News | Clinical Study | March 20, 2018

What is the Cost of Interrupting a Radiologist?

University study finds interruptions change focus and time spent on case reviews, but don't increase error rate

 

What is the cost of interrupting a radiologist?

March 20, 2018 – A first of its kind study shows typical interruptions experienced by on-call radiologists do not reduce diagnostic accuracy but do change what they look at and increase the amount of time spent on a case.

The implication of the finding is that as radiologists contend with an increasing number of workplace interruptions, they must either process fewer cases or work longer hours - both of which have adverse effects in terms of patient outcomes, said Trafton Drew, the study's lead author. They also may spend more time looking at dictation screens than reviewing medical images.

"In radiology, there is a growing recognition that interruptions are bad and the number of interruptions faced by radiologists is increasing," said Drew, an assistant professor of cognitive and neural science in the University of Utah's Department of Psychology. "But there isn't much research at all on the consequences of this situation."

The Journal of Medical Imaging published the study online; it will appear in its July-September issue. Co-authors are: Lauren Williams, Department of Psychology, University of Utah; Booth Aldred, Department of Radiology and Imaging Sciences, University of Utah/Austin Radiological Association, Austin, Texas; Marta Heilbrun, Department of Radiology and Imaging Sciences, University of Utah/Emory University Hospital; and Satoshi Minoshima, Department of Radiology and Imaging Sciences, University of Utah.

Other research has shown that an on-call radiologist typically receives an average of 72 phone calls during a typical 12-hour overnight shift. An interruption, for example, might involve conferring with an emergency department physician about a new patient.

In the study, experienced radiologists were given a list of pre-selected, complex cases to read and were then interrupted by a telephone call that played a pre-recorded message from another physician that asked them to evaluate a different patient's case. The study is the first to experimentally manipulate whether specific cases were or were not interrupted.

"This let us look at the effect of the interruption without worrying about whether a particular case might have been more difficult than others," Drew said.

The researchers used eye-tracking software to determine what radiologists were looking at before, during and after being interrupted. Drew and his team anticipated that an interruption would lead to errors in interpreting images, but "it didn't change the error rate at all."

However, radiologists spent several additional minutes overall on the case they were reviewing the first time they were interrupted. They also spent more time looking at a dictation screen, suggesting the screen serves as an external memory aid, and less time viewing medical images after the distraction.

"That suggests they had to recollect what they looked at and the dictation screen helped them do that," Drew said. "Given that radiologists spend about 10 minutes on a complex case, we think this could be a big problem in the aggregate. They can go back to what they were doing but there is a significant cost there in terms of time. If we could do something to reduce the interruptions it could really help radiologists out."

Some radiologists who participated in the study noted that the interruptions used by researchers were benign compared to the disruptions they often experienced in the workplace. Drew and his colleagues hope to follow up on this concern in future research.

"If radiologists truly spend less time on medical images and more time on dictation after being interrupted, it may explain why prior research has found that shifts with more interruptions tend to have more uncertainty about patient diagnosis," Drew said. "If it takes some period of time for the radiologist to reconstruct what he or she saw prior to the interruption, it might actually be good practice to take a little longer on cases when they are interrupted. Ultimately, this means that interruptions will either lead to more potential for error or fewer cases being seen by the radiologists."

Watch a video on the topic here

Related Content

MACRA Implications for Payers, Providers and EHR Systems
Feature | Radiology Business | April 18, 2018 | Christopher Emper
For better or worse, the Medicare Access, CHIP Reauthorization Act (MACRA) is expected to disrupt healthcare at every
Chest X-ray AI Algorithm Correctly Identifies Lung Disease for Dubai Health Authority
Feature | Artificial Intelligence | April 17, 2018
The Dubai Health Authority (DHA) announced the preliminary results of a chest X-ray artificial intelligence (AI)...
Healthcare Administrative Partners Launches Deep Dive Analytics Service
Technology | Analytics Software | April 12, 2018
Healthcare Administrative Partners (HAP) announced the launch of Deep Dive Analytics, an integrated clinical data...
First Patient Treated in Online Adaptive Radiotherapy Trial With CyberKnife System
News | Stereotactic Body Radiation Therapy (SBRT) | April 06, 2018
Accuray Inc. and Erasmus MC announced the first patient has been successfully treated using an online-adaptive (OA)...
Veritas Capital Acquiring Three Software Units from GE Healthcare
News | Radiology Business | April 02, 2018 | Jeff Zagoudis, Associate Editor
April 2, 2018 — GE Healthcare announced the...
News | Endoscopes | April 02, 2018
Results from a recent prospective trial found the Wide Area Transepithelial Sampling with 3D Tissue Analysis (WATS3D)...
Edwards Completes Enrollment in PARTNER 3 Low-Risk CT Sub-Study
News | Computed Tomography (CT) | March 27, 2018
March 27, 2018 — Edwards Lifesciences Corp.
Combination Radiotherapy Beneficial in Treating Prostate Cancer
News | Prostate Cancer | March 27, 2018
March 27, 2018 — While there are many treatment options for men with...
3-D Printed Models Improve Medical Student Training
News | Medical 3-D Printing | March 23, 2018
March 23, 2018 — A relatively inexpensive...
Overlay Init