Diagnostic Reporting in Radiology

BUSINESS PLANNING & TECHNOLOGY DEVELOPMENT

On the work flow front, radiologists have begun moving toward structured diagnostic reports. An approach long used by cardiologists, structured reports are created by selecting predefined text and descriptors to create a narrative diagnostic report. In addition to producing the report, this methodology creates an underlying database of clinical data that can be analyzed to evaluate the quality of care and outcomes. By contrast, traditional dictated reports create a lump of unstructured text from which statistically relevant data cannot be extracted. As clinical outcomes increasingly drive payers' and patients' decisions about providers, the pressure to embrace structured reporting will increase.

At the 2006 meeting of the Radiological Society of North America, a number of vendors presented solutions designed to capitalize on this renewed interest in the diagnostic reporting process. Commissure (New York City) has built an infrastructure around the needs for structured reporting. It provides speech recognition and point-and-click structured reporting within a system that connects radiology information systems (RIS) and picture archiving and communications systems (PACS). Divided into three packages, the Commissure solution supports diagnostic reporting, remote physician access, and online analytical processing of clinical and departmental data contained in reports.

In addition, Commissure supports another new information technology trend through an alliance with another recent start-up, Vocada Inc. (Dallas). Vocada provides critical test results management software to ensure the delivery of clinically significant diagnostic reports. "Vocada's Veriphy system connects diagnostic reporting physicians with referring physicians with real-time communications systems," says Peter White, Vocada founder and CEO. Vocada provides a systemwide communications directory for hospitals that includes medical staff, as well as attending, consulting, and referring physicians. The underlying messaging engine manages the delivery of messages to physicians on the device of their choice, based on the type of message and when the message is sent. To ensure message delivery, the system also incorporates a tool for system monitoring and compliance reporting. Vocada integrates its product into broader third-party systems. Besides recent deals with Agfa and PowerScribe-Dictaphone, Vocada is also a part of Commissure's solution.

Connectivity among medical devices and reporting systems can greatly improve the reporting process for physicians. Standards like digital imaging and communications in medicine (DICOM) structured reporting are becoming more prevalent in diagnostic imaging. Such standards enable medical devices to transmit patient data into clinical information systems so that they can automatically appear when the physician creates a structured report.

Many medical device vendors—particularly top players such as GE, Philips, and Siemens—provide related clinical information systems that include diagnostic report generation capabilities. Vendors with no clinical information products must also find ways to enable the transfer of device data to third-party systems in an efficient way. As with other kinds of connectivity, the way in which a medical device's configuration affects work that occurs before, during, and after the use of the device can be as important as traditional features like image quality or the accuracy of the physiological data produced by the device.

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