Computer-Aided Reporting of Chest Radiographs: Efficient and Effective Screening in the Value-Based Imaging Era

In the post-PACS era, mammography is unique in adopting specialized ergonomic interfaces to improve efficiency in a high volume setting. Chest radiography is also a high volume area of radiology. The authors hypothesize that applying a novel interface for chest radiography interpretation and reporting could create high productivity while maintaining quality. A custom version of the ClearCanvas open source software, EzRad, was created with a workflow re-designed specifically for tuberculosis screening chest radiographs, which utilized standardized computer generated reports. The preliminary reports from 881,792 studies evaluated by radiology residents over a nine-year period were analyzed for productivity as RVU/FTE and compared to the finalized reports from a subspecialty attending chest radiologist for accuracy. Radiology residents were able to produce 7480 RVU/FTE per year in screening chest radiography productivity when using a custom interface at a large academic medical center with a miss rate of 0.1%. Sensitivity was 77% and specificity was 99.9%. An ergonomic user interface allowed high productivity in interpretation of chest radiography for tuberculosis screening while maintaining quality.