wu
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
| | - Jake Luo
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
- Correspondence:
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Blackley SV, Huynh J, Wang L, Korach Z, Zhou L. Speech recognition for clinical documentation from 1990 to 2018: a systematic review. J Am Med Inform Assoc 2019; 26:324-338. [PMID: 30753666 PMCID: PMC7647182 DOI: 10.1093/jamia/ocy179] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/16/2018] [Accepted: 11/28/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The study sought to review recent literature regarding use of speech recognition (SR) technology for clinical documentation and to understand the impact of SR on document accuracy, provider efficiency, institutional cost, and more. MATERIALS AND METHODS We searched 10 scientific and medical literature databases to find articles about clinician use of SR for documentation published between January 1, 1990, and October 15, 2018. We annotated included articles with their research topic(s), medical domain(s), and SR system(s) evaluated and analyzed the results. RESULTS One hundred twenty-two articles were included. Forty-eight (39.3%) involved the radiology department exclusively and 10 (8.2%) involved emergency medicine; 10 (8.2%) mentioned multiple departments. Forty-eight (39.3%) articles studied productivity; 20 (16.4%) studied the effect of SR on documentation time, with mixed findings. Decreased turnaround time was reported in all 19 (15.6%) studies in which it was evaluated. Twenty-nine (23.8%) studies conducted error analyses, though various evaluation metrics were used. Reported percentage of documents with errors ranged from 4.8% to 71%; reported word error rates ranged from 7.4% to 38.7%. Seven (5.7%) studies assessed documentation-associated costs; 5 reported decreases and 2 reported increases. Many studies (44.3%) used products by Nuance Communications. Other vendors included IBM (9.0%) and Philips (6.6%); 7 (5.7%) used self-developed systems. CONCLUSION Despite widespread use of SR for clinical documentation, research on this topic remains largely heterogeneous, often using different evaluation metrics with mixed findings. Further, that SR-assisted documentation has become increasingly common in clinical settings beyond radiology warrants further investigation of its use and effectiveness in these settings.
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Affiliation(s)
- Suzanne V Blackley
- Clinical and Quality Analysis, Information Systems, Partners HealthCare, Boston, Massachusetts, USA
| | - Jessica Huynh
- General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Liqin Wang
- General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Zfania Korach
- General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Li Zhou
- General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Fernandes J, Brunton I, Strudwick G, Banik S, Strauss J. Physician experience with speech recognition software in psychiatry: usage and perspective. BMC Res Notes 2018; 11:690. [PMID: 30285818 PMCID: PMC6167903 DOI: 10.1186/s13104-018-3790-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/25/2018] [Indexed: 11/22/2022] Open
Abstract
Objective The purpose of this paper is to extend a previous study by evaluating the use of a speech recognition software in a clinical psychiatry milieu. Physicians (n = 55) at a psychiatric hospital participated in a limited implementation and were provided with training, licenses, and relevant devices. Post-implementation usage data was collected via the software. Additionally, a post-implementation survey was distributed 5 months after the technology was introduced. Results In the first month, 45 out of 51 (88%) physicians were active users of the technology; however, after the full evaluation period only 53% were still active. The average active user minutes and the average active user lines dictated per month remained consistent throughout the evaluation. The use of speech recognition software within a psychiatric setting is of value to some physicians. Our results indicate a post-implementation reduction in adoption, with stable usage for physicians who remained active users. Future studies to identify characteristics of users and/or technology that contribute to ongoing use would be of value.
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Affiliation(s)
- John Fernandes
- Shannon Centennial Informatics Lab, Centre for Addiction and Mental Health, 1001 Queen St W, Toronto, M6J 1H4, Canada
| | | | - Gillian Strudwick
- Shannon Centennial Informatics Lab, Centre for Addiction and Mental Health, 1001 Queen St W, Toronto, M6J 1H4, Canada.,University of Toronto, Toronto, Canada
| | | | - John Strauss
- Shannon Centennial Informatics Lab, Centre for Addiction and Mental Health, 1001 Queen St W, Toronto, M6J 1H4, Canada. .,University of Toronto, Toronto, Canada.
