Examinations and Usability

A study not yet submitted for publication that was conducted by resident physician Yehonatan N. Turner, concluded that the inclusion of patient photographs alongside digital radiographic examinations should be routine due to the apparent positive effect this practice had on the performance of radiologists.  This study was presented earlier this week at the Radiological Society of North America conference along with 4,000 other studies.  Much attention is being given to this particular study, however, because it focuses on the radiologist-patient relationship rather than traditional radiology training.

As reported in The Wall Street Journal (the presentation can be viewed here), the absence of an accompanying patient photograph for a given set of tomography images submitted to radiologists resulted in an 80% drop in “incidental findings”, which are often life-saving since these are associated with pre-symptomatic problems.  The study suggests that radiologists are more careful in the presence of patient photographs, which serve as a reminder that patients are people while reviewing at a frequent rate a high quantity of high-tech images.  While further study is needed for conclusive evidence, this matter raises a number of implications from both business and architectural quality perspectives.

  • Usability.  One of the interesting aspects of these findings is that usability of software applications is impacted for both the end-user physician, as well as the patient.  While the default display of patient photographs does not make the associated software easier to use, the study essentially argues that user effectiveness of individual physicians is increased, resulting in error reduction.  Patient empowerment is also enabled because the photographs they provide contribute to the medical process.  Some radiologists are also beginning to think a step further, indicating that additional information provided about the purpose behind any particular scan may provide additional value apparently since patients and clinicians often do not communicate the reasons for a scan.
  • Performance.  It is well known in the health care industry that radiologists spend very little time reading each scan, due in part to the sheer quantity of images they need to review, as well as productivity expectations.  It is not clear at this point whether resultant performance of these individuals will be positively or negatively impacted.  Although radiologists may look more carefully at images when photographs are provided, leading to spending more time on each image, this is not necessarily the case.  And that potential accompanying error reduction can increase Sigma Level underscores the reality that increased performance is not always synonymous with decreased cycle time.
  • Cost and benefit.  This study implies virtually no short-term cost, and decreased costs and increased benefits from a long-term perspective.  As with usability, these costs and benefits can apply to both end-user physicians and corresponding provider organizations, as well as patients.  Decreased error rates can lead to a reduction in lawsuits.  Early detection of illnesses can lead to less costly procedures for patients.  And the combination of these two benefits can lead to increased trust in health care.

As I have frequently communicated to clients and colleagues during my years in consulting, business and architectural quality are very subjective aspects of any problem and solution, including those within the realm of e-health.  It is important for any project team consisting of clients and fellow consultants to come to a common understanding of sometimes seemingly esoteric topics such as quality in order to create the most effective solutions.  Would it not bring anyone great satisfaction if just a single item, such as a patient photograph, could bring such positive results?

Topics: Healthcare Tech, Executive Insights

Written by Erik Gfesser

Erik is a Sr. Technical Architect at NVISIA LLC.

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