The purpose of this study was to objectively quantify the impact of implementing picture archiving and communication system-electronic medical record (PACS-EMR) integration on the time required to access data in the EMR and the frequency with which data are accessed by radiologists. Time to access a clinic note in the EMR was measured before and after integration with a stopwatch and compared by t test. An IRB-approved, HIPAA-compliant retrospective review of EMR access data from security audit logs was conducted for a 14-month period spanning the integration. Correlation of these data with report signatures identified the studies in which the radiologist accessed the EMR to obtain additional clinical data. Proportions of studies with EMR access were plotted and compared before and after integration using a chi-square test. Time to access the EMR decreased from 52 to 6 s (p < 0.001). Proportion of studies with EMR access increased from 36.7% (10,175/27,773) to 44.9% (10,843/24,153) after integration (p < 0.001). Integrating PACS and the EMR substantially decreases the time to access the EMR and is associated with a significant increase in the proportion of studies for which radiologists obtain additional clinical data.

Rationale and objectives

Radiologists play a pivotal role in patient management, primarily through interacting with referring clinicians. Despite this extensive cross-specialty interaction, radiology resident education rarely involves direct education from clinicians outside the department. We surveyed resident attitudes toward integrated conferences with subspecialty referring physicians both before and after a pilot lecture series at our institution.

Materials and methods

Three thoracic-themed multidisciplinary conferences were organized, which involved a variety of clinicians lecturing during normal resident conference times. Resident surveys were administered before and after the complete lectures series as well as immediately after each individual lecture.

Results

The prelecture series survey indicated residents felt neutral about their confidence in knowing what clinicians want from radiology reports and the current level of "clinician-focus" in the curriculum. Residents indicated a desire for more clinician involvement in lectures. After completion of the series, residents expressed that the integrated conferences were useful and that they had greater confidence in understanding the clinicians' expectation of reports. Resident interest in clinician participation in lectures was higher after series completion. Most residents indicated that prespecified, self-identified learning objectives were met by the lectures. After the completion of the series, most residents indicated that they wanted the series to continue, with the most commonly indicated desired frequency being once or twice a month.

Conclusion

Subspecialty clinician participation in a cross-specialty integrated resident lecture series was highly favored and well received. An "Integrated Clinical Lecture Series" may be a beneficial addition to radiology residency curriculums.