It can be difficult to balance the needs to work as efficiently as possible while also addressing the healthcare requirements of the patients we see every day. Managing a busy radiology department requires finesse and an astute ability to balance resources, including personnel and the equipment they rely on to accomplish their radiology tasks. For example, how often are second opinion readings made in your department? How do the rates compare with your colleagues, or at least those who are willing to share this information with you?
When a radiologist renders a second opinion and then other professionals do not manage to take this information into account, it amounts to a waste of time and resources, keeping this radiologist from other critical studies to be read in a timely manner.
Indeed, concern about this waste of resources has led to a report in the American Journal of Roentgenology about unread second opinion radiology reports, from Sabine Heinz and colleagues in the University Medical Center Groningen’s radiology department.
Their study is concerning. It should be taken seriously by healthcare policymakers, including governmental bodies and insurance companies.
Heinz and colleagues cited earlier research indicating that reinterpretations of radiology images have gone up by 150% during the last five years. Similar trends have been seen in studies focusing on the U.S.
With that background, the researchers from Groningen conducted a retrospective analysis of 4,696 radiology rereads at their own center. The examinations were commissioned by subspecialty radiologists in the Dutch medical center. It turned out that 537 of these rereads went unused, a rate of 11.4%. According to Heinz and her team, these unread reports cost an estimated $63,375 and about 134 hours of interpretation time by the radiologists.
“Although these numbers appear modest, they pertain to a single institution during a one-year time period. Cumulative nationwide figures would raise these totals, possibly substantially,” the authors noted.
Of primary concern was the reason why these radiology rereads are not being read at the expected rates. The researchers identified five variables that were independently associated with the reports not being read: inpatient status, sonography as the imaging modality, surgery or neurology, and interventional radiology as the subspecialty of the radiologist who authorized the second-opinion reports.
“We found no significant independent associations between the clinician not reading the second-opinion report and patient age, patient sex, or time between submission of the second-opinion request and finalization of the report,” Heinz and colleagues wrote.
The report concludes with a look toward reducing waste in the future: The reasons why clinicians do not read reports need to be investigated in future studies. If subspecialty radiologists and clinicians take the proven determinants into account, the amount of second-opinion readings with limited additional clinical value may be reduced.
We’ve seen reports from radiologists in the United States wondering about how often second opinions go unread in their departments and the numbers are not encouraging. This new report from the Netherlands confirms our concerns. It is crucial to implement changes in radiology departments to reduce expenses and waste. The result will be better care for patients with reduced costs for all, patients, and physicians.
So, what is the solution?
With so many developments emerging in the field of radiology, it can be tough for busy professionals like physicians to stay on top of trends, such as the revenue lost due to problems from unread second opinions.
As a result, we must develop the tools specifically designed to address such concerns of unread second opinions in radiology departments. Tools that can limit or rather eliminate unneeded secondary read. It is important to have analytics about the use of time of radiologists beyond the traditional Work Relative Value Unit. In the case of second opinion studies, it is imperative to have the analytics of elapsed time and results in vale and revenue to be able to make an informed decision on whether to continue the service. Radiology is in a time where quantifiable, and not just anecdotal, information is critical to decision making.
Dhruv Chopra is the chief executive officer of Collaborative Imaging.
Last Updated September 28, 2020