Radiologists and referring physicians need dependable, clear communication to collaborate on accurate diagnoses for their patients. When that communication is lacking, the risk of errors can quickly compound.
Annette Johnson, MD, MS, describes a particularly worrisome case on the Agency for Healthcare Research and Quality website. This is an example of what can go wrong when physicians and radiologists don’t have quick, easy-to-use access to one another.
Radiology Report Transmission Errors: An Alarming Story
A 62-year-old man was admitted to the hospital with swelling in his abdomen and legs, Johnson reports. His right leg was slightly more swollen than the left, and the attending physician was concerned that he might have a deep vein thrombosis (DVT). The physician ordered an ultrasound to check for evidence of a blood clot.
The imaging procedure didn’t show any signs of DVT. The radiologist called the primary care team and told them this verbally after dictating the report, so the team continued to treat the man with the understanding that he did not have a DVT. All was well up to this point.
The problem occurred when the night team rotated in. As the radiologist verbally dictated the report, it turns out, the dictation system clicked just as it recorded the words “no DVT is seen” — obscuring the word “no.” As a result, the hospital’s voice recognition software recorded the phrase “DVT is seen.” That’s the statement that made it into the truncated radiology report, which the night resident read when beginning the shift.
This confusion eventually led to two unnecessary surgeries: One to place a filter in a blood vessel leading to the lung, to block the (nonexistent) blood clot; and the other to remove the filter after someone finally tracked down the reporting radiologist and learned about the mistake. The good news is that there were no complications, and the patient emerged from the surgeries no worse for wear.
Improving Communication Between Radiologists and Referring Physicians
So where did the care team go wrong in this case? Let’s break the issues down into two categories: technology and procedure.
- There were two clear technology issues in this case: First, a microphone that clicks when activated, and second, the voice recording software’s inability to understand the word “no” beneath the click.
But the case also illustrates the simplest way around reporting errors. Remember that when the patient was first admitted, the reporting radiologist spoke directly to the primary care team. That sort of one-on-one interaction is ideal.
At Precise Imaging, we offer a physician’s web portal that allows real-time sharing, analysis, and annotation of diagnostic images. This provides yet another way for physicians and radiologists to collaborate directly, no matter where they are.
- As for procedural issues, Johnson points out that dictation using VRS is more error-prone than using human transcriptionists. Of course, her report dates back to 2011, and voice recognition systems have improved since her estimation.
The team also missed the opportunity to provide all physicians involved in the patient’s care with access to more information — while the truncated radiology report might have read “DVT is seen,” with access to images, annotations, and detailed analysis, the night resident might not have proceeded under the assumption that a blood clot was present. Again, comprehensive image-sharing web portals for physicians offer greater communication between radiologists and physicians.
Physician web portals aren’t the only innovation that can improve information-sharing between all members of a medical care team. You also need experienced, board-certified radiologists who work onsite in the U.S. to read diagnostic images, such as those at Precise Imaging.
All of our radiologists are devoted to patient care, and that means excellent communication with doctors, every time. Radiologists and referring physicians can work together to improve patient outcomes — but only if they commit to quality communication.