E1122. Seconds, Shortcuts, and Savings: EMR Optimization in the Modern Era
  1. Kyle Stumetz; Dartmouth-Hitchcock Medical Center
  2. Peiying Hua; Dartmouth-Hitchcock Medical Center
  3. Marc Seltzer; Dartmouth-Hitchcock Medical Center
  4. Tor Tosteson; Dartmouth-Hitchcock Medical Center
Electronic medical record (EMR) data utilization plays an essential role in improving accuracy and preventing misdiagnoses in diagnostic imaging. Although it is estimated that radiologists spend approximately 15-20% of total interpretation time reviewing EMR clinical data, few studies have explored the value and efficacy of EMR optimized clinical history templates (OCHT’s). The goal of the present study is to quantitatively assess the value of EMR OCHT’s in nuclear medicine diagnostic imaging given their simplicity, cost-effectiveness, and reproducibility across all radiologic subspecialities.

Materials and Methods:
Following implementation of a new nuclear medicine positron emission – computed tomography (PET-CT) EMR OCHT, 16 resident physicians (4 radiology trainees per year, PGY-2 to PGY-5) and 4 nuclear medicine board-certified radiologists were quantitatively assessed for speed, accuracy, and efficiency during EMR clinical data acquisition. 8 clinical data elements were collected by each physician for 3 PET-CT scans on 3 separate patients where clinical information played a critical role in the final interpretation. The speed, accuracy, and efficiency of data acquisition were compared across groups with different training levels using univariate and multivariate regression models. A generalized estimating equation with logit link was used to account for multiple measurements within the same physician.

Of the 20 physicians who were quantitatively assessed, the average time (speed analysis) required to record all 8 EMR OCHT data points was 4.83 +/- 1.62 minutes, the average number of clicks (efficiency analysis) was 13.7 +/- 5.8 clicks, and the average score for correct data acquisition (accuracy analysis) was 6.5 +/- 0.90 points out of a total of 8 points (80.6% +/- 11.0%). There was no statistically significant difference in speed (p = 0.81), accuracy (p = 0.07), or efficiency (p = 0.13) among physician groups with different training levels after adjusting for clinical data elements and patients, although attending physicians and senior residents scored slightly better on accuracy measurements than earlier trainees.

EMR OCHT’s play a critical role in increasing speed, efficiency, and accuracy during imaging interpretation. By estimates of the current study, radiologists can save up to 4.83 +/- 1.62 minutes per PET-CT exam and avoid potentially catastrophic interpretation errors by utilizing this simple, cost-effective, and reproducible tool.