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Kumah-Crystal YA, Pirtle CJ, Whyte HM, Goode ES, Anders SH, Lehmann CU. Electronic Health Record Interactions through Voice: A Review. Appl Clin Inform 2018; 9:541-552. [PMID: 30040113 DOI: 10.1055/s-0038-1666844] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Usability problems in the electronic health record (EHR) lead to workflow inefficiencies when navigating charts and entering or retrieving data using standard keyboard and mouse interfaces. Voice input technology has been used to overcome some of the challenges associated with conventional interfaces and continues to evolve as a promising way to interact with the EHR. OBJECTIVE This article reviews the literature and evidence on voice input technology used to facilitate work in the EHR. It also reviews the benefits and challenges of implementation and use of voice technologies, and discusses emerging opportunities with voice assistant technology. METHODS We performed a systematic review of the literature to identify articles that discuss the use of voice technology to facilitate health care work. We searched MEDLINE and the Google search engine to identify relevant articles. We evaluated articles that discussed the strengths and limitations of voice technology to facilitate health care work. Consumer articles from leading technology publications addressing emerging use of voice assistants were reviewed to ascertain functionalities in existing consumer applications. RESULTS Using a MEDLINE search, we identified 683 articles that were reviewed for inclusion eligibility. The references of included articles were also reviewed. Sixty-one papers that discussed the use of voice tools in health care were included, of which 32 detailed the use of voice technologies in production environments. Articles were organized into three domains: Voice for (1) documentation, (2) commands, and (3) interactive response and navigation for patients. Of 31 articles that discussed usability attributes of consumer voice assistant technology, 12 were included in the review. CONCLUSION We highlight the successes and challenges of voice input technologies in health care and discuss opportunities to incorporate emerging voice assistant technologies used in the consumer domain.
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Affiliation(s)
- Yaa A Kumah-Crystal
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, United States
| | - Claude J Pirtle
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, United States
| | - Harrison M Whyte
- Department of Computer Science, Vanderbilt University College of Arts and Science, Vanderbilt University, Nashville, Tennessee, United States
| | - Edward S Goode
- Department of Computer Science, Vanderbilt University College of Arts and Science, Vanderbilt University, Nashville, Tennessee, United States
| | - Shilo H Anders
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, United States.,Department of Anesthesiology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, United States
| | - Christoph U Lehmann
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, United States
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Hammana I, Lepanto L, Poder T, Bellemare C, Ly MS. Speech recognition in the radiology department: a systematic review. Health Inf Manag 2016; 44:4-10. [PMID: 26157081 DOI: 10.1177/183335831504400201] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To conduct a systematic review of the literature describing the impact of speech recognition systems on report error rates and productivity in radiology departments. METHODS The search was conducted for relevant papers published from January 1992 to October 2013. Comparative studies reporting any of the following outcomes were selected: error rates, departmental productivity, and radiologist productivity. The retrieved studies were assessed for quality and risk of bias. RESULTS The literature search identified 85 potentially relevant publications, but, based on the inclusion and exclusion criteria, only 20 were included. Most studies were before and after assessments with no control group. There was a large amount of heterogeneity due to differences in the imaging modalities assessed and the outcomes measured. The percentage of reports containing at least one error varied from 4.8% to 89% for speech recognition, and from 2.1% to 22% for transcription. Departmental productivity was improved with decreases in report turnaround times varying from 35% to 99%. Most studies found a lengthening of radiologist dictation time. CONCLUSION Overall gains in departmental productivity were high, but radiologist productivity, as measured by the time to produce a report, was diminished.
