Analyzing the differential impact of radiology information systems across radiology modalities

The aim of this study was to assess the impact of redesigning a medical imaging workflow using a commercial radiology information system (RIS), particularly the impact of implementing a disciplined collection of background clinical information all along the clinical service chain.

The impact of the RIS on the total report turnaround time and on its various components, such as the radiologist interpretation, transcription, and radiologist review turnaround times, was empirically investigated. Advanced statistical tools were used, including lognormal survival functions and t-tests, to compare and analyze the pre-RIS and post-RIS operational performance of a regional network of outpatient clinics.

The RIS installation did not produce uniform benefits for all modalities. There was no statistically significant impact on report turnaround times for magnetic resonance imaging. On the other hand, turnaround times for mammographic studies declined significantly.

Although the additional time needed to navigate through the RIS screens might have (unexpectedly) increased the radiologists' interpretation cycle times, the overall benefits of the RIS outweighed this negative effect in this study. Before the RIS installation some clinical background information was not available to the radiologists at the time of interpretation. As a part of the RIS implementation the radiology practice introduced several disciplined data collection procedures to make such information readily available downstream. These procedures significantly reduced the percentage of mammographic studies that had to be put on hold, increasing radiologists' overall performance and income. The effectiveness of any RIS solution, therefore, significantly depends on systemwide analyses of all relevant performance metrics and also on the creative implementation of new clinical and administrative workflows.