Ordering providers are producing less clinical information in radiology requisitions

The quality of communication between ordering providers and radiologists via radiology requisitions is declining, according to a new study published in Academic Radiology. If this trend continues, it could potentially hurt a radiologist’s ability to provide the best patient care possible.

The authors studied radiology requisitions from 2011 to 2016, focusing on three categories of imaging studies: chest x-rays, abdomen/pelvis CTs and head CTs. Overall, declines were seen in the quality of clinical questions in CT requisitions and in the quality of medical history in chest x-ray requisitions.

“The declining quality of clinical information in requisitions may indicate either increasing time demands in the clinical environment or shifting attitudes toward radiology,” wrote authors Travis B. Wassermann, MPH, Pritzker School of Medicine at the University of Chicago, and Christopher M. Straus, MD, department of radiology at the University of Chicago Medicine. “Regardless of the cause, this study provides evidence of a decline in the quality of communication within the medical team.”

The study also revealed that radiology requisitions are getting longer. There were nine study types with more than 1,000 total requisitions, and six of them showed a trend of increasing character length. This suggests, Wassermann and Straus noted, that researchers should reconsider the value they attribute to character count in these scenarios.

“Although character count has been used as an ancillary measure of the quality of radiology requisitions and reports in previous studies, the fact that it generally increased while the quality of clinical information contained in requisitions generally declined over the course of this study suggests that character count may be a poor proxy for requisition quality,” the authors wrote.

Wassermann and Straus added that further research into this subject could go in numerous directions. For example, researchers could examine how this trend in the quality of clinical information in requisitions impacts “the value that radiologists add to patient care.” Or they could also study if these trends exist in other modalities.

“For now, this study suggests that there is a current trend toward a decline in the quality of clinical information via the radiology requisition,” the authors concluded. “Medical educators and hospital administrators should be aware that without concerted efforts to improve the quality of information provided to radiologists in requisitions, it may continue to decline, which may hamper the ability of radiologists to optimally contribute to patient care.”