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Affiliation(s)
- Imane Hammana
- Centre hospitalier de l'Universitè de Montrèal Montrèal, Quèbec CANADA
| | - Luigi Lepanto
- Centre hospitalier de l'Universitè de Montrèal Tour Saint-Antoine, Montrèal, Quèbec, H2X 0A9 CANADA
| | - Thomas Poder
- Centre hospitalier de l'Universitè de Sherbrooke Sherbrooke, Quèbec CANADA
| | | | - My-Sandra Ly
- Universitè de Montrèal, Ècole Polytechnique Montrèal, Quèbec CANADA
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Jabin SR, Schultz T, Hibbert P, Mandel C, Runciman W. Effectiveness of quality improvement interventions for patient safety in radiology: a systematic review protocol. ACTA ACUST UNITED AC 2016; 14:65-78. [PMID: 27755318 DOI: 10.11124/jbisrir-2016-003078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this review is to find the best available evidence regarding effectiveness of quality improvement interventions in clinical radiology and the experiences and perspectives of staff and patients. More specifically, the review questions are.
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Affiliation(s)
- Shafiqur Rahman Jabin
- 1Centre for Population Health Research, University of South Australia, Adelaide, South Australia, Australia 2Centre for Evidence-based Practice South Australia (CEPSA): a Joanna Briggs Institute Centre of Excellence 3Department of Radiology/Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
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Clarke MA, King JL, Kim MS. Toward Successful Implementation of Speech Recognition Technology: A Survey of SRT Utilization Issues in Healthcare Settings. South Med J 2015; 108:445-51. [PMID: 26192944 DOI: 10.14423/smj.0000000000000302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate physician utilization of speech recognition technology (SRT) for medical documentation in two hospitals. METHODS A quantitative survey was used to collect data in the areas of practice, electronic equipment used for documentation, documentation created after providing care, and overall thoughts about and satisfaction with the SRT. The survey sample was from one rural and one urban facility in central Missouri. In addition, qualitative interviews were conducted with a chief medical officer and a physician champion regarding implementation issues, training, choice of SRT, and outcomes from their perspective. RESULTS Seventy-one (60%) of the anticipated 125 surveys were returned. A total of 16 (23%) participants were practicing in internal medicine and 9 (13%) were practicing in family medicine. Fifty-six (79%) participants used a desktop and 14 (20%) used a laptop (2%) computer. SRT products from Nuance were the dominant SRT used by 59 participants (83%). Windows operating systems (Microsoft, Redmond, WA) was used by more than 58 (82%) of the survey respondents. With regard to user experience, 42 (59%) participants experienced spelling and grammatical errors, 15 (21%) encountered clinical inaccuracy, 9 (13%) experienced word substitution, and 4 (6%) experienced misleading medical information. CONCLUSIONS This study shows critical issues of inconsistency, unreliability, and dissatisfaction in the functionality and usability of SRT. This merits further attention to improve the functionality and usability of SRT for better adoption within varying healthcare settings.
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Affiliation(s)
- Martina A Clarke
- From the Informatics Institute, and the Department of Health Management and Informatics, University of Missouri, Columbia
| | - Joshua L King
- From the Informatics Institute, and the Department of Health Management and Informatics, University of Missouri, Columbia
| | - Min Soon Kim
- From the Informatics Institute, and the Department of Health Management and Informatics, University of Missouri, Columbia
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Olisemeke B, Chen YF, Hemming K, Girling A. The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review. J Digit Imaging 2014; 27:751-78. [PMID: 24888629 PMCID: PMC4391068 DOI: 10.1007/s10278-014-9706-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.
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Affiliation(s)
- B Olisemeke
- Radiology Department, Heart of England NHS Foundation Trust, Birmingham, UK,
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Woznitza N, Piper K, Rowe S, West C. Optimizing patient care in radiology through team-working: A case study from the United Kingdom. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2014.02.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Prevedello LM, Ledbetter S, Farkas C, Khorasani R. Implementation of Speech Recognition in a Community-based Radiology Practice: Effect on Report Turnaround Times. J Am Coll Radiol 2014; 11:402-6. [DOI: 10.1016/j.jacr.2013.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 07/02/2013] [Indexed: 11/29/2022]
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Comprehensive review of the limitations of relative value unit measurements of productivity in academic departments. Ultrasound Q 2014; 29:97-102. [PMID: 23676323 DOI: 10.1097/ruq.0b013e3182915931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Measuring radiologist, especially sonologist, productivity has never been of greater interest than now, as radiology has moved from its historical status as a cost center to the largest revenue generator in most institutions. With more local institutional and federal oversight and regulation into the reimbursement and valuation of imaging procedures, including emphasis on outsourcing, overvalued procedures, and bundling, the ability to measure productivity and to draw meaningful conclusions from the data becomes increasingly imperative if we as radiologists and sonologists expect to contribute meaningfully to the process. This article presents a history of the "relative value unit" and discusses the valuation of radiologist/sonologist productivity in this era of ubiquitous high-technology implementation.
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Abstract
Speech recognition (SR) speeds patient care processes by reducing report turnaround times. However, concerns have emerged about prolonged training and an added secretarial burden for radiologists. We assessed how much proofing radiologists who have years of experience with SR and radiologists new to SR must perform, and estimated how quickly the new users become as skilled as the experienced users. We studied SR log entries for 0.25 million reports from 154 radiologists and after careful exclusions, defined a group of 11 experienced radiologists and 71 radiologists new to SR (24,833 and 122,093 reports, respectively). Data were analyzed for sound file and report lengths, character-based error rates, and words unknown to the SR's dictionary. Experienced radiologists corrected 6 characters for each report and for new users, 11. Some users presented a very unfavorable learning curve, with error rates not declining as expected. New users' reports were longer, and data for the experienced users indicates that their reports, initially equally lengthy, shortened over a period of several years. For most radiologists, only minor corrections of dictated reports were necessary. While new users adopted SR quickly, with a subset outperforming experienced users from the start, identification of users struggling with SR will help facilitate troubleshooting and support.
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Affiliation(s)
- Tomi A Kauppinen
- HUS Medical Imaging Center, Helsinki University Central Hospital, PO Box 750, 00029, Helsinki, Finland,
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Towbin AJ, Iyer SB, Brown J, Varadarajan K, Perry LA, Larson DB. Practice Policy and Quality Initiatives: Decreasing Variability in Turnaround Time for Radiographic Studies from the Emergency Department. Radiographics 2013; 33:361-71. [DOI: 10.1148/rg.332125738] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Process mapping of PTA and stent placement in a university hospital interventional radiology department. Insights Imaging 2012; 3:329-36. [PMID: 22695945 PMCID: PMC3481077 DOI: 10.1007/s13244-012-0147-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 11/05/2011] [Accepted: 01/16/2012] [Indexed: 10/29/2022] Open
Abstract
OBJECTIVE To apply the process mapping technique in an interdisciplinary approach in order to visualize, better understand, and efficiently organize percutaneous transluminal angioplasty (PTA) and stent placement procedures in a university hospital's interventional radiology department. METHODS After providing an overview of seven established mapping techniques for medical professionals, the process mapping technique was chosen and applied in an interdisciplinary approach including referrers (physicians, nurses, and other staff in referring departments, e.g., vascular surgery), providers (interventional radiologists, nurses, technicians, and staff of the angiography suite), and specialists of the hospital's controlling department. RESULTS A generally binding and standardized process map was created, describing the entire procedure for a patient in whom the radiological intervention of PTA or stent treatment is contemplated from admission to the department of vascular surgery until discharge after successful treatment. This visualization tool assists in better understanding (especially given natural staff fluctuation over time) and efficiently organizing PTA and stent procedures. CONCLUSION Process mapping can be applied for streamlining workflow in healthcare, especially in interdisciplinary settings. By defining exactly what a business entity does, who is responsible, to what standard a process should be completed, and how the success can be assessed, this technique can be used to eliminate waste and inefficiencies from the workplace while providing high-quality goods and services easily, quickly, and inexpensively. MAIN MESSAGES Process mapping can be used in a university hospital's interventional radiology department. • Process mapping can describe the patient's entire process from admission to PTA/stent placement until discharge. • Process mapping can be used in interdisciplinary teams (e.g., referrers, providers, and controlling specialists). • Process mapping can be used in order to more efficiently organize PTA and stent placement procedures. • Process mapping can assist in better understanding and efficiently organizing procedures in standardized fashion.
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