Radiologists have a role in improving patient safety and healthcare quality -- especially in the reduction of duplicate or inappropriate testing -- and information-technology tools can play a major part in making these improvements happen, said speakers at a plenary session at the Radiological Society of North America's annual meeting held earlier this month in Chicago.
"Suboptimal" was a common word used to describe most test-tracking, abnormal-result follow up and communication systems currently used in healthcare today.
While the problems patients may suffer as a result may not be as obvious as a surgical error, these errors can result in treatment delays that cause patient harm, said David Bates, M.D., chief of general medicine at Boston's Brigham and Woman's Hospital.
"Our current system communicates rather poorly," Bates said, adding that trucking is the only major industry that has invested less in information technology than healthcare, and that current systems are "far from a Federal Express-level" of reliability and accountability.
Other issues he cited that lead to errors in radiology included patient identification and labeling of radiology images.
Brigham's vice-president of radiology, Ramin Khorasani, M.D., cited estimates that 20% to 30% of imaging tests may be inappropriate or unnecessary.
"That is a form of error -- an error that results in additional costs," Khorasani said.
IT decision-support tools are available to reduce these errors, Khorasani said, including alerts that tell ordering physicians whether current evidence supports the need for a test or whether the test they're ordering has already been done.
Some systems allow the physician to go another layer deeper by listing the research abstracts that provide evidence of whether a test is necessary, and others go further by grading the level of evidence that the research provides.
Patient ID is an issue
Bar-coded patient ID bracelets are another IT tool hospitals can use to avoid giving the wrong patient the wrong test, Khorasani said.
The importance of having systems in place to prevent human errors was noted during a question-and-answer session as a radiologist noted that his institution has no way to determine with 100% accuracy whether a technician correctly labeled "right" or "left" on a chest X-ray, adding that the hospital's current system -- which calls for firing technicians after they make three errors -- is insufficient.
"What does that do?" he said. "You just have new techs all the time."
A third speaker, Curtis Langlotz, M.D., an associate professor of radiology at the University of Pennsylvania in Philadelphia, noted that human errors are inevitable and that the work environments need to be engineered to prevent those errors from harming patients
Langlotz also noted another way IT is changing radiology: There are more systems and fewer people. He explained that clerks and transcriptionists (as well as actual film) are "disappearing" from the process, creating a tighter network between ordering physicians, technicians and radiologists.
Khorasani said there was "broad support but suboptimal adoption" of healthcare IT, and said that increased adoption will transform radiology's role from being just a technology provider to being more of a knowledge provider.
To do this, "Radiology must take a leadership role," he said.