Electronic imaging clinical implementation strategies and principles need t
o be developed as we move toward replacement of film-based radiology practi
ces. During an 8-month period (1998 to 1999), an Electronic Imaging Clinica
l Implementation Work Group (EICIWG) was formed from sections of our depart
ment: Informatics Lab, Finance Committee, Management Section, Regional Prac
tice Group, as well as several organ and image modality sections of the Dep
artment of Diagnostic Radiology. This group was formed to study and impleme
nt policies and strategies regarding implementation of electronic imaging i
nto our practice. The following clinical practice issues were identified as
key focus areas: (1) optimal electronic worklist organization; (2) how and
when to link images with reports; (3) how to redistribute technical and pr
ofessional relative value units (RVU); (4) how to facilitate future practic
e changes within our department regarding physical location and work redist
ribution; and (5) how to integrate off-campus imaging into on-campus work-f
low. The EICIWG divided their efforts into two phases. Phase I consisted of
Fact finding and review of current practice patterns and current economic
models, as well as radiology consulting needs. Phase II involved the develo
pment of recommendations, policies, and strategies for reengineering the ra
diology department to maintain current practice goals and use electronic im
aging to improve practice patterns. The EICIWG concluded that electronic im
ages should only be released with a formal report, except in emergent situa
tions. Electronic worklists should support and maintain the physical presen
ce of radiologists in critical areas and direct imaging to targeted subspec
ialists when possible. Case tools should be developed and used in radiology
and hospital information systems (RIS/HIS) to monitor a number of paramete
rs, including professional and technical RVU data. As communication standar
ds improve, proper staffing models must be developed to facilitate electron
ic on-campus and off-campus consultation. Copyright (C) 1999 by W.B. Saunde
rs Company.