Underutilization of Reporting Automation in Radiology: Missed Opportunity?

Crazy times with innovations like the large language model (LLM) ChatGPT recently passed the Radiology Board Exams. Additionally, some of the most cited articles in Radiology in 2023 involve ChatGPT [Radiology Link].

Shockingly, my research finds that most Radiologists are not utilizing reporting automation ‘innovations’ that have been available for over a decade in ultrasound reporting software.

This article will discuss the ultrasound reporting software innovation of transferring measurements and findings from imaging modalities directly into the Radiologist’s reporting package. Unlike ChatGPT, this innovation will improve reporting efficiency, accuracy, and quality today.

Structured Reporting and Ultrasound Reporting Software

A good starting point for a discussion regarding Reporting Automation is Structured Reporting since both focus on improving Radiology Reporting. Structured Reporting is an approach to creating reports in a predefined format with standardized terminology and checklists. Many institutions are adopting Structured Reporting to improve report content, clarity, and efficiency [AJR Link].

Studies show the benefits of Structured Reporting in improving clinical outcomes, including reducing missed diagnoses [Journal of Digital Imaging Link]. Additionally, a study showed decreased time to generate standardized or structured reports and a preference for those reports by radiologists and clinicians [Clinics Link].

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DICOM SR and Measurement Transfer

The first reporting automation is measurement transfer from the imaging modality into the reporting package, with ultrasound and DEXA being the most common modalities. Technically, measurements are transferred from the imaging modality to the reporting system using DICOM Structured Reporting (DICOM SR). Many companies developed products that parse DICOM SR files and transfer the measurement data into the reporting package, typically Nuance Powerscribe. After implementation, a Radiologist should never dictate another measurement again (period).

So, why have most sites yet to implement this reporting automation? A stated reason centers around the perception of implementation difficulty. The difficulties are similar to implementing Structured Reporting: A Radiologist has to start deciding the measurements each sonographer will take for each exam type. Scan protocols are then programmed for each ultrasound vendor’s system to ensure each measurement is repeatability labeled repeatedly. It is not difficult, but it is daunting to someone with other responsibilities.

Additionally, in-house IT could need help with sophisticated implementations as there are peculiarities with different vendor implementations.

– The pay-off for a one-time effort is rather substantial –

Documented studies discuss median reporting time reductions of 40% in measurement-intensive reports such as OB [Dr. Horii SIIM Presentation] and individual testimonials demonstrate implementation success [Main Street Radiology Case Study]. Some institutions reduce tedious and error-prone numeric dictation by transferring thousands of measurements daily.

Companies such as Imorgon Medical bring experience and guarantee success in a reporting automation effort. Implementing ultrasound reporting software and automatic data transfer yields a Return on Investment (ROI) of just a few months!

Ultrasound reporting software, such as Imorgon Medical, automatically transfers data directly into Radiology reporting software, leading to significant productivity and quality benefits in addition to Structured Reporting efforts.

Ultrasound Worksheets and Ultrasound Reporting Software

Some sites have implemented measurement transfer into Radiology reporting software for over a decade. A more advanced reporting automation strategy is transferring sonographer findings from worksheets and templates into radiology reporting software without radiologists’ dictation.

Many publications and articles guide the constituent elements of a good ultrasound report and worksheet. One study reported favorable outcomes through the implementation of standardized ultrasound report templates, including a reduction in the use of CT [Journal of Pediatric Surgery Link]. There are undeniable benefits with inexperienced sonographers, night shift workers, or travelers in providing improved reports through standardization.

Though transferring observations is a relatively newer topic, it is also important from a productivity perspective. Recent research collected data on the number of ‘fields’ in Powerscribe templates across several academic and imaging centers and the most common exam types. The research found approximately half of the ‘fields’ in the Findings section of a Radiology report are sonographer observations [Imorgon Research Article]. Stated another way, if measurement transfer by itself offers only 50% of the productivity opportunity available. Advanced concepts for transferring sonographer findings in ultrasound worksheets directly into radiology findings are discussed in a different article [3 Things to Make Your Life Better Link].

Imorgon provides customizable web pages that enable all sonographers to provide obvious, concise, and consistent observations directly into your Radiology reporting package.

Reporting Automation Future and Ultrasound Reporting Software

I see a couple of different Reporting Automation innovations in the future. Large language models will make a significant impact on draft Impression generation. The LLMs will be particularly powerful when paired with the current innovations of consistently capturing and transferring measurements and sonographer findings.

Another initiative is the development of Common Data Elements [Link], which aims to standardize and increase the clinical content of transferred information, facilitate data extraction, and improve decision support tools. Implementing a standardized report content process today can enable content-generating AI to be more consistent, leading to the development of better tools.

Report Automation tools, such as those developed by Imorgon, complement future innovations by providing consistent and standardized input. Adopting ultrasound reporting tools in Radiology improves reporting productivity and quality today and helps ensure improvements tomorrow.