Double Take

The Bulletin follows up on some of its most popular articles and Imaging 3.0™ case studies.

Double Take, ACR Imaging 3.0 Case Studies

Articles in the Bulletin often feature practices and physicians who have implemented strategies to help them stay ahead of the rest in a shifting health care system; they often showcase successes or lessons learned. But as everyone knows, those stories do not end once you’ve closed the pages of the Bulletin.

We’ve gone back to the cast of some of our most popular articles and Imaging 3.0™ case studies to check in on their progress as they bring value to patients and the health care team. Check out some of their recent accomplishments and tips for implementing these strategies and innovations in your own practice.

ACR Information Overload

Mining for Gold

People have been throwing the term “data mining” around for a while now. Some proponents claim it’s the solution to everything, while others caution the promises may be larger than the actual gains.1 In February, the Bulletin article “Information Overload” sought to explain exactly what data mining is and how radiologists are using the information they gather. Michael P. Recht, MD, the Louis Marx Professor and chair of the department of radiology at NYU Langone Medical Center, explained how his facility uses data mining tools that are integrated into their PACS, RIS, and EMR systems. By using data mining tools, Recht and his practice have reduced radiation dose and turnaround times, as well as other workflow-related issues.

Since the Bulletin article was published, Recht’s practice has begun looking at the retake rate of their exams. Retaking an image increases radiation risk, says Recht. And although there is very little literature on what practices should strive for in terms of retake rate, it’s still an important aspect of workflow to consider, he adds. Recht and his colleagues are now able to examine data from each imaging machine to determine how many times it has had to retake an image. From there, the data is broken down according to what kind of test was retaken and which technologist performed the original exam.

Data mining also has helped Recht’s practice make improvements in collaboration. Recht’s practice also uses data mining software to look at how often patients are examined at their scheduled time, the average wait time for patients, and the different wait times at various times of the day. “We use these numbers to create ‘Smart Goals’ for technologists,” he says. Smart Goals are goals that the technologist and practice agree to meet in order to improve performance. “These goals have really helped create a continuous performance improvement cycle by reinforcing the importance we place on improving the patient experience in our department, increasing staff investment in achieving this objective, and rewarding the staff with increased bonuses if they improve their numbers and meet our goals. It also motivates our staff to continuously strive to improve barriers to these goals.” He adds that their technologists now work with the rest of the staff to brainstorm how the practice as a whole can make sure patients start their exams on time. It’s dramatically improved their start time numbers. “Our on-time starts for CT exams have increased by approximately 20 percent,” says Recht.

To read the original article, visit

ACR Taking Imaging to the Cloud

Connecting in the Cloud

When the Bulletin last spoke with Gary H. Dent, MD, president of South Georgia Radiology Associates (SGRA), in January of 2013, his practice had just begun to implement its single, cloud-based PACS, which was shared across multiple facilities. The system used a single interface that based multiple facilities’ data in one central place. By implementing this system, SGRA was able to cut its subspecialty reading turnaround time to an average of 15 minutes because radiologists could now access their patient information from any of the SGRA facilities.

And now? The cloud has only helped the practice grow, says Dent. The group has been able to take on nearly double the amount of exams it had in January 2013. As a result, the practice has increased its size from nine radiologists to 17. SGRA’s growth has a lot to do with the cloud. It has enabled the radiologists to refine their efficiency and allowed them to provide patient data when and where it is needed, says Dent. If a patient is transferred from one hospital to another, their radiologists can read the exams directly without having to log in to separate PACS systems. Because the group provides services to both facilities, the data is all in one place.  

Having a cloud-based PACS system also allows SGRA to better utilize RADPEER™. Before the cloud, the radiologists were only able to review those cases that were performed in their facility. “When it’s limited like that, it’s a fairly homogenous review scope,” says Dent. But now the cloud enables all of his radiologists to peer-review any reading done at any of their facilities, allowing for a much broader pool of opinion.

