Electronic Health Record–Driven Workflow for Diagnostic Radiologists

Abstract

In most settings, radiologists maintain a high-throughput practice in which efficiency is crucial. The conversion from film-based to digital study interpretation and data storage launched the era of PACS-driven workflow, leading to significant gains in speed. The advent of electronic health records improved radiologists’ access to patient data; however, many still find this aspect of workflow to be relatively cumbersome. Nevertheless, the ability to guide a diagnostic interpretation with clinical information, beyond that provided in the examination indication, can add significantly to the specificity of a radiologist’s interpretation. Responsibilities of the radiologist include, but are not limited to, protocoling examinations, interpreting studies, chart review, peer review, writing notes, placing orders, and communicating with referring providers. Most of the aforementioned activities are not PACS-centric and require a login to one or more additional applications. Consolidation of these tasks for completion through a single interface can simplify workflow, save time, and potentially reduce the incidence of errors. Here, the authors describe diagnostic radiology workflow that leverages the electronic health record to significantly add to a radiologist’s ability to be part of the health care team, provide relevant interpretations, and improve efficiency and quality.

Introduction

Most radiologists agree that clinical data are important for creating focused and relevant reports 1, 2. Radiologists can use patient-specific information to help generate a useful differential diagnosis and drive an educated second look at an area of clinical concern 2, 3, 4, 5, 6. Unfortunately, important clinical data are often missing from the order [1].

Here, we share a model of radiology workflow that enhances a radiologist’s ability to provide more meaningful interpretations and interact with the health care team through the shared electronic health record (EHR). We term this model EHR-driven workflow. We have used this model through local configuration of our EHR (Epic versions 2010-2014; Epic Systems, Verona, Wisconsin) since 2011 at our large academic practice. Benefits include centralization of radiologist tasks, streamlining of workflow, improved interoperability, and placement of clinically relevant data points at the radiologist’s fingertips during image interpretation. The purpose of this report is to describe EHR-driven workflow.