From the July 2015 issue of HealthCare Business News magazine
HealthCare Business News spoke with Steve Baker, founder and president of Radiology Protocols in Iowa City, Iowa, about the modernization of radiology protocol management.
HCBN: Can you give us some background on what a radiology protocol is, and then tell us how radiologists and techs stay up to date on those protocols?
SB: A protocol is the detailed instruction set for performing a diagnostic imaging test, such as an MRI of the knee or a CT scan of the head. The three main pieces of information contained in protocols are positioning (i.e., body part and orientation of imaging plane), scan duration, and monitoring of radiation dosage. Protocols also contain hundreds of machine-specific technical settings that tell a scanner how to acquire images.
These settings will vary depending on the imaging modality of the equipment vendor (and the specific scanner model). Protocols require periodic updates as new scanner hardware and software and new contrast agents become available.
It may be hard to believe, but many organizations still rely on physical three-ring binders and Post-It notes to keep current with machine protocols. Before operating the CT scanner, the radiology tech consults the binder, which contains the machine protocols, written out. Besides being cumbersome, that system can lead to inconsistent practice across an organization. Results will depend on which binders are up-to-date and which are not. When hospitals or organizations have multiple imaging facilities with different kinds of scanners from different vendors, this is a real problem.
HCBN: They really don’t use computers to store and sync that kind of information?
SB: Some do use electronic folders stored on a file server — mainly just a collection of Word documents — but they still need someone to update the information manually and then communicate to everyone that the protocol had changed.
HCBN: What are the consequences when a new protocol isn’t followed?
SB: Well, there’s a range. First, there’s the confusion that will be familiar to any radiologist or tech: when people aren’t sure if they have the latest protocol, there’s a lot of needless extra discussion. “Remind me again, what were we doing with this? I think we changed the protocol, but this looks the same…” That confusion is particularly hard on younger radiologists and inexperienced techs, but it’s frustrating to the veterans, too. Confusion wastes the time of the tech, doctor and patient.
Second, an image could be taken incorrectly and come back inconclusive or non-diagnostic, and the patient would have to come back for a rescan. That’s a waste of everyone’s time. It also means lost revenue for the hospital because insurance companies typically do not reimburse for rescans due to avoidable errors.
