Saving time, improving satisfaction: the impact of a digital radiology system on physician workflow and system efficiency.

The objective of the study was to assess UC Davis Health System's transition to digital radiology. The study involved pre- and post-PACS analyses of workflow and costs, physician satisfaction surveys, and self-recorded radiology interactions by on-call residents. The study revealed significant results. Before the PACS implementation, physicians spent one to three hours searching for films daily and were dissatisfied with radiology services. After implementation, images were readily available, physicians were more likely to view and interpret images themselves, and they reported increased satisfaction. From real-time reporting, residents viewed studies with radiologists 90.2 percent less often. Average image search time decreased, from 16 to 2 minutes, saving 21.5 physician years, worth dollar 1,034,150 annually. Reductions in film printing (73.4 percent) and file clerk full-time equivalents (50.3 percent) saved dollar 1,001,452 annually, and freed up 1,218 hospital and 8,108 warehouse square feet, worth dollar 2,018,320. As a result, UCDHS's digital radiology system improved clinician satisfaction and workflow, increased clinician image viewing, and decreased clinician engagement with radiologists. System implementation saved 21 physician years and dollar 2 million annually.

The impact of patient-physician Web messaging on provider productivity.

Patients increasingly want electronic access to providers, but physicians have been slow to offer e-access, fearing they will be overwhelmed by unreimbursed patient messages. This article reports on efforts to measure how patient-provider Web messaging affects physician productivity. To measure productivity, researchers analyzed the work of a group of physicians using a secure Web messaging system, compared with a control group that did not use the system. Results showed that physicians using the electronic media to communicate had about a 10 percent increase in productivity. Secure Web messaging's benefits also outweigh those of e-mail in increasing productivity and allaying concerns of physicians.

Patient-physician web messaging. The impact on message volume and satisfaction.

BACKGROUND: Patients want electronic access to providers. Providers fear being overwhelmed by unreimbursed messages. OBJECTIVE: Measure the effects of patient-physician web messaging on primary care practices. DESIGN/SETTING: Retrospective analysis of 6 case and 9 control internal medicine (IM) and family practice (FP) physicians' message volume, and a survey of 5,971 patients' web messaging with 267 providers and staff in 16 community primary care clinics in the Sacramento, CA region. MEASUREMENTS AND MAIN RESULTS: Case telephone volume was 18.2% lower (P=.002) and fell 6.50 times faster than control. Case total telephone plus web message volume was 13.7% lower (P=.025) and fell 5.84 times faster than control. Surveys were responded to by 40.3% (1,743/4,320) of patients and 61.4% (164/267) of providers and staff. Patients were overwhelmingly satisfied and providers and staff were generally satisfied; both found the system easy to use. Patient satisfaction correlated strongly with provider response time (Gamma=0.557), and provider/staff satisfaction with computer skills (Gamma=0.626) (Goodman-Kruskal Gamma [Gamma] measure of ordinal association). CONCLUSIONS: Secure web messaging improves on e-mail with encryption, access controls, message templates, customized message and prescription routing, knowledge content, and reimbursement. Further study is needed to determine whether reducing telephone traffic through the use of web messaging decreases provider interruptions and increases clinical efficiency during the workday. Satisfaction with web messaging may increase patient retention.

Personal health records.

Nationwide, momentum is growing to provide patients with computer tools called personal health records (PHRs). These allow patients to participate in their own healthcare management by viewing, editing, or discussing their own medical data. Historically, PHRs targeted consumers, but contemporary PHRs are increasingly aimed at providers and payers. This article reviews the types of PHRs that are currently available, discusses the PHR functionalities that offer the best value for a medical practice, and provides strategies for making purchasing decisions.

Web messaging: a new tool for patient-physician communication.

OBJECTIVE: There is a high demand by patients to communicate electronically with their doctor. This study evaluates the use of a web messaging system by staff and patients of UC Davis community Primary Care Network (PCN) clinic. DESIGN: Eight providers and their staff and patients were surveyed on use of this web messaging system, and physician productivity was measured with Relative Value Unit (RVU) and office visit data. RESULTS: 36.9% (238/645) of registered users responded to the survey. The web messaging system was preferred over phone calls by both providers and patients for the communication of non-urgent problems. A great majority of patients found it easy to use (88.8% or 206/232) and were satisfied (85.8% or 199/232). Satisfaction was significantly associated with timely provider response (Goodman-Kruskal Gamma = 0.667, 95% CI = 0.546-0.789). Clinicians were also favorable to the system and, despite concerns, were not inundated with messages. Most found it easy to use, perceived it to improve patient communication, and valued the insurance reimbursement capability. Furthermore, the system did not have a negative impact on physician productivity. CONCLUSION: A patient-provider web messaging system, which provides a combination of security and access controls, customized routing, rich knowledge content, and insurance reimbursement capability, is a useful addition to the array of communication options available to health care providers and their patients.