Believe it or not, in this day and age when cloud storage and applications have become the basis for all forms of information management, many radiology technologists are still using paper notebooks – files stored on local computer hard disks, or at best a homegrown sharing solution like a Sharepoint file or a corporate wiki – to maintain all-important protocols for performing diagnostic imaging tests such as MRIs of knees or CT head scans. It is time for radiology technologists, radiologists and administrators to enter the future which is upon us. Cloud-based radiology protocol management is now completely viable – and there truly is “no better way” to define, organize and maintain imaging protocols, for all modality types, than on a centralized, web-based platform.
Here are answers to key questions about how cloud-based radiology protocol management supersedes old fashioned methods.
How organizations have traditionally managed radiology protocols
Radiology protocols are detailed instructions for positioning (i.e., body part and orientation of the imaging plane for MRI), scan duration, and monitoring of radiation dosage for CT scans. Protocols contain hundreds of machine-specific technical settings that radiology technologists must input in order to tell a scanner how to correctly acquire the required images. These settings will vary depending on the imaging modality, equipment vendor and the specific scanner model. Protocols require periodic updates as new mandates, hardware, software, imaging techniques and contrast agents become available. Many times one procedure will have numerous instruction sets (protocols) based specific radiologist preferences.
To this day, most organizations have relied on paper-based records contained in physical three-ring binders and updated by hand or even on Post-lt™ notes to keep current with these exceedingly complex instructions. Before operating the scanner, radiology techs consult the binder which contains the protocols, as printed or amended. More recently, some forward thinking RTs have kept and updated protocols in computer files, sometimes posted on the web, but then print them out so they are on hand as they operate the machines. This often results in a disorganized mixture of media and verbal updates for maintaining these essential instructions.
Problems with the traditional methods
Besides being cumbersome, the old methods can lead to inconsistent practice, waste of time, and even dangerous practices since results will depend on which binders or local file directories are up-to-date and which are not. Improvised management of protocols on multiple media (printed, hand edited, post-its, web posts) often results in confusing situations that will be familiar to any radiologist or tech, when people aren’t sure it they have the latest protocol and have to search and consult various sources to determine the correct procedure. That confusion is particularly hard on younger radiologists and inexperienced techs, but it’s also frustrating to veterans because confusion wastes the time of the tech, radiologist, doctor and patient. This issue is exacerbated when an organization is a teaching institution or one with a large transient population of imaging professionals.
Even worse, this antiquated workflow can result in the use of outdated protocols, incorrect application of protocols to scanning, and ultimately bad scans that have to be redone in order to make accurate diagnoses. As a result patients may have to come back for rescans and that’s a waste of everyone’s time. It also means lost revenue for the hospital because insurance companies typically do not reimburse for rescans due to avoidable errors.
Protocol upkeep is frequently neglected, resulting in decreased quality, increased medical error, and increased costs.
Moreover, scans performed with outdated protocols can deliver higher radiation doses than scans performed with newer protocols designed with dose-reduction in mind. Without constant renewal according to the latest standards, patients could receive unnecessarily high doses during scans. Of course the most troubling risk of traditional protocol record-keeping is that imperfect images could result in misdiagnoses – which could endanger patients and lead to malpractice suits.
How cloud management of radiology protocols works
The solution to all of these potential problems is a painstakingly developed software platform hosted in the cloud that can reduce and even eliminate protocol related knowledge-transfer errors in the medical imaging industry. People are sometimes confused by the notion of “the cloud.” But it just means that a service provider hosts information or applications on its servers, and users access them via the internet through their local computers, tablets, or smart phones. In this way data, in this case radiology protocols, are safely stored, easily accessed, and can be readily updated – for all users. Above all this means that technologists access single-standard records, eliminating the potential errors of ad hoc storage on manifold media.
With a cloud-based system, the service provider gathers all of the information from previous collections (binders, computer files, etc.) and puts it into a clear, highly organized database. Technologists, radiologists, and administrators do not have to enter it themselves. But, as protocols change, admins will be able to adjust the platform according to best practices, local regulations, physicians’ preferences and specific machine capabilities. All of this can be done by an administrator with any computer with web access. The platform is managed by the service provider, but the data is controlled by the organization according to particular needs, and the protocols are easily and consistently accessed by technicians at the point of service.
Improving Clinical Efficacy using cloud-based management of radiology protocols
First and foremost, the most important benefit is increase in patient safety. Proper protocols make patients safer by using best practices for all types of scanning, and of course by ensuring radiation dose levels are appropriate. This step into modern information management in healthcare is certain to improve patient outcomes, since it will insure that the right exam is given to the right patient using the right protocol. The chances for incorrect diagnoses are therefore reduced significantly. Also, since delays, repeated scans and even callbacks will be rarer, patient satisfaction is also heightened.
Overall, management, communication and training is rendered much more efficient. Any time a standard is changed, administrators can adjust their protocols via the shared platform and notifications go out to all the users of the program. For technicians, cloud-based access to protocols and images by which they can compare their own settings will make their lives much easier. They won’t have to worry about settings since all the documentation that they need to complete a scan will be in one place which they can pull up any time, any place. A cloud-based system puts this information in their hands where they need it – just as the old three-ring binders did, but without the risk of errors based on inconsistency.
Advantages for administrators
Above all, the protocol management system of today will serve health administrators by increasing patient outcomes and satisfaction. Avoiding repetition of procedures, callbacks, misdiagnoses, and of course, excessive radiation dosages are priorities shared by everyone involved. In addition, it gives administrators full control over the whole process of imaging which helps with training and establishing accountability at all levels of the organization. Without the standardization inherent in cloud-based information sharing, resources can go to waste, meaning higher costs. Analytics can alert you if some members of your health care team are ordering inappropriate, unnecessary, or unreimbursed imaging studies. Data maintained in a transparent, measurable way allows for better identification of inefficiencies, such as incorrectly ordered or performed examinations that are not being reimbursed. Moreover, delays, postponements, and rescheduling not only reduce patient satisfaction but are also expensive. Costs can be significantly controlled by the better management of time afforded by a modern protocol management system.
Meeting federal mandates and reporting requirements
Existing and forthcoming mandates demand levels of accuracy, efficiency, safety, and accountability that only a standardized, easily updatable, radiology protocol system can achieve – and this outcome is best reached on a cloud-based platform. At every level of health care management, clinical decision support will influence the procedural management solution selection. Some studies suggest that up to 30 percent o f radiology exams are unnecessary or duplicative, and health care reform is really going after such unnecessary procedures. All the advantages discussed here pertain to best meeting Medicare appropriateness scores, for the benefit of the patient and in ways that will increase reimbursement rates for health care providers. If the Joint Commission comes in to check on whether your protocols are current, a cloud-based system will clearly provide the proof and the assurance that they are – across your organization.
Conclusion
At a time when web-based software and applications have become standard for almost every area of patient care, from registration and scheduling to clinical systems and billing, it is something of a surprise that radiology protocol management has not yet fully transitioned to the new normal. The protocol management system of the future is now available. It is time to take advantage of the benefits of cloud-based tools in this area, because this simply is the best way to do these things.
About the author
Stephen Baker is President and Founder of Radiology Protocols,
Which provides cloud based platform radiology protocols that help healthcare organizations meet and comply with the many mandates, laws, and regulations.
He can be reached at sbaker@radiologyprotocols.com
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker’s Hospital Review/Becker’s Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.
