How do you deal with adding extra information to an exam? A specific scenario is when a report is checked prior to MDT and the radiologist wants to record that they agree or otherwise with the report. Currently we are adding an addendum, which is then sent through to the other systems. This is causing friction with the referrers as they then get an alert to check a report which usually has no real difference, increasing their workload. We use CRIS and a note in the “Comments” section has been suggested but is not keen to be accepted.
What do you folks do?
Unsure if this is helpful , but is there an end user controlled customised notifications option ? We had this very problem so we ended up just coding our own in our veterinary orthopaedic planning and referral system ( cloud based with PACs connection etc) , along with a casestudy live message ‘ chat ‘ for each end user that is invited and part of the case study. Admin staff , clinicians, surgeons etc can choose to be ( natively) notified for individual items such as new images uploaded, new lab work / surgery reports/ histopath / CT reports etc as well as for any requests or updates in the case chat .
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In a former Trust, we used to have the provision of dummy codes in the RIS for MDT Review and MDT Outcomes. The Review would be the Radiologist confirming they have read the report, reviewed the imaging and agree with the original report. The Outcome would be recorded from the MDT and shared to the Radiology secretarial team who would add the outcome event into the RIS.
I’m sure there would likely be a similar but more efficient way of doing this with a full EHR/EMR.
What about the double reporting function in CRIS? This has a drop down box where one can make the statement “agree”, “disagree with …”. Not sure how this is worked into an efficient workflow without a permission hassle. It is obviously intended for a 2nd radiologist’s response.
For us, it depends on the purpose of creating a note. We only had an addendum to the report if there is a discrepancy and the report needs to be corrected for clinical safety reasons.
We record the outcome of the MDT including clinical discussions and Radiology opinion in a separate clinical MDT note/form as part of the EPR.
If the purpose is to use MDT as per review, to say whether you agree or not, it would be better to use the peer review function in RIS or PACS, if you have it. That captures the agreement/disagreement and any comment separate from the report. Again we would only add an addendum if there is a clinically significant difference in a report that has been issued.
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We run our MDT system using EPR generated orders for each MDT, for example Prostate MDT, ordered by the clinician. This is then used to generate an MDT list and finally record an MDT opinion once the MDT has taken place. It negates the need to add addendums for MDT review, records the activity (afterall points mean prizes) and as our EPR is not able to launch in context from our PACs or RIS its an easy way to see if I a patient has had an MDT discussion.
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This double reporting function we have found very limited as it is difficult (? impossible) to review the changes afterwards short of searching the database. Have you managed to access the feedback after verifying the report from within the Cris application?
We have PACS [Agfa EI] based reporting. We add patients to MDT conferences within PACS. A separate MDT entry is made in CRIS in advance by our Med Secs and subsequently reported in EI after the event. Therefore MDT activity is captured using CRIS stats.
It is not without faults. If the process isn’t followed to the letter we end up with a large number of unreported studies in PACS to remove [now removed as an automated process].
Years back I developed a stat report in CRIS which would pull out the outcomes of the double reporting function in CRIS I could find the stat key and share if that would help? It was used for appraisal data each year for all the radiology consultants at my former trust
Thank you Bonnie.
I don’t think we’d currently use it as we haven’t actively encouraged using this feature because of the additional workload it is likely to create.
I may come back to you if I’m asked about it again.
We have an exam code for MDT (ZMDT) that the person reviewing the images adds when reviewing the exams. I am not sure if the Radiologists add comments it notifies the referrer with the MDT exam report comments, but it might be that in the Interface between your RIS and EPR you can block these codes so they wont appear in the EPR but still appear in CRIS and on PACS.
We have ‘ZCMDT’ & ‘ZOMDT’ for cancer and other MDTs respectively.
Our MEd Secs add the codes prior to the MDT from the booked list. These are reported during or after the MDT. The report creates a new entry in ICE and the report is viewable from within ICE. The gap at the moment is I don’t believe it populates our cancer system [InfoFlex].