Don’t Get Lost in Translation

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Cristen Bolan, Executive Editor, Applied Radiology

Radiologists Add Real Value through Concise Communication

When the ER doc read my results from an ultrasound, all I heard was doom and gloom. In the report, the radiologist recommended a follow-up MRI, meanwhile the doctor told me I probably had cancer due to the appearance of blood flow to a small mass.

After two days of begging for the follow-up MRI, they found that there was there was no cancer – a gallstone had traveled into the biliary tract. That shouldn’t have been a surprise since I already had an appointment to have my gallbladder removed at the same hospital. Cancer was the ER doctor’s interpretation — not the radiologist’s conclusion. What ended up almost killing me was the anxiety I endured from the doctor’s strong certainty that I had cancer, which made me fear for my life and for the well being of my two small children.

An estimated 80% of serious medical errors occur between caregivers during the transfer of patients.¹ These errors lead to more adverse events, more hospital readmissions, more unnecessary duplication of care, and higher costs.¹ Clearly, the transfer of patient information falls within this category.

In the world of Accountable Care Organizations (ACO’s) radiologists will be tasked with demonstrating their value to the patient. At RSNA last year, Mary C. Mahoney, MD, chair of RSNA’s Patient-Centered Radiology Steering Committee Chair, said radiologists must be portrayed “as knowledgeable physicians and show they are patient advocates by demonstrating concern and knowledge about safety and risks.” But how do you demonstrate value to the patient when the results get lost in translation?

How can radiologists show their value? It’s hard to nail down a number, but in theory, as Bibb Allen Jr., MD, vice-chair of the ACR Board of Chancellors says, there would be a “measurable role for radiologists in improving population health and we would have a calculation of radiology’s value in reducing per capita cost.”

Lowering per capita cost may be immediately evident through imaging appropriateness. ACO’s may provide a framework for control costs by reducing avoidable, duplicative resources, but what about measurable improvements to population health?

Interpreting a radiology report just doesn’t cut it these days. This may require quantifying and tracking all the non-interpretation value-added activities, such as hours spent on conferences, committees, transcription time, teaching, and research. And how is this extra time supposed to cut down on cost? Radiologists are already doing these things, but it looks like CME credits are just not enough.

If you really want to add value to patients – go back the basics and ensure the referring physicians get the story straight before hitting the panic button. From the patient’s perspective, that might actually have a real impact on the patient experience.

Reference:

1. Joint Commission Center for transforming healthcare releases targeted solutions tool for hand-off communications. Joint Commission Perspectives. 2012;32:8.