4542. Implementation of a Remote Reading Radiology Program at an Academic Health Care Institution: A Longitudinal Assessment
Authors * Denotes Presenting Author
  1. Hanan Sayed *; University of Washington
  2. Ken Linnau; University of Washington
  3. David Zamora; University of Washington
  4. Matthew Fix; University of Washington
  5. Marlon Mensalvas; University of Washington
  6. Susan Rajan; University of Washington
  7. Nathan Cross; University of Washington
Our institution prioritized the development and implementation of a diagnostic remote reading program (RRP) for diagnostic radiologists during the COVID–19 pandemic to maintain standard of care in diagnostic imaging. We present a longitudinal survey before and after implementation of this program. Before implementation, a non-FDA-approved CITRIX-based image viewing system was utilized. More recently, our program deployed 21 in-home review workstations identical to those used on premise. This study aims to obtain qualitative and quantitative measures to assess the impact of a diagnostic RRP at a single large academic institution.

Materials and Methods:
We developed a 10-item survey that included open-ended, Likert scale, and multiple-choice questions. This instrument was validated by cognitive debriefing and was administered electronically to all radiologists (fellows and attendings) who had the ability to remotely generate diagnostic imaging reports. Following the deployment of full reading workstations and after a 3-month cooling period, we administered the same survey again to all radiologists who participated in the RRP to measure change. Concomitantly, we measured remotely finalized radiology report counts per radiologist before and after program implementation as a quantifiable key performance measure.

Response rate was 62% (31 of 50) and 52% (11 of 21) before and after implementation, respectively. Demographics of survey participants were similar before and after implementation. About 10% of preimplementation respondents were fellows. The subjective impact on productivity measured on Likert scale shifted substantially postimplementation from a composite Likert score of 2.04 pre-implementation, to 2.57 postimplementation , with the largest impact on technical parameters including system integration, remote connectivity, and display quality. Qualitative variables mentioned by radiologists included speed of report generation, system stability, system integration and the ability to communicate consultant information. We observed increased willingness to work remotely post-RRP implementation. Variables influencing willingness to work remotely included increased system stability, commute time, schedule flexibility, childcare, and increased work-life balance. Variables arguing for onsite reading included better interaction with trainees and other faculty and increased interpersonal interaction. The average monthly count of remotely finalized radiology reports per participating radiologist in the first 6 months was 98 (± 101) with the majority of these being after hours and cross-sectional. Approximate cost for hardware and on-site installation was $13,500 per workstation.

The implementation of a diagnostic workstation to radiologist’s home offices improves productivity and radiologist satisfaction, as shown by longitudinal quantitative and qualitative data.