With a 5% yearly increase in imaging studies and no growth in radiologists and technologists, healthcare departments need to improve operational efficiency. To address this, departments incorporate enterprise ultrasound reporting software to enhance reporting processes and streamline workflows.
Many reporting tools are available, making selection challenging. Prioritizing key criteria is crucial before discussing details. This article provides a checklist of essential items for imaging centers and radiology departments.
An ultrasound reporting system can significantly improve productivity. Imaging departments using Imorgon save an average of 2 minutes per sonographer exam and 1-2 minutes per radiologist report [Link].
Improving reporting efficiency starts with accurate data transfer to avoid manual entry. A software application converts DICOM SR files and merges them into a reporting template. When an ultrasound is completed, the measurements are captured and transferred to the reporting system. This automated process eliminates data entry.
Beyond parsing and sending measurements to the reporting system, a standard function is formatting data. Vendors use different units (cm vs. mm), precision (x.xx vs. x.x), or labeling. For example, one ultrasound vendor requires converting shear-wave measurements from mmHg to kPa or m/s. Most data transfer applications handle different units, precisions, and labeling.
Data transfer with many solutions is not always reliable. One popular ultrasound system records measurements differently depending on which buttons the sonographer presses.
Two decades ago, radiology needed to exchange data between systems. DICOM SR (structured reporting) was a file format designed to address this problem. Today, a modality generates this file as a standardized method for exchanging measurement data. Although similar in name, it should not be confused with the systematic organization of information in a radiology report, also known as a structured report. This blog covers the history and levels of structured reporting in radiology [link].
Finding and transcribing prior measurements is difficult because it requires manual lookups and is error-prone. These processes consume time, delay reporting, and introduce risks that affect patient care. For example, manual lookups result in additional errors and data-entry delays of 5%-10%.
Imorgon automatically calculates volumes and interval growth values from prior measurements. For example, all volumes, such as masses, can be calculated, and the percent difference from prior helps estimate progression.
Ultrasound reporting software needs sophisticated yet simple electronic worksheets to improve productivity compared with unstructured notes and handwritten worksheets. Required features include:
The needs of an academic radiology department differ from those of an outpatient imaging center. A solution must customize worksheets to your department’s requirements. Many reporting software solutions cannot be modified.
Other solutions cannot hide masses or inapplicable findings on a worksheet. These are electronic versions of paper and do little to improve efficiency.
A typical evaluation is to determine the fewest keystrokes or mouse clicks required to complete an exam.
Most reporting software produces simple 1:1 text output, which often requires a radiologist to dictate text around the transferred field. Ideally, the system generates a detailed sentence from one or two mouse clicks. This feature saves time and ensures consistency in reporting. [Link: Deep Dive].
A compelling application of conditional text generation is reporting exceptions, such as masses. With one or two mouse clicks, complete text is generated, including extra line breaks in the reporting template to separate the mass from the rest of the organs. Most ultrasound reporting software does not include this feature.
Most reporting software includes options to send drawings or illustrations to PACS as secondary captures, but it does not help radiologists by displaying them on a white background.
Exclusive Imorgon research found ultrasound measurements account for less than 50% of radiologist findings [Link: 50% of fields]. To improve efficiency, all information from worksheets must be transferred to the reporting system, not just measurements.
Since most radiologists are body imagers, they are using reporting packages such as PowerScribe or Fluency. Ultrasound reporting software must fully leverage these reporting packages.
The illustration below shows how quantitative and qualitative data are transferred into a PowerScribe Report, producing a complete report.
Structured reporting is discussed in detail in this article [Deep dive into structured reporting and productivity]
Conditional text generation reduces reliance on illustrations, while automatically mapping exceptions further reduces time and effort when generating quick reports.
Medical societies, including the American College of Radiology (ACR), recommend using clinical decision support tools, such as TI-RADS and O-RADS, to improve diagnostic accuracy. Using ACR-endorsed calculators lends credibility and ensures alignment with industry standards. Lacking an integration of these calculators defeats the purpose of improving efficiency with reporting software. [Link: Deep Dive].
