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Multimedia-Enhanced Radiology Reports: One Researcher Peers Into the Future

January 10, 2015
by Mark Hagland
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Researchers are beginning to look at the potential role that multimedia-enhanced radiology reporting, or MERR, might play in radiological studies, to enhance physician-to-physician interaction

Can enhancing radiology reports with web-based multimedia presentation prove to be clinically significant for radiologists? Researchers believe so. Indeed, a few researchers are beginning to look at the potential role that multimedia-enhanced radiology reporting, or MERR, might play in radiological studies that might enhance the clinical interactions between radiologists and referring physicians, and even better help patients to understand the results of their diagnostic imaging procedures.

Last year (2014), a group of researchers came together under the aegis of the Harvey Neiman Health Policy Institute, a research division created in late 2012 by the American College of Radiology (ACR), the governing specialty society for radiologists in the U.S., to study just that question.

Richard Duszak, Jr., M.D., the vice chair of Health Policy and Practice in the Department of Radiology at Emory University (Atlanta), and the chief medical officer at the Harvey Neiman Health Policy Institute, helped to lead and coordinate the study, which was presented as a poster session at the 2014 RSNA Conference, sponsored by the Radiological Society of North America and held Nov. 30-Dec. 4 at Chicago’s McCormick Place Convention Center.

Richard Duszak, Jr., M.D.

The title of the RSNA poster session was “Traditional Text vs. Image and Interactive Data Embedded Multimedia Enhanced Radiology Reporting: Referring Physicians Perceptions about Value,” and was produced by a team of researchers led by Gelareh Sadigh, M.D., and which included Dr. Duszak. As the authors noted in their presentation, “over a two-week period in 2014, medical oncologists, radiation oncologists, neurosurgeons and pulmonologists practicing in the United States were contacted via email and asked to complete a 22-quesiton online survey with embedded images describing and illustrating MERR. The survey included questions about physician satisfaction with current text-based radiology reporting, and their perceptions about the value of enhanced reporting.”

As the authors noted, “194 responding physicians met inclusion criteria… Although 78 percent were satisfied with the current format of received radiology reports, 79 percent believed MERR would represent an improvement. The most commonly reported advantages of MERR were ‘improved understanding of radiology findings by correlating images to text reports’ (68 percent) and ‘easier access to images while monitoring progression of a disease/condition’ (60 percent).” The authors ultimately concluded that “Most specialist referring physicians believe that MERR represents an improvement over current text-based radiology reporting. Most would preferentially refer patients and peers to facilities offering enhanced reporting.

The actual creation of MERR-based solutions is only beginning to emerge. One vendor, the Rochester, N.Y.-based Carestream Health, announced in November a new “Clinical Collaboration Platform” that, according to a Nov. 12 company press release, “can facilitate teleconsultancy with remote specialists who can access multimedia reports containing embedded hyperlinks to key findings within the image data on their mobile devices using a zero-footprint viewer.” Industry observers expect other vendor companies to pursue this type of a solution soon as well.

Dr. Duszak, who makes it clear that he has no financial relationship with Carestream, hopes that multiple vendors will emerge that will provide some type of MERR-based solution to enhance radiology reporting and information-sharing among physicians. He spoke in November with HCI Editor-in-Chief Mark Hagland regarding the topic of MERR-based radiology reporting. Below are excerpts from that interview.

Could you explain a bit more about the concept of multimedia-enhanced radiology reporting?

What it contrasts to is traditional, text-only reporting. That’s the standard of care for how reports go out there. Before EMRs really took off, radiologists’ job was to put toner on white paper, I would joke! It was text on white paper, and not interactive. That has now evolved from paper-based, which got faxed or mailed, to electronic sharing. Both referring physicians and patients are still receiving basically text-only reports, but now in electronic form. We asked folks about a new world: if this were commercially available, what would you do? Now we’re at the point where the technology is available. So how MERR would be consumed, based on how we’d survey people is, rather than a blank text coming up on your screen, where you’re reading a Word document, the platform would be a web-page presentation. And it would be more interactive. We showed people a couple of specific pieces, such as, if you see the language “3-centimeter liver lesion,” you would get a hyperlink that would take you to a web page showing that image. So my report is supplemented by real-time information that’s web-based.

Second, we looked at referring physicians ordering follow-up imaging, particularly for cancer. So the lesion has decreased from 3 centimeters to 2 centimeters to 1, for example. So when there’s a comment on size, you could click those measurements, and it would graph it out. Kind of like what Fitbit does. So that graphic visualization helps people consume information better. So those were the two graphic enhancements we thought of.

You yourself are a radiologist, correct?