Can You Efficiently Incorporate Patient-Specific Electronic Medical Record Data Into Radiology Workflow?

Abstract

The Health Information Technology for Economic and Clinical Health Act, passedbyCongressaspartof theAmericanReinvestmentandRecoveryActof 2009, created financial incentives for the adoption and meaningful use of electronic medical record (EMR) applications for health care providers to improvequalityandreducewaste[1,2]. Clinical information that once resided in paper charts is now and will be increasingly available in digital format in EMR databases. Physician notes; hospital discharge summaries; operative notes; pathologic, radiologic, and laboratory results; lists of allergies; medications; and active clinical problems will be a rich source of relevant information to help radiologists provide the highest quality of interpretative and consultative services to improve the care of patients. A major performance improvement opportunity for our specialty is to efficiently and consistently enable access to relevant patient-specific data in theEMR[3]. Inthiscolumn,Idescribe omeof theprosandconsof3strategies or incorporating EMR data in radiolgists’ workflow. Our existing radiology requisitions, traditionally the vehicle for communicating clinical information among referring physicians and radiologists, will be an inadequate tool for sharing relevant clinical information. Because today’s predominantly transactional heath care financing model promotes physician time constraints over ambiguous measures of quality, it will be unlikely for our referring colleagues to consistently create an optimal synopsis of a patient’s relevant clinical information by reentering information already present in the EMR, in a computerized radiology requisition. Just as our referring colleagues will have to search the EMR for relevant clinical information when evaluating their patients, they will expect radiologists to search the EMR for information relevant to the interpretation of imaging studies. Thus, the radiologyrequisition is likely, at its best, to include the minimum clinical information to justify the need for the imaging study (a solution for billing compliance rather than optimum quality of care). Radiologists’ time constraints, on the other hand, create substantial barriers for an EMR search beyond what is communicated ina radiology requisition,particularly if such a search is onerous (eg, login to multiple systems, reentry of medical record numbers, and searching for informationthatmaynotexist intheEMR). Strategies to enable the optimum communication of relevant clinical information among referring physician and radiologists beyond existing radiology requisitions will require various health IT tools. Below, I explore the pros and cons of 3 strategies to help enable efficient access to relevant EMR data within current radiologist workflow.