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Traditional Text-only vs. Multimedia Enhanced Radiology Reporting:
Referring Physicians’ Perceptions about Value
Gelareh Sadigh MD1, Timothy Hertweck BA2, Cristine Kao BSc 3,
Paul Wood BA2, Danny Hughes PHD4, Richard Duszak, Jr. MD1,4
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 2 IDR Medical GmbH, Boston, MA
3 Carestream Health, Inc., Rochester, NY 4 Harvey L. Neiman Health Policy Institute, Reston, VA
Disclosures
Gelareh Sadigh: Nothing to disclose.
Timothy Hertweck: Vice president of IDR Medical.
Cristine Kao: Vendor partner that supplies the technology for the research.
Paul Wood: Director of IDR Medical.
Danny Hughes: Nothing to disclose.
Richard Duszak: Nothing to disclose.
Traditional Text-only Reports
Historically, radiology reports have been generated in traditional text-only format, probably partly related to cultural inertia and the lack of widely available enabling software platforms.
Multimedia-Enhanced Radiology Reporting (MERR)
With technological advances, a transition to commercially available PACS-integrated technology such as MERR is now feasible.
*Patient names in images are fictitious.
*Patient names in images are fictitious.
With MERR, referring physicians and radiologists are more easily able to assess the measurements of a mass/lesion/nodule and its changes over time in form of Tables…
…and in the form of Graphs…
*Patient names in images are fictitious.
…or by viewing relevant comparison images themselves.
Additionally, data and key images can be printed without a computer viewer for physicians who prefer to receive reports in a paper format.
Purpose
• To explore referring specialist physicians’ satisfaction with the format of traditional text-only radiology reports.
• To study their perceptions of the value of an early MERR platform and its potential impact on their referral behavior.
Methods
A web-based survey was created for:
a) Medical oncologists
b) Radiation oncologists
c) Neurosurgeons
d) Pulmonologists
Practicing in the United States.
Inclusion Criteria:
• > 2 years in practice after residency/fellowship training.
• Personally referring ≥10 patients/week to a radiology department.
Enrollment terminated when qualifying responses from 50 physicians for each of the four included specialties were obtained (total of 200).
22-question survey with questions on:
• Participant demographics.
• Opinions on the format of currently received radiology reports and level of satisfaction.
• Perceived value of MERR as an alternative reporting mechanism.
Results
• 200 survey respondents
• Mean age: 46 years
• Mean post training practice: 15 years
• 85% male
• 47% from academic medical centers
Current Radiology Reports Format
Paper vs. Electronic
2% 6%12%
2% 6%
26%26%
24%32% 27%
72% 68% 64% 66% 68%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
MedicalOncology
Neurosurgery RadiationOncology
PulmonaryMedicine
Total
Only Paper Only Electronic Electronic and other formats
Text only vs. Text & Image
40%
60%
46% 50% 49%
60%
40%
54% 50% 51%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Text Only reports Reports including images
Satisfaction with Current Reports
4.9 5.7
0
2
4
6
Text only reports Text & Imagereports
Level of Satisfaction (1-7 scale)80% were satisfied (score > 5) with the current format of their radiology reports.
Satisfaction levels were higher with combined text & image reports vs. text-only (P <0.001).
Perceived Value of MERR
80% believed MERR would represent an improvement over current format of radiology reports:
• Improved understanding of findings by correlating images to text reports (86%)
• Easier access to images while monitoring progression of a condition (79%)
• Time saved trying to understand findings without supporting imaging (66%)
• Easier access to images while planning treatment (64%)
Perceived Value of MERR
28% had concerns regarding implementation of MERR:
• Too time intensive (15%)
• Clinic workflow does not allow itself to view reports in such a fashion (12%)
Information
overload;
multimedia reports
are very "busy“
– Pulmonologist
Resistance to
adopt by less
tech-savvy
colleagues
– Pulmonologist
Radiologists will
not spend the time
to make the
annotations as
even now they do
not write good
reports
– Pulmonologist
The amount of computer space
needed may be too much/time to
retrieve or upload may be too long
– Pulmonologist
Data overload
– Radiation
Oncologist
It will take too long to
load everything –
Radiation Oncologist
Will likely involve even
longer wait at terminal
waiting for report images
to appear
– Medical Oncologist
I don't want that up in the
OR when I am operating-
need the studies only
– Neurosurgeon
Impact of MERR on Referring Behavior
• 80% indicated an increased likelihood of preferentially referring patients to facilities that offer MERR.
• 79% indicated an increased likelihood of recommending peers use facilities offering MERR.
Impact of MERR on Patient Communication
• 67% believed using MERR, they would be more likely to review report text and images with patients.
• 65% believed using MERR, they would be more likely to provide patients access to report text and images.
Conclusion• Surveyed referring physicians strongly view image- and data-
embedded multimedia enhanced radiology reporting as an
improvement over traditional text-only radiology reporting.
• Large majorities of referring physicians indicate that they
would preferentially refer patients and peers to facilities that
adopt more interactive user-friendly enhanced reporting
practices.
