Method and apparatus for generating a radiologist quality assurance scorecard

• US 8,301,461 B2
• Filed: 01/30/2007
• Issued: 10/30/2012
• Est. Priority Date: 01/30/2006
• Status: Active Grant

• Current Assignee: Bruce Reiner
• Original Assignee: Bruce Reiner
• Inventors: Reiner, Bruce
• Primary Examiner(s): Lubin, Valerie
• Application Number:
  US11/699,344
• Publication Number:
  US 20070232868A1
• Time in Patent Office: 2,100 Days
• Field of Search: 705/2, 705/3, 434/262, 713/193
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 10/06395 Quality analysis or management
• CPC Class Codes: G06Q 10/06398 Performance of employee with respect to a job function
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/0202 Market predictions or forecasting for commercial activities
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Abstract

The present invention provides a quality assurance system and method that generates a quality assurance (QA) scorecard for radiologists that use digital devices in a radiological-based medical imaging study. According to one embodiment, client computers, servers, imaging devices, databases, and/or other components may be coupled to provided a unified data collection system. According to one embodiment, systems and methods are provided that analyze various parameters that are derived from the unified data collection system to calculate a QA score for the radiologist. The QA score provides a combined subjective and objective feedback system that includes performance evaluations from other users, including clinicians and patients. According to one embodiment, the feedback may be provided in real-time.

Claims

1. A computer-implemented method of generating a quality assurance score, comprising:

obtaining and storing information on a patient, in at least one patient profile, in at least one database of a client computer or a server computer of a computer system;

displaying, on a display, at least one image from an imaging exam stored with said at least one patient profile;

receiving and storing in said at least one database, an image quality evaluation of said imaging exam by a user;

providing a survey of a predetermined list of questions to a predetermined group of respondents, including said user, whom includes at least a technologist and a radiologist, via an electronic communication mechanism;

receiving and storing responses to said predetermined list of questions, in said at least one database, including said responses on at least said image quality evaluation, from said predetermined group of respondents;

determining a diagnostic accuracy of at least one of said predetermined group of respondents by analyzing said responses using said computer system, including said responses on at least said image quality evaluation, along with said at least one patient profile; and

generating a quantifiable quality assurance score using said computer system, indicating a measure of quality assurance compliance of at least one of said predetermined group of respondents, wherein said quality assurance score includes a time response calculated by said computer system, of at least a time taken by said respondent radiologist from receipt to review of said imaging examination, and at least a time taken in reviewing said imaging exam by said respondent radiologist.

2. The method according to claim 1, further comprising:

performing an access authorization procedure on said user at said client computer, prior to retrieving said information from said at least one database;

alerting said user via electronic means at said client computer, when less than full access privileges are associated with said user;

initiating a reduction in privileges at said client computer for a user, for at least one of failure to follow a predefined protocol, frequent misdiagnosis of an ailment, failure to follow a cost-effective treatment plan, or failure to complete continuing medical education;

identifying and recommending at least one re-credentialing program to said user, using said computer system when said privileges are reduced; and

restoring full access privileges at said client computer, to said user, after completion of said re-credentialing program;

wherein said at least one re-credentialing program includes at least one of board certification;

residency and fellowship training;

specialty certification;

continuing medical education (CME);

or specialized training in a specific area of interpretation.

3. The method according to claim 2, further comprising:

granting a grace period for regaining full privileges to said user before all of said access privileges are revoked at said client computer;

wherein said grace period is calculated by one of a number of log-ins or days by said computer system,

wherein said number of log-ins or days is determined by a frequency of occurrence of predetermined triggers, including at least one of a severity of an error, or an amount of time required to complete a re-credentialing program.

4. The method according to claim 2, wherein said information includes an imaging data sheet;

and further comprising;

completing said imaging data sheet using said computer system, with data including past medical and surgical history, including at least one of prior imaging exams and results, including those performed at outside facilities;

current clinical problems;

pertinent findings on a physical exam;

pertinent laboratory or pathology data;

procedural findings;

operative or consultation notes;

clinical testing;

technical information related to a previous imaging exam performed;

technologist observations including pertinent findings and measurements;

technologist notes including complications and imaging exam limitations.

5. The method according to claim 2, further comprising:

completing said imaging sheet using said computer system, with data including all pertinent clinical data elements related to a diagnosis being evaluated, including at least one of a past medical and surgical history;

allergies;

reactions to contrast media used in medical imaging;

risk factors, including family history and tumor markers;

non-imaging data, including laboratory and clinical testing;

pathology;

clinical indication and presumptive diagnosis;

findings on physical examination;

historical imaging data, or outside imaging exams and findings.

6. The method according to claim 5, further comprising:

receiving user-created patient profiles for said imaging data sheet at said client computer;

storing a customized imaging data sheet on said patient in said at least one database;

recording a time-stamp each time a new entry or modification is made to said imaging data sheet using said computer system; and

displaying on said display, said user'"'"'s individual preferences based on said customized imaging data sheet stored by said user.

7. The method according to claim 1, further comprising:

displaying on said display, a computerized physician order entry (CPOE) to the user for clarification of discrepancies or clinical questions; and

storing corrections of said discrepancies in said at least one database.

8. The method according to claim 7, further comprising:

identifying clinically unexpected or emergent findings during the course of an imaging exam interpretation using said computer system; and

alerting at least one other user from said predetermined group of respondents to said findings, wherein said alert is sent via any type of electronic communication; and

wherein when said clinically unexpected or emergent findings are not present, said image is presented to said user on said display, with a predetermined display protocol.

9. The method according to claim 8, further comprising:

creating a time stamp of said electronic communication using said computer system;

recording, with said time stamp, in said at least one database, at least one of a scheduling time of said imaging exam;

an arrival of said patient;

a start and a completion time of said imaging exam;

a transmission of said imaging exam to a PACs for interpretation;

an opening time of said imaging exam by the user;

a closing time of said imaging exam;

a time that a report is dictated; and

a signing time of an imaging report;

storing, in said at least one database, said alert; and

generating said quality assurance score using an analysis of said alert, using said computer system.

10. The method according to claim 9, further comprising generating said quality assurance score using said computer system, said instructions which including receiving and storing data in said at least one database, said data which includes at least one of information on a time from receipt of said image from said imaging exam to receipt by at least one respondent of said predetermined group of respondents;

specific components of said image reviewed by said respondent radiologist;

an image open time and image close time;

a time incurred by a respondent clinician in responding to said alert;

said type of said electronic communication;

acknowledgements of receipt of said alert by said predetermined group of respondents;

bi-directional consultations held between individual of said group of respondents;

a time taken to initiate treatment;

tracking of follow-up recommendations;

clinician satisfaction; and

referral patterns.

11. The method according to claim 10, further comprising:

providing access for a respondent clinician at said client computer, to enter data electronically into an electronic medical report (EMR) in said least one database;

tracking clinician actions using said computer system, including recording progress notes, consultations held, ordering of clinical tests and imaging studies, and treatment options entered into said client computer; and

tracking said data and actions for analysis and generation of said quality assurance score using said computer system.

12. The method according to claim 11, further comprising:

enabling said respondent radiologist to dynamically manipulate said image on said display, and to highlight at least one key image from a large data set on said display;

wherein said manipulation includes at least one of a reconstruction images in multiple imaging of planes or image processing of said image.

13. The method according to claim 1, further comprising:

receiving data from said radiologist at said client computer, on a rating of said image quality and on a finding of whether said image quality is acceptable for review;

wherein said image quality evaluation is performed by one of said radiologist or a clinician using a Likert scale.

14. The method according to claim 13, further comprising:

using said computer system to request that said imaging exam be rescheduled when said image quality is poor as analyzed by said computer system; and

using said computer system to provide at least one recommendation to a technologist for improving a future imaging exam having similar parameters, said recommendation being provided by electronic means;

wherein said recommendation includes at least one of producing alternate image examinations or adjusting a dosage.

15. The method according to claim 1, further comprising:

receiving a structured text report at said client computer, that is correlated with said imaging exam by said computer system; and

database mining said reports which contain a standardized lexicon, such that community and nationwide norms are established using said computer system.

16. The method according to claim 15, wherein reporting templates are used by said computer system to create consistent and reproducible data which are used in a statistical analysis by said computer system, said statistical analysis which is performed by said computer system on a predetermined schedule, and used in generation of said quality assurance score by said computer system;

wherein said quality assurance score provides questions for said user to identify hidden biases, and to adjust said quality assurance score based on answers to said questions.

17. The method according to claim 16, further comprising:

updating at least one data profile of said patient with said structured text report in said at least one database;

wherein said data profile is at least one of an electronic medical record (EMR), a hospital information system (HIS), and a radiology information system (RIS).

18. The method according to claim 17, further comprising:

using said computer system to computer search databases at institutional, local, national, and international levels to establish community and national norms for context-specific diagnostic accuracy measures; and

providing said user at said client computer, with said quality assurance score for diagnostic accuracy based on cumulative data obtained from all said databases.

19. The method according to claim 18, further comprising:

analyzing quality assurance metrics for adherence of said user to community standards or professional guidelines using said computer system;

wherein said community standards may be applied to provide uniformity to at least one of imaging service utilization;

imaging study protocols;

application of ancillary technologies including computer aided detection software (CAD); and

reporting/communication profiles; and

including said analysis using said computer system, including said image quality evaluation, in a trending analysis performed by said computer system.

20. The method according to claim 19, further comprising:

obtaining a complication rate and adverse outcomes related to said imaging exam and imaging procedures from said at least one database using said computer system;

correlating misdiagnostic trends with local, regional, and national norms using said computer system;

performing trending analysis using said computer system, of said user'"'"'s diagnostic accuracy; and

providing all said outcomes of said trending analysis, using said computer system, to said user at said client computer, for performance improvement and to third parties as an educational resource.

21. A computer system for generating a quality assurance score, comprising:

at least one memory containing at least one program comprising the steps of;

obtaining and storing information on a patient, in at least one patient profile, in at least one database of a client computer or a server computer of a computer system;

displaying, on a display, at least one image from an imaging exam stored with said at least one patient profile;

receiving and storing in said at least one database, an image quality evaluation of said imaging exam by a user;

providing a survey of a predetermined list of questions to a predetermined group of respondents, including said user, whom includes at least a technologist and a radiologist, via an electronic communication mechanism;

receiving and storing responses to said predetermined list of questions, in said at least one database, including said responses on at least said image quality evaluation, from said predetermined group of respondents;

determining a diagnostic accuracy of at least one of said predetermined group of respondents by analyzing said responses using said computer system, including said responses on at least said image quality evaluation, along with said at least one patient profile; and

generating a quantifiable quality assurance score using said computer system, indicating a measure of quality assurance compliance of at least one of said predetermined group of respondents, wherein said quality assurance score includes a time response calculated by said computer system, of at least a time taken by said respondent radiologist from receipt to review of said imaging examination, and at least a time taken in reviewing said imaging exam by said respondent radiologist; and

a processor for running said program.

22. A non-transitory computer-readable medium containing instructions for generating a quality assurance scorecard, comprising:

obtaining and storing information on a patient, in at least one patient profile, in at least one database of a client computer or a server computer of a computer system;

displaying, on a display, at least one image from an imaging exam stored with said at least one patient profile;

receiving and storing in said at least one database, an image quality evaluation of said imaging exam by a user;

providing a survey of a predetermined list of questions to a predetermined group of respondents, including said user, whom includes at least a technologist and a radiologist, via an electronic communication mechanism;

receiving and storing responses to said predetermined list of questions, in said at least one database, including said responses on at least said image quality evaluation, from said predetermined group of respondents;

determining a diagnostic accuracy of at least one of said predetermined group of respondents by analyzing said responses using said computer system, including said responses on at least said image quality evaluation, along with said at least one patient profile; and

generating a quantifiable quality assurance score using said computer system, indicating a measure of quality assurance compliance of at least one of said predetermined group of respondents, wherein said quality assurance score includes a time response calculated by said computer system, of at least a time taken by said respondent radiologist from receipt to review of said imaging examination, and at least a time taken in reviewing said imaging exam by said respondent radiologist.