Radiologists' Variation of Time to Read Across Different Procedure Types

Abstract

The workload of US radiologists has increased over the past two decades as measured through total annual relative value units (RVUs). This increase in RVUs generated suggests that radiologists' productivity has increased. However, true productivity (output unit per input unit; RVU per time) is at large unknown since actual time required to interpret and report a case is rarely recorded. In this study, we analyzed how the time to read a case varies between radiologists over a set of different procedure types by retrospectively extracting reading times from PACS usage logs. Specifically, we tested two hypotheses that; i) relative variation in time to read per procedure type increases as the median time to read a procedure type increases, and ii) relative rankings in terms of median reading speed for individual radiologists are consistent across different procedure types. The results that, i) a correlation of -0.25 between the coefficient of variation and median time to read and ii) that only 12 out of 46 radiologists had consistent rankings in terms of time to read across different procedure types, show both hypotheses to be without support. The results show that workload distribution will not follow any general rule for a radiologist across all procedures or a general rule for a specific procedure across many readers. Rather the findings suggest that improved overall practice efficiency can be achieved only by taking into account radiologists' individual productivity per procedure type when distributing unread cases.

Keywords: Efficiency; PACS; Productivity; Radiology workflow.

Fig. 1

Median time to read per procedure type and radiologist, sorted according to overall median time to read per procedure type. The thicker black line corresponds to the overall median time to read for all radiologists per procedure type

Fig. 2

Median time to read and CV per procedure type with fitted linear regressions for all procedure types and per modality. The different symbols correspond to the following modalities: ◊ = CR, + = CT, x = MG, ○ = MR, □ = US

Fig. 3

Relative rankings for time to read per procedure type and radiologist for radiologists considered to be consistent in their relative rankings. Dotted lines correspond to general radiologists and dashed to subspecialized

Fig. 4

Relative rankings for time to read per procedure type and radiologist for radiologists considered to be inconsistent in their relative rankings. Dotted lines correspond to general radiologists and dashed to subspecialized