REducing Disruptive and Unnecessary Calls with Education and Electronic Chat for Asynchronous Liaison with RadioLogy:...

Frequent telephone calls to radiology departments are a major source of workflow interruption and inefficiency. Asynchronous messaging integrated within an electronic medical record (EMR) may provide a more efficient communication pathway. This study evaluated the impact of implementing an EMR-integrated chat function, supported by targeted education initiatives, on communication volumes and protocolling workflow in a tertiary academic radiology department.

A retrospective pre- and post-intervention study compared workflow metrics across 20 matched weekdays before and after implementation. The primary outcome was in-hours telephone calls per weekday to the duty radiologist. Secondary outcomes included studies protocolled per day, time-to-protocol, total communication events (telephone calls plus messages), workload-adjusted communication events (communication events per 100 protocolled studies), and chat responsiveness. Comparisons were performed using the Mann-Whitney U test, with workload-adjusted contact rates analysed using a Poisson model.

Median telephone calls to the duty radiologist decreased from 181 (IQR 166 - 220) to 82 (IQR 60 - 103) per day (p < 0.001). Total communication events decreased from 181 (IQR 166 - 220) to 104 (IQR 87 - 134) per weekday (p < 0.001). Number of studies protocolled was unchanged (92 [IQR 88 - 101] vs 97 [IQR 89 - 108] per day; p = 0.29). Workload-adjusted communication events decreased from 205 to 114 per 100 studies protocolled (rate ratio 0.56, 95% CI 0.53 - 0.59; p < 0.001). Median time-to-read and time-to-reply for chat were 8 minutes (IQR 2 - 24) and 14 minutes (IQR 5 - 34), respectively.

Implementation of asynchronous messaging, supported by targeted education initiatives, was associated with a substantial reduction in both telephone calls and total communication volume (calls plus messages) without affecting protocolling productivity. Chat messages were reviewed and answered in a timely manner. These findings support a scalable strategy to reduce communication-related interruptions in high-volume radiology departments.