Moving Radiology Workflow to the Electronic Health Record: Quantitative and Qualitative Experience From a Large Academic Medical Center

• Published in: Academic radiology Vol. 27; no. 2; pp. 253 - 259
• Main Authors: Wildman-Tobriner, Benjamin, Thorpe, Matthew P., Said, Nicholas, Ehieli, Wendy L., Roth, Christopher J., Jaffe, Tracy A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2020
• Subjects: Clinical information; Electronic medical record; Priority; Stat; Stat; Priority; Clinical information; Electronic medical record
• ISSN: 1076-6332; 1878-4046
• DOI: 10.1016/j.acra.2019.02.006

To objectively and subjectively evaluate a large, academic radiology department's transition to electronic health record (EHR) centered workflow.
Multiple metrics were compared from before and after the move to EHR-driven workflow. Examination ordering and reading priority data were obtained for 30 days both before and after the transition. Sixteen radiologists were observed opening a computed tomography (CT) examination, and time to open, mouse clicks, and keystrokes were recorded. Information available to the radiologist during interpretation was also compared. Additionally, a 12 question survey was sent out to the residents and faculty both before and after the transition.
Implementation of an eight-level reading priority system increased worklist granularity and improved identification of more urgent studies to read. Radiologists opened CT studies in picture archiving and communications system-driven workflow in 52.4 ± 16.9 seconds using 9.5 ± 3.9 clicks and 6.3 ± 2.9 keystrokes, compared to 17.3 ± 9.5 seconds, 4.8 ± 1.5 clicks, and 0.1 ± 0.3 keystrokes in EHR-driven workflow (p < 0.001 for each measure). More information was available to the radiologist during examination interpretation, and 54.7% of radiologists rated the ease of use of the new system as good or very good (compared to 4.2% for the old system, p < 0.001).
Transitioning to an EHR-driven workflow at a large academic medical center improved efficiency, was favorable to radiologists, and enhanced examination prioritization.