SOLO PRACTICE MANAGEMENT - VALUE OF A COMPUTERIZED REPORTING SYSTEM

OBJECTIVE. A computerized reporting system based on keyed entry of acr onyms and eponyms was developed to reduce transcription delays and spe ed report output for a solo radiology practice that covers several com munity hospitals in a large region. The purpose was to improve practic e outcomes, quality assessments, continuing medical education, and bil ling efficiency. SYSTEM AND APPLICATIONS. Over a 10-year period, probl ems in accurate reporting, transcription delays, slowed report deliver ies, and incomplete or lost billings were described to computer progra mmers. These programmers composed 31,000 lines of computer code design ed to address the problems. The resultant program was applied to 100,0 00 imaging procedures. Entry of commonly used clinical acronyms, epony ms, and other symbol strings chosen by the interpreting radiologist tr iggered the immediate printing of a report's text at the radiologist's desk. After the reports were proofread, electronically authenticated, and/or hand signed, they were sent to distant locales by facsimile tr ansmission. During new case interpretations, potentially erroneous sta tements of fact or judgment were prevented by enabling the interpreter to instantly review old reports, informative elements of a patient's history, and pertinent medical literature, all of which was placed in various caches of the computer's memory. Billing labor was reduced by automatically providing the number identifying each procedure and the diagnoses made during image interpretation. OPERATION. The acronym/epo nym-based reporting system was time- and cost-effective. The new syste m reduced typing strokes by 84%, and reports were generated in 1 min, while the studies were being interpreted. With the retrieval and monit oring techniques operating on old, stored information, new reporting e rrors, as well as some diagnostic oversights, were reduced by 50%. Cou nting the acronyms and symbols representing imaging quality and techni cal problems showed an 11% mistake rate. Modem transmission of automat ically included current procedural terms and disease classification nu mbers reduced billing labor by 50% and reduced lost charges to zero. T he same messaging mechanism of the program sent the text of interpreta tions to remote clinics and hospitals a few minutes after the radiolog ist's interpretation was made. CONCLUSION. Wry experience suggests tha t a computerized reporting and messaging system based on acronyms and eponyms is a time- and cost-effective technique for managing a solo ra diology practice. By using a programmable relational data base, one ca n modify the system to include educational, quality improvement, and b illing functions.