This is the first in a series of blog posts we’re calling “@vRad” where radiologists can get a sneak peek behind the curtain to see what it’s like to read as a vRad radiologist.
As radiologic systems trainers at vRad, my partner and I are responsible for training all new radiologists on our system during their onboarding. In other words, we know the system like the back of our hands.
Today’s topic is radiologist safety nets. What do I mean by this? In a nutshell, a safety net is something that helps radiologists in their day-to-day work like automated reminders for key information or technology features to minimize errors. Let’s look at 12 safety nets vRad has put in place for our radiologists.
1. Never worry that there is a critical patient buried in the worklist
At many radiology practices, the radiologist is responsible for “triaging” their worklist (or worse yet multiple worklists from multiple facilities). This consumes a lot of time, and it creates anxiety by asking the radiologist to determine which case should have priority. On the vRad system, the most urgent case has already been determined for you based on patient need.
2. Easily verify that all anatomical structures are mentioned
After dictating your findings, any relevant anatomical structures that have not been mentioned are highlighted and easy to spot. This is a quick and effective way to verify that you’ve touched on every step of your search pattern. Watch Dr. Christopher Garcia describe this feature. Search patterns are one of the top ways to reduce errors and med mal risk. For more on this, read a short and informative blog post on the importance of search patterns by vRad Chief Medical Officer, Dr. Benjamin W. Strong.
3. Never forget (or mix up!) important clinical or billable information on a report
The amount of information a radiologist must remember has become overwhelming, and this can lead to errors. Here are a few of the things vRad’s Report Facilitator does to minimize the burden:
- Alerts for the presence of conflicting statements in the report, such as mixed-matched gender, left/right laterality errors, an upper extremity procedure mentioning tarsals vs. carpals, etc.
- Reminders for missing required information such as an ASPECTS score, Injury Grading Scale number, or Incidental Finding Follow-Up to fulfill MIPS requirements.
- Automatic categorization of dictated statements into appropriate anatomical elements and a consistently structured report.
4. Monitor your stamina
On the vRad system, your read rate is always visible to you. Some of our radiologists keep track of their monthly, quarterly and annual read rates compared with their discrepancies to determine exactly what rate they can read at for peak accuracy and stamina/longevity through their shift. If they see it ticking up, they take a break, refresh their head, then continue. And yes, breaks are not only possible but encouraged.
5. Never dictate a case into the wrong patient’s report
I hear from rads all the time that this is fairly easy to do on other systems. On the vRad system, the text color for the current study is yellow, and for prior studies the text is red. Between font color and the warnings for mismatching info mentioned above (like gender, laterality, etc.), it’s nearly impossible to dictate into the wrong patient’s report.
6. What if the power goes out?
Don’t worry. If you’re in the middle of a case and you lose power for an extended period, we will “take the case back” and reassign it so patient care isn’t delayed. If your cat steps on the “off” switch of your power strip, but you get your computer fired back up right away, you simply continue reading—your dictation is saved every 15 seconds, so you won’t have to start over.
7. Never lose track of a critical finding call
If a radiologist signs a report, and our system sees a critical finding mentioned in the report but a call hasn’t been initiated, it will automatically place the call and alert the Operations Center to make sure the call gets completed. What if the doctor hasn’t called back by the end of your shift? Don’t worry about that either. The Operations Center Support team will make sure it gets verbally reported by a radiologist even if your shift is over.
8. If the study is on your worklist, you are eligible to read it
At some practices, the radiologist must determine on their own if they are licensed and credentialed to read a study. Anything we put in front of you has been verified, uploaded to your workstation, and is ready to read.
9. Never read alone
Working as a teleradiologist may sound isolating, but at vRad you are never alone.
There are several aspects to this. First, it means our schedulers work hard to ensure all modalities and skillsets are covered so you are not in a position to dictate a case that you are not comfortable with. Second, there are always many subspecialists you can consult with who are reading on the system at any given time—and new radiologists are assigned a shift mentor. Last, it means when your shift is over, you are done. At other practices, the radiologist can’t leave until their worklist is empty. That is a heavy burden to carry. At the end of your vRad shift, any studies remaining on your worklist will be redistributed to other working radiologists who hold the same license and credentialing as you.
10. What if your computer has issues?
The vRad Operations Center is staffed 24/7/365 with live tech support to keep you up-and-running. There will never be a time that you are left to sort out technical challenges alone.
11. Quickly find relevant information on priors
vRad’s HPF (Highlight Prior Findings) Tool analyzes historic reports to draw your attention to important prior findings relevant to the current study.
12. Artificial intelligence for QA—the last opportunity for a safety net
Wouldn’t it be nice to have one final safety net after a report has been signed and sent to the ordering physician? For this purpose, we have created artificial intelligence models that immediately review every relevant study and report for 8 critical pathologies such as epidural lesion, PE, and SMA occlusion. If AI sees positive pathology on the images and that pathology is not mentioned in the report, the study is immediately sent for review by a second radiologist on our QA team. If an error is confirmed, the care team is immediately notified, and the report is amended. In 2022 this process led to the timely correction of 592 reports.
Just like you wouldn’t drive without putting on your seatbelt, you don’t need to read without a safety net (or 12!) in place. If you would like to learn more about how we support our radiologists and what it is like to read at vRad, just click the contact us button and fill out the form. Someone from our physician careers team will be in touch.