Electronic imaging and clinical implementation: Work group approach at Mayo Clinic, Rochester

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.