The Reading Room

Want higher quality radiology reports? Consider disease-specific templates.

by Miriam Sznycer-Taub and Ty Aderhold

Structured report templates, while not new to radiology, have been growing in popularity in recent years. These templates provide a standardized format and layout—differing based on exam type—that guide the radiologist through the read and generate clear, consistent reports for referring providers.

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Some organizations are now taking structured reports even further, developing disease-specific reporting templates. These templates enhance the quality benefits of structured reports by reminding radiologists what aspects of the image they need to examine for the suspected condition and providing a straightforward, consistent organization of findings that match directly to the reason for exam. 

While structured reports are not without detractors, as some radiologists feel that the structure limits personal preferences during the read-and-report process, we here at the Imaging Performance Partnership feel that structured reports—and disease-specific templates in particular—are an effective way to improve quality in radiology.

The benefits of a disease-specific template

To assess the efficacy of disease-specific templates