Dent hopes SGRA will be able to tie data mining analytics to the PACS in the future. “We want to use real-time analytics to help us react to the day’s volume rather than just guessing what it will be,” he says. “This way, we can keep an eye on our growing volume and shift resources from one facility to another,” he adds.

To read the original article, “Taking Imaging to the Cloud,” visit

ACR Taking The Lead

Taking the Lead

Imaging 3.0™ case studies bring news of successful strategies radiologists are using to thrive in today’s health care climate. But how do you ensure success continues after your initial efforts? According to Syed F. Zaidi, MD, president and CEO of Radiology Associates of Canton Inc. (RAC), you continue to add and experiment with those ideas that provide value to your patients and practice. Zaidi and RAC were featured in the 2013 case study “Better Together,” which showcased the co-management relationship that RAC had developed with its hospital administrators.

RAC is full of success stories, and the radiologists have continued to implement shared-savings projects with their administrators. They have reduced the length of stay for patients by determining how to expedite the biopsy process for interventional radiologists. One of their most recent successes, says Zaidi, has been their investment in clinical coordinators, individuals who function more or less as clinical managers and patient navigators for the practice. By having someone manage the department workflow and oversee some of the processes, radiologists have been able to follow up with patients more easily and expedite procedures such as biopsies. It’s helped a great deal in improving workflow and communication, Zaidi adds.

Clinical coordinators will help with RAC’s next big project, which will explore population health management for the entire spectrum of inpatient, outpatient, and ER care. Clinical coordinators will work alongside radiologists to use the ACR Appropriateness Criteria® and ACR Select™ to ensure that various procedures ordered within the hospital are the best courses of action for each patient. “Because we are in an integrated health system with an insurer owned by the system, our radiologists and the hospital will benefit from the shared savings our health system receives as a result of our efforts in utilization management,” says Zaidi.

To read “Better Together” and learn how to develop a better relationship with your administration, visit

Speaking Clearly

Communication is key to a positive patient experience, and some radiologists have embraced the patient portal as a way to reach out and connect with their patients. Annette J. Johnson, MD, professor of radiology at Wake Forest School of Medicine, part of Wake Forest Baptist Medical Center, was featured in the May 2014 article “Reaching Across” as a result of her department’s use of patient portals. Wake Forest Baptist’s portal allows patients access to routine laboratory tests (such as bloodwork) immediately and all radiology report conclusions after 96 hours. Patients are also able to send secure messages to their physicians.

Today, one of the things the implementation of patient portals has affected most is the radiology report. “Because we know our patients will be looking at these, we take extra care to make our conclusions as straightforward and succinct as possible,” says Johnson. “We want our patients to be able to understand exactly what their results may mean, so we try to limit ourselves to answering the specific clinical question and any other actionable findings there may be.” Wake Forest has also improved its communication efforts by conducting a department-wide quality assessment review of its dictation-related errors and launching a PQI project aimed at reducing them.

Portals have also created an informal change in the way Wake Forest radiologists dictate reports; they are much more aware that there should be an effort to create clarity for referring physicians, and as a result, their reports are more clear. “There’s a lot of informal discussion at our PACS stations now about how we can be more clear in the words we use and whether or not patients benefit from some of the things we include in our reports,” says Johnson.

Based on feedback from patients and providers, Wake Forest Baptist recently (on October 1, 2014) expanded test result access via their patient portal by releasing all laboratory test results (even non-routine tests) immediately and full radiology reports after 96 hours. They have also recently completed a successful pilot study involving patient access to outpatient visit notes via the portal.

To read more about patient portals, check out “Reaching Across,” at

By Meghan Edwards, copywriter for the ACR Bulletin

1. Bottles K, Begoli E, Worley B. Understanding the pros and cons of big data analytics. Physician Exec. 40(4):6–10. Accessed September 12, 2014.

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