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  • 13 Apr-2016
Structured Reporting, Quality Control & Radiology Audits - Need of the hour

Structured Reporting, Quality Control & Radiology Audits - Need of the hour

CARG - the leading  provider of teleradiology services has now made imaging reporting convenient thereby increasing the efficiencies of the radiology practices.  Our services enable clear, accurate, easy-to-understand and appropriately thorough reporting.  Hospitals, diagnostic centers and radiology groups across geographies who have partnered with CARG, are finding our model to be a winning strategy for them with access to exceptional subspecialty radiologists.  CARG has enabled our clients with optimal radiology coverage, improved patient care, reduced costs and increased efficiencies. CARG’s full spectrum of reporting services includes pre-reads, final reads, subspecialty reads, locum services, night-hawk services, emergency, quality assurance services and peer reviews.

In a recently published report of Bruno et al (2014), the authors have highlighted the significance of impact of accessibility for a radiologist in order to avoid technical lingo. Today, the complexity of medical imaging has increased dramatically, providing radiologists with an ever-larger number of images to interpret and more imaging modalities to compare.

Need of Structured Reporting

Medical imaging is uniquely positioned to play a pivotal role in a patient’s journey, from early detection as part of screening till treatment and cure. Imaging studies are often an integral part of a patient’s evaluation, and these reports become a permanent part of the medical record and are often consulted for patient management. Therefore, their completeness and effectiveness are critical. A radiologist’s official report study is a proprietary communications between radiologists and referring physician. The end product of an imaging examination - the report provides the information needed for optimum patient management. However, given the growing complexity of the information radiologists are charged with interpreting, it is worth considering whether greater standardization could result in better communication, more-complete reports, and fewer misdiagnoses.

Thumbs up to Structured Reporting in comparison with conventional free text

Lawrence H. Schwartz, MD, and co-authors from Memorial Sloan-Kettering Cancer Center in Manhattan, N.Y. conducted a study in 2011 to evaluate the differences between structured reporting and conventional reporting.

The study included 11 physicians who made use of conventional and structured reporting. The group included 6 radiologists, 3 surgeons and 2 oncologists, each of whom read 15 conventional and 15 structured reports (no physicians read the same reports) on body CT scans.

The authors assessed the differences in content and clarity as reported by these physicians. Conventional reports earned a mean content satisfaction rating of 7.61 out of 10, which was significantly lower than the 8.33 score tacked onto structured reports. Structured reports likewise significantly outscored conventional ones in clarity, receiving a mean score of 8.25, compared with 7.45 for conventional reports.

Structured reports also received a total of 90 perfect scores for content and clarity, vs. 28 for conventional reports. Conventional reports earned poor scores for clarity and content than did structured reports. Non-radiologists expressed greater satisfaction with structured reports. In the study, physicians displayed significantly greater satisfaction with the content and clarity of structured reports than with the content and clarity of conventional reports.

Structured reporting makes the evaluation of quality indicators for both radiologic studies and reports much easier, since individual elements measuring quality are more easily defined in a structured report. Thus for a better communication, more-complete reports and fewer misdiagnoses structured reporting with greater standardization is worth considering. Now more radiology practising groups are shifting towards structured reporting systems.

CARG’s Standardized Structured Reporting

CARG’s standardization of reporting in radiology has been proposed to increase quality, in part since our structured reporting templates, when used as checklists, helps convert what is largely an intuitive cognitive process into a more rational cognitive process.

Structured reporting at CARG aims to standardize the format and lexicon used in reports, which improves the communication of findings allowing ease of reading and comprehension while facilitating a case review with much focused attention and analysis. CARG has a unique 3 tier system of reporting which includes indication and impression followed by itemized reporting and true structured reporting respectively. Following a structured template for reporting helps keep consistency in reporting procedure. Structured reporting also offers many benefits like decreased ambiguity and enhanced opportunities for research, clinical decision support and quality improvement.

Quality control

Quality control system at CARG has evolved after rigorous trails of various tried and tested methods. This has enabled us to implement new processes, workflows, and structures within the hospital. We can help organizations achieve highest quality standards through our Quality Assurance Services that includes external audits and peer reviews.

CARG maintains quality assurance of reporting services in the form of prereads, second reads and final reads with 97% accuracy through harmonized workflow guided under various parameters to check every aspect. Subspecialty reads at CARG offer highest levels of quality standards in providing expert opinion facilitating diagnosis. The structured reporting service at CARG provides a careful review of diagnostic accuracy and outcomes including standardized results of both normal and abnormal cases during the interpretation and comparison of imaging studies.

Radiology auditing

Audits or self-assessments are designed to familiarize staff with general auditing technology, and help employees identify their strengths as well as weaknesses most in need of urgent improvement. Audits also ensure that internal experts recognize the weaknesses and improvement possibilities in their longstanding and routine practices. CARG follows a controlled radiology auditing system, which identifies the discrepancies and provide sufficient information for specific process improvement. Radiology auditing ensures satisfaction with content accuracy and clarity of reporting, solidifying the fact that teleradiology auditing at CARG is remarkable. Our audit protocols help with challenges of audit, revalidation, and accreditation. With top-notch reporting and relaying services, we can help you through accreditation process.

