Efficiency and effectiveness of an innovative RIS function for patient information reconciliation directly integrated with PACS

Abstract

In RIS-PACS systems, potential errors occurring during the execution of a radiologic examination can amplify the clinical risks of the patient during subsequent treatments, e.g., of oncologic patients or of those who must do additional treatments based on the initial diagnosis. In Reggio Emilia Province Diagnostic Imaging Department (REDID) we experienced different strategies to reduce clinical risks due to patient reconciliation errors. In 2010, we developed a procedure directly integrated in our RIS-PACS that uses Health Level 7 (HL7) standard messaging, which generates an overlay with the text "under investigation" on the images of the study to be corrected. All the healthcare staff is informed of the meaning of that overlay, and only the radiologist and the emergency services staff can consult these images on PACS. The elimination of image overlay and of any access limitation to PACS was triggered to confirm of the right correction made by RIS-PACS system administrator (SA). The RIS-PACS integrated tool described in this paper allows technologists and radiologists to efficiently highlight patient exam errors and to inform all the users to minimize the overall clinical risks, with a significant savings in costs. Over the years, we have observed a steady decrease in the percentage of reconciled studies. Error reconciliation requires an effective and efficient mechanism. The RIS-PACS integrated tool described in this paper enables technologists and radiologists to quickly and efficiently highlight patient exam errors and inform all the users. Next generation of RIS-PACS could be equipped with similar reconciliation tools.

Fig. 1

Percentage of examinations divided by type of patient and by company (ASMN-IRCCS or AUSL). The data refer to year 2011

Fig. 2

Percentage of examinations divided by type of modality and by company (ASMN-IRCCS or AUSL). The data refer to year 2011

Fig. 3

Descending trend of the reconciliation requests for ASMN-IRCCS and AUSL (all the hospitals and mean value) from 2008 and 2011

Fig. 4

Percentage of distribution of errors for the different types in the two Healthcare companies (ASMN-IRCCS and AUSL)

Fig. 5

Median time elapsed between a reconciliation request and its execution for the two approaches: the new RIS-PACS integrated (year 2011) and former intranet-based form (year 2008)