The University of Virginia Health System has collaborated with industry partners Epic and Carestream Health to create a better way to view X-rays and other imaging tests and then impart that information through a technique called interactive multimedia radiology reporting.

The solution encompasses artificial intelligence and voice recognition technologies as well as robust data integration among multiple vendor’s imaging systems and electronic health records software.

Artificial intelligence assists with study interpretation such that algorithms can be automatically inserted into reports as a further advancement in technique.

The broader interactive multimedia reports include enriched content such as images, charts, and graphs. They also contain embedded hyperlinks to add interactive functionality, according to Cree Gaskin, MD, associate chief medical information officer at UVA’s health system.

A hyperlink can immediately take a doctor from a finding in the report text to the relevant images in PACS, the picture archiving and communication system.

“We’re not just putting images in the report,” Gaskin said. “We’re putting in interactive elements.”

For instance, on the screen, the radiologist can measure a lesion in the left kidney and give a voice command which directs the system to insert the last measurement and its image location into the report.

“My report ends up with more information in it than I dictated,” Gaskin said. “A connection is made between the report and images that we didn’t have before. That enriched content has the ability to improve communication between radiologists, referring providers, trainees, and patients.”

Most reporting systems use speech recognition to create a plain text report. Sometimes words get misconstrued.

“Speech recognition is imperfect,” Gaskin said. “All it takes is a word or two to change the meaning of what you’re saying.  So if your system is intelligent enough to insert the data you want without you saying it, then it can save time and reduce error.”

The multimedia reporting application is cost neutral since associated expenses are similar to other reporting applications, Gaskin said.  He also believes the multimedia reporting saves money as it’s saving time.

There are two hurdles.

To make the interactive multimedia reporting possible needs robust integration between the reporting application and the viewing application, two systems traditionally made by different vendors.

Gaskin and Les Folio, lead CT radiologist for the National Institutes of Health, both worked with Carestream Health, their PACS vendor, to design and implement a reporting application with tight integration to the image data in the PACS. The system is commercially available.

Another barrier is delivery of the reports via the electronic health record which is designed for plain text reports. Multimedia content may be stripped out by the EHR. Gaskin and others worked with Epic to place hyperlinks in the imaging results section of the EHR to launch multimedia reports. 

Within a year the multimedia content is expected to be directly available in-line with the standard report text in the EHR, he said.

The reporting system was installed in November 2015 and in September 2016, the health system began teaching radiologists how to use the interactive multimedia reporting technique.

“People are focused on quality and value in medicine today,” Gaskin said. “Multimedia reports add value and improve quality. Through improving communications, we’re helping people to collaborate.”

Gaskin and Folio are scheduled to speak in the HIMSS18 session, “Creating value via analytics and AI-driven interactive radiology reports,” at 4 p.m. March 7 in Venetian, Murano 3304. 

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com