References:

http://www.healthimaging.com/topics/health-it/radiology-structured-reporting-beats-conventional-free-text.

McCreadie G and Oliver TB(2009). Eight CT lessons that we learned the hard way : An analysis of current patterns of radiological error and dispcrepancy with particualt emphasis on CT. Clinical Radiology 64; (5): 491- 499

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  • 13 Apr-2016
Trends in Teleradiology: “What makes 3D unique”

Trends in Teleradiology: “What makes 3D unique”

At CARG, plain teleradiology is the thing of the past. What’s new, of course, is technology that allows organizations to set up sophisticated medical imaging systems. CARG is continually at the forefront of current technology trends in radiology and teleradiology with our highly trained and qualified subspecialty radiologists. Combining industry insights with cutting-edge technology know-how, CARG is one of the top leaders among teleradiology service providers globally offering high-quality radiology solutions and reporting services in India and across geographies. CARG offers radiology education to help radiologists and allied staff to keep abreast with latest technology trends and to gain mastery over their subspecialty.

Various new developments afoot in the medical imaging world. Most of the companies are shifting towards 3D imaging technology and its solutions to meet the requirements of today's business and patients’ needs. The introduction of enhanced technologies such as 3D image sensors and 3D displays, providing high resolution visuals, is seen to give a boost to the adoption of 3D imaging across various modalities. The interventions done through new radiological methods, are remarkably striking targeting relatively more minimal invasive, where the aim is to keep natural milieu with least disturbance, a more precise approach as none else can see so well the target like the proverbial eye of the fish for Arjuna- knocking on the target!

To produce 3D images, many scans are made, and then combined by computers to produce a 3D model, which can then be manipulated by the physician. 3D imaging dates back to 1960 when Larry Roberts wrote his PhD thesis at MIT on the possibility of extracting 3-D geometric information from the standard 2-D views. The development of current 3D technology combined with recent developments enable an exciting range of applications for visualisation, measurement relevant both for diagnostic imaging and for anatomy.

Medical Visualisation: Revolutionized by 3D imaging 

Much of modern medicine relies on the 3D imaging that is possible with magnetic resonance imaging scanners and computed tomography (CT) scanners, which make 3D images out of 2D slices. Almost all surgery and cancer treatment in the developed world relies on it. So an interesting question is what is trending in 3D imaging today and where medical visualisation will take us next.

CARG teleradiology services exemplify the fact that 3D imaging has changed the way teleradiology is seen. The 3D imaging technology at CARG enables accurate detailing and correct diagnosis by the expert radiologists making CARG as one of the eminent names in the field of teleradiology.

Various 3D diffusion imaging techniques like Diffusion weighted magnetic resonance (MR) imaging, tractography reveal the diffusion of water through the body and neural tracts using diffusion tensor imaging (DTI). Imaging of these structures is opening important new areas of study in neuroscience and biomechanics.

3D Mammography

Digital breast tomosynthesis (DBT) has been a latest trend topic in last few years. As more studies are released, hyping the success of this technology is increasing its popularity. 3D breast tomosynthesis offers clarity at a low dose using a short X-ray sweep around the compressed breast with only nine exposures. The principle of this technology is that it shoots multiple images and creates a 3-D dataset that produces multiple slices - between 40-140 at 2 mm each, which can be rolled through and looked at in different sections.

Thin client 3D viewers

Cloud-based solutions are becoming more widely adopted specialized solutions in the world. Previously radiologists at independent workstations performed 3D viewing. But with the recent trends in Teleradiology, multiple thin client solutions are accessible that permits 3D post processing and viewing of medical images. Reduction in the cost and direct data accessibility irrespective of the geographical barriers has been achieved by this development. Thin client 3D viewers allows post processing of image data from multiple scanners across different locations that have been transmitted to a centralized server thereby compensating against staffing shortage.

3D Multimodality registration and visualization

Sometimes different measurements are necessary to obtain a complete picture, e.g. an MRI scan augmented with functional information from a PET scanner for which an accurate registration (or matching) is crucial step for the effective integration of patient data from such different image sources. The registration is accomplished by translating, rotating and scaling the 3D datasets relative to each other, such that some criterion for ‘minimal distance’ is reached. The registered datasets can be presented by a variety of methods, of which integrated 3D display is the most popular.

Today’s changing healthcare landscape places an urgent emphasis on improving the quality of patient care and reducing overall costs in health facilities. The advantage of recognising and understanding new trends allows one to become an early adopter and thereby achieve advantage.

CARG is regularly updating itself to highlight the advances of the teleradiology industry, and pushing boundaries in achieving detailed patient care through its far reaching system. By partnering with Columbia Asia Radiology Group, our clients are availing all the latest in radiology and we are happy to extend a helping hand to hospitals, imaging centers and radiology groups for any radiology services.

By keeping pace with new trends, CARG helps healthcare providers to:

  • Improve customer satisfaction 
  • Decrease reimbursement 
  • Improve workflow and productivity 
  • Create new revenue sources 
  • Have edge over your competitors

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