The Evolution of Diagnostic Image Reporting in the United Kingdom

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Radiologists are sharing more reporting responsibilities with Radiographers in the UK.

Richard Evans is the Chief Executive Officer of The Society and College of Radiographers (SoR) in the UK. As we approach the New Year, Everything Rad asked him to shares his insights into the most significant regional advances in radiology over the past decade, as well as his predictions on the future of medical imaging.

Everything Rad: As you look back at the last decade in the United Kingdom, which changes in diagnostic imaging stand out as the most impactful?

Richard Evans: I’d have to say that despite the astonishing acceleration in imaging technology over the last 10 years, it’s actually the sharing of responsibility for reporting between Radiologists and Radiographers that has had the greatest impact.

ER: Was this a new trend? Or was there some precedent for teamwork between Radiologists and Radiographers?

RE: There was. The production of definitive reports by Radiographers has actually been part of diagnostic imaging service in the UK for over 20 years. However, beginning a decade or so ago, the expansion in advanced clinical radiographic practice and consultant radiographic practice has been very marked.

ER: Can you quantify that for us?

RE: National statistics in England indicate that some 32 percent of all diagnostic images are now reported by radiographers or sonographers.

ER: Where has this sharing of reporting responsibility found support?

RE: Across the board, really. It has been driven by close collaboration between radiology teams at the local level and supported by national health policy. At the professional body level, the 2012 guidance published by the Royal College of Radiologists and the College of Radiographers (“Team Working in Clinical Imaging”) was groundbreaking. It advised that indeed, the two professions could work together in better meeting the growing demand for high-quality reporting.

ER: Have there been concerns expressed along the way about Radiographers issuing reports?

RE: Well, clearly, Radiographer reporting is a sound solution only if patient care is ultimately enhanced and patient safety is scrupulously maintained. The accuracy – that is, the sensitivity and specificity – of a Radiographer’s report must be equivalent to that of a consultant Radiologist.

Continuous clinical audits and an increasing body of clinical and academic research indicate that this criterion for quality and accuracy are being met.

Patients and referring physicians expect the highest quality reporting of their examinations. We feel confident that Radiologists and Radiographers working in teams to provide reporting services are meeting their expectations.

ER: Let’s look ahead to the future of medical imaging. What important developments are on the horizon?

RE: As we move forward, we will continue to face an issue that’s already become a major concern. Namely, Radiologists and Radiographers have become justifiably anxious over the commoditisation of our specialty, as increasing imaging capabilities and availability have accompanied dwindling clinical diagnostic capability amongst the referrer community. This has led in turn to an over-reliance on imaging services. Even terminology has evolved with this regression, as the term “referral for imaging” became “request” and ultimately, “order”.

ER: Will anything help turn this commoditisation around?

RE: Artificial intelligence technologies – machine learning and deep learning – will allow us to offer enhancements such as referral support, workload management, prioritisation, screening and first-line reporting. This will offer us the opportunity to reverse the commoditisation process.

RE: How so?

ER: Supported by these advances, Radiologists and Radiographers will be able to regain their clinical credentials as the professionals who receive referrals for imaging, and that then make the most appropriate onward referral in consultation with their patients and clinical colleagues.

The unparalleled opportunities for imaging professionals to interact directly with patients should lead to new roles in clinical leadership of patient healthcare pathways facilitating efficient, speedy and person-centered care.

In short, the practice of patients returning to their physician, surgeon or general practitioner in order to receive radiological results could become a thing of the past. Rapid progression along the most appropriate care pathway, facilitated by expert advice and support from the imaging team, will benefit everyone. We must all rise to this challenge as we embrace the future of imaging.

Richard Evans, OBE, is Chief Executive Officer of The Society and College of Radiographers (SoR).

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