Last week we discussed some tips and tricks on how to create great synoptic templates. This week, we’re going to take a focused look at an area of medicine where synoptic reporting can be especially useful: radiology.
There was a time when narrative reporting transcription was the best means available to radiologists for recording relevant information in any particular medical case. However, this method of medical reporting suffers from a few critical shortcomings. Dictated operative reports often miss valuable information, and the transcription process can result in errors from miscommunication [1, 2]. Transcription can also create typographical errors in a medical report, which can have serious consequences for patients, even when the error is minor . In fact, studies have repeatedly demonstrated that synoptic reporting is significantly more accurate and captures more relevant data than traditional reporting [4, 5].
But if there are empirically proven benefits of synoptic reporting over narrative reporting and transcription, why is there continued resistance to its widespread adoption? Medical professionals are a forward-thinking, empirically-driven group, so it can’t just be that old habits die hard. The problem is a lack of robust, refined templates. Synoptic reporting is great, but developing the templates takes time and effort, and the unfortunate truth is that most medical professionals simply don’t have the time to devote to developing templates.
The problem is a lack of good synoptic templates for radiology. The challenge is creating them.
The Radiological Society of North America (RSNA) has created a valuable resource that can be applied to the challenge of creating synoptic templates for radiology. They’ve developed a comprehensive library of structured templates for radiologists. These templates define questions that should be answered for each major procedure. The library offers hundred of templates, and is organized according to speciality, the organization that developed them, or even the most popular template.
The RSNA template library is excellent, but vast majority are not fully synoptic because answers to the structure defined are in text narrative format except for. The CT Lung Cancer Screening template, for example, still relies heavily on text entry. In contrast a fully-synoptic template, as shown below, uses check-lists and drop-downs for most answers. This improves consistency in reporting and makes possible error checking where answers in different questions are logically inconsistent (e.g. female gender and male anatomy selections).
Not only are unstructured reports often less complete than structured reports , but they can also be difficult to easily analyse. One of the great benefits of predefined options in synoptic reporting is that they lend themselves to research. Text boxes are much more difficult to analyse than check boxes and radio buttons.
So what do to about it? We want to take the existing radiology templates and refine them even further. Take a look at an example of similar synoptic template for lung cancer screening created by Cancer Control Alberta. Opportunities for error are curtailed by the use of predefined options and checklists, and all the information collected is readily accessible, quickly understood and easily exported for study. The template also incorporates branching logic that hides or reveals relevant panels as required. Knowing which information needs to be captured is crucial to building a template that can be adopted for wide-use among radiologists, and that is very specialized information.
The RSNA templates are an excellent starting point for helping radiologists transition to synoptic reporting. That’s why Synoptec™ is looking to work with radiologists across North America to help build a robust library of refined radiology templates. We’re offering free beta licenses for Synoptec™ to radiologists willing to lend us their expertise. You’ll not only get free access to our world-class clinical documentation software (not including hosting expenses), but you’ll also get an opportunity to contribute to the development of a radiology template library featuring your input and addressing your needs.
Radiology is a critical component of modern health care and is vital to ensuring accurate diagnoses and positive patient outcomes. We’re convinced the adoption of synoptic reporting can profoundly help with both of these goals, while simultaneously reducing waste and providing valuable, research-ready reports. Making sure radiologists have access to an extensive library of effective and efficient synoptic templates is only one step towards making synoptic reporting a new standard, but it’s an important one. If you’d like to help out, and take advantage of our free beta license in the process, fill out the form below.
- Marcovici PA, Taylor GA. Structured radiology reports are more complete and more effective than unstructured reports. American Journal of Roentgenology. 2014 Dec;203(6):1265–71.
- Lin E, Powell DK, Kagetsu NJ. Efficacy of a checklist-style structured radiology reporting template in reducing resident misses on cervical spine computed tomography examination. Journal of Digital Imaging. 2014 Oct;27(5):588–93.
- Ronald L. Sirota (2006) Defining Error in Anatomic Pathology. Archives of Pathology & Laboratory Medicine: May 2006, Vol. 130, No. 5, pp. 604-606.
- Larson DB, Towbin AJ, Pryor RM, Donnelly LF. Improving consistency in radiology reporting through the use of department-wide standardized structured reporting.Radiology. 2013 Apr;267(1):240–250.
- Donahoe L, Bennett S, Temple W, Hilchie-Pye A, Dabbs K, Macintosh E, Porter G. Completeness of dictated operative reports in breast cancer–the case for synoptic reporting. Journal of Surgical Oncology. 2012;106(1):79–83.
- Schwartz, LH. Panicek, DM, Berk AR, Li Y, Hricak H. Improving communication of diagnostic radiology findings through structured reporting. Radiology. 2011 Jul;260(1);174–81.