An enterprise standard requires a single-source solution that integrates natively into the existing radiology environment. Typical imaging centers or radiology practices perform MR, CT, X-ray, and other exams, with ultrasound accounting for only 20% of the workflow. Ultrasound software must integrate into radiologists’ workflows.
The solution should facilitate a unified workflow by utilizing standard HL7/FHIR interfaces and integrating with Epic EHR (or alternate) to automatically launch the correct clinical worksheet for each patient. By providing extended functionality for Nuance PowerScribe, Fluency, and other primary reporting packages, the system eliminates the need for separate applications.
This consolidated architecture needs to support any modality generating standard formats, including DEXA, CT, and MR while ensuring that ultrasound reporting remains a seamless component of the broader enterprise imaging workflow.
Traditional ultrasound reporting often relies on siloed applications for subspecialties like OB/MFM, vascular, or echocardiography. Though these excellent solutions may include clinical AI capabilities and voice recognition and cloud implementations, these fragmented systems frequently require disparate worklists and standalone applications, which increase IT management overhead.
On-premises architecture ensures all Protected Health Information (PHI) remains within the institution’s physical and logical control. This model fulfills legal data sovereignty requirements through direct institutional oversight of security layers and access protocols.
SOC 2 Type II is an independent audit validating the operational effectiveness of security controls over a sustained 3- to 12-month period. This certification confirms that privacy and security protocols are maintained continuously, exceeding the baseline mandates of HIPAA.
Ultrasound departments operate during overnight and weekend shifts. The company or department responsible for support must provide 24/7/365 assistance.
You need a guarantee that unmapped measurements will be fixed after installation. Many sites report that their solutions have degraded, and many measurements no longer transfer. A well-known ultrasound manufacturer has changed their DICOM SR data structure several times. In many cases, previously mapped measurements stop transferring.
For automation to work, there needs to be agreement and coordination between IT, sonography, and radiology departments. The solution provider must offer expert guidance to handle the different technical details of DICOM SR structures and clinical scan protocols from various manufacturers. This managed transition makes sure that reporting worksheets meet the needs of each department and sets up a strong technical base for lasting operations without disrupting current diagnostic processes.
The best enterprise ultrasound reporting software provides robust DICOM SR measurement transfer, sophisticated ultrasound report worksheets, seamless enterprise integration, and 24/7 support. These features are crucial for improving radiology reporting efficiency, reducing sonographer effort, increasing referring doctor satisfaction, and advancing clinical care.
Peer Validation: Case Study of a Multi-Modality Enterprise Implementation.
The time frame is usually a few months. Keys to faster implementation include starting the IT and clinical teams immediately and in parallel, getting the clinical team to agree on the measurements for which the ultrasound systems will be configured, and scheduling manufacturing applications immediately.
Relatedly, it is essential to have a strong technical lead, a radiologist, and a sonographer who are empowered to make decisions and who have allocated time to the project.
The project’s length is usually determined by delays caused by the project team’s failure to allocate time
Most vendors charge a startup fee plus an ongoing fee per study.
A simple ROI calculation is first to determine whether additional studies can be performed by existing staff—i.e., whether temporary contract radiologists or sonographers are used to make up for the staffing shortfall. If that’s the case, here’s a straightforward calculation:
Savings for sonographers are typically in the 2-minute range, and for radiologists, 1-2 minutes.
Salary for radiologists is $4.5 to $9 per minute (take the salary and divide by 2000, and then again by 60)
Sonographers earn $ 0.50 to $1 per minute.
Multiply the savings for a radiologist by the number of exams per year; do the same for a sonographer.
Divide that number by any start-up costs. Return on investment is usually measured in months.
For on-premises solutions, demonstrating data security is much easier, as patient data does not leave the healthcare institution. For on-premises solutions, the focus is on ensuring the radiology software provider adheres to best practices, such as obtaining a SOC 2 Type II certification.
True cloud solutions introduce more risk because they create additional threat vectors. These include increased internet exposure and the risk of hacking and data leakage from multi-tenant storage and data training.
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