Shifting to subspecialty-based radiology reporting significantly improves turnaround time

Shifting to a centralized system of radiology reporting based around physician subspecialties—rather than imaging modalities—helps to significantly improve turnaround time, researchers reported Friday.

The gains were particularly notable in MRI and conventional radiography and at smaller hospitals that are part of a larger network. As an added benefit, Swiss experts also saw a drop in second reads, possibly propelled by radiologists remaining in their sweet spot of expertise.

“One may speculate that centralized/subspecialized radiology increases the experience and confidence of radiologists in their dedicated tasks,” Andreas Otto Josef Zabel, with the Division of Radiology and Nuclear Medicine at Kantonsspital St. Gallen, in Switzerland, and colleagues wrote Oct. 30 in Insights into Imaging. “Thus, centralized/subspecialized radiology may decrease the necessity for requesting a second opinion for challenging radiology reports,” they added.

Kantonsspital St. Gallen’s network consists of 11 imaging sites of various sizes scattered about the country. Previously, the provider shipped radiologists off to each center while working in the hospitals for reporting, with support from telerads. However, starting in 2017, the institution underwent a “paradigm shift,” whereby most rads remained at the main hospital, subspecialization groups were formed, while a select few physicians remained at satellite locations for modality-specific problems.

Zabel et al. set out to gauge the impact of this shift on turnaround time, comparing them from the last four months of 2017 to the same time in 2018, following implementation of the intervention. They determined that the turnaround time for getting a second signoff on the report dropped from 119 minutes down to 107.

Looking more closely at each category, Zabel and colleagues noted that the same metric dropped for MRI reporting (1,051 minutes down to 401) and conventional radiographs (278 minutes down to 171). And they also found gains at both major and minor hospitals, though the latter reported more notable gains.

At the same time, the need for such second signatures dipped from 16,632 down to 15,967, at a time when Kantonsspital St. Gallen actually saw a 3.9% uptick in imaging exams.

“As hypothesized, it appears that the [radiology report turnaround time] decreased in spite of the increased workload. One may assume that the experience gained by residents and board-certified radiologists may also have improved the RTAT values,” the authors concluded.  

Read more of their analysis in Insights into Imaging here.