The RADCAT-3 system for closing the loop on important non-urgent radiology findings: a multidisciplinary system-wide approach.

The goal of this project was to create a system that was easy for radiologists to use and that could reliably identify, communicate, and track communication of important but non-urgent radiology findings to providers and patients. Prior to 2012, our workflow for communicating important non-urgent diagnostic imaging results was cumbersome, rarely used by our radiologists, and resulted in delays in report turnaround time. In 2012, we developed a new system to communicate important non-urgent findings (the RADiology CATegorization 3 (RADCAT-3) system) that was easy for radiologists to use and documented communication of results in the electronic medical record. To evaluate the performance of the new system, we reviewed our radiology reports before (June 2011-June 2012) and after (June 2012-June 2014) the implementation of the new system to compare utilization by the radiologists and success in communicating these findings. During the 12 months prior to implementation, 250 radiology reports (0.06 % of all reports) entered our workflow for communicating important non-urgent findings. One-hundred percent were successfully communicated. During the 24 months after implementation, 13,158 radiology reports (1.4 % of all reports) entered our new RADCAT-3 workflow (3995 (0.8 % of all reports) during year 1 and 9163 (1.9 % of all reports) during year 2). 99.7 % of those reports were successfully communicated. We created a reliable system to ensure communication of important but non-urgent findings with providers and/or patients and to document that communication in the electronic medical record. The rapid adoption of the new system by radiologists suggests that they found it easy to use and had confidence in its integrity. This system has the potential to improve patient care by improving the likelihood of appropriate follow-up for important non-urgent findings that could become life threatening.

A survey of clinical research coordinators in the cooperative group setting of the American College of Radiology Imaging Network (ACRIN).

RATIONALE AND OBJECTIVES: As one of the newest cooperative groups funded by the National Cancer Institute in 1999, the American College of Radiology Imaging Network (ACRIN) is interested in conducting successful clinical research programs and pursuing quality research. The ACRIN Research Associate (RA) committee was formed in 2000 and felt it important to better understand the demographics, duties, needs, and concerns of ACRIN RAs. Therefore, in 2008, the committee conducted a survey of ACRIN RAs regarding these issues. MATERIALS AND METHODS: The survey instrument consisted of 33 multiple choice questions covering demographics, salary, job satisfaction, work load, educational background, and training. RAs completed the survey electronically in June 2008. RESULTS: A total of 110 responses were received. All regions of the United States were represented. The years of experience and salary ranged widely from <1 year to 28 years and ≤$20,000 to ≥$80,000 per year. The majority of respondents held at least a bachelor's degree, with many having previous health-related clinical training; only a small percentage of respondents having had formal training in research. CONCLUSION: Our survey summarizes the demographics and educational background of the research associates within ACRIN. This may help administrators understand the needs and characteristics of RAs participating in cooperative group research. In today's environment with tight regulatory control, it may become necessary to improve educational standards or require certification through one of the professional research organizations.

The Research Associate Committee of the ACR Imaging Network.

Research associates (RAs) play an important role in ensuring the quality of clinical trials. They are largely responsible for maintaining the accuracy and timeliness of data collected and for complying with applicable regulations. At the ACR Imaging Network (ACRIN), a cooperative group, RAs have formed a committee with the mission of helping ACRIN achieve its goal of conducting quality multi-institutional imaging clinical trials. Because of the varying backgrounds and levels of experience of ACRIN's RAs, one of the first goals of the committee was to develop an educational program that would provide standard training to all RAs. The committee also felt that RAs should be involved in the protocol development process from the earliest stages, and they are now represented on each major ACRIN committee. Other committee activities include publishing a newsletter, conducting an RA questionnaire, maintaining a Web page, and developing an online training tool. With hard work from the committee members, support from ACRIN's leadership, and demonstrated accomplishments, the committee has become an integral part of ACRIN's organization.

Transportable versus fixed platform CT scanners: comparison of costs.

PURPOSE: To compare the aggregate hospital technical costs of a transportable computed tomographic (CT) scanner used to image patients in an intensive care unit with those of a fixed platform CT scanner in the radiology department. MATERIALS AND METHODS: Direct fixed costs (ie, machine and service contract costs) and direct variable costs (ie, personnel costs) were calculated. Indirect costs, including space costs and departmental overhead, were calculated. Total costs were calculated as the sum of indirect, direct fixed, and direct variable costs. Personnel costs were calculated from time-motion analyses involving 95 patients who underwent brain CT with either a transportable (n = 51) or a fixed platform (n = 44) CT scanner. Costs per examination were calculated by using both low- and high-examination-volume models and compared with use of the Wilcoxon rank sum test. RESULTS: The total cost per examination for the transportable scanner ranged from 108.98 dollars to 167.20 dollars for the high- and low-volume models. Total cost per examination for the fixed platform scanner ranged from 75.24 dollars to 112.39 dollars for the high- and low-volume models. For the transportable scanner, direct fixed, variable, and overhead costs were 87.05 dollars, 70.73 dollars, and 9.42 dollars per examination, respectively, with the low-volume model. The corresponding costs for the fixed platform scanner were 46.66 dollars, 55.69 dollars, and 10.04 dollars, respectively. CONCLUSION: The technical cost of using an in-hospital transportable CT scanner is higher than that of using a fixed platform scanner.

Preferential use of sonographically guided biopsy to minimize patient discomfort and procedure time in a percutaneous image-guided breast biopsy program.

OBJECTIVE: To determine whether preferential use of sonographic guidance for percutaneous biopsy of breast masses results in a subset of patients with a shorter procedure time and less discomfort compared with patients undergoing stereotactic biopsy. METHODS: A prospective observational study was performed on 193 women undergoing percutaneous image-guided breast biopsy between 1997 and 1999. Data were collected on room time, physician time, and patient comfort levels for 122 stereotactic and 71 sonographically guided biopsies. Differences between stereotactic and sonographically guided biopsy for all lesions and for masses were analyzed for statistical significance. RESULTS: Mean room times were 62.2 minutes for stereotactic biopsy and 39.4 minutes for sonographically guided biopsy (P < .0001). Mean physician times were 23.0 minutes for stereotactic biopsy and 15.8 minutes for sonographically guided biopsy (P < .0001). When we limited our analyses to women undergoing biopsy for masses, the difference in physician time largely disappeared, but the difference in room time remained (P < .0001). Women undergoing stereotactic biopsy were more likely to report discomfort due to body positioning than were women undergoing sonographically guided biopsy (P < .001). These differences existed whether we included all lesions or restricted our analyses to masses. CONCLUSIONS: Preferential use of sonographically guided breast biopsy for masses results in shorter procedure times and less patient discomfort compared with prone stereotactic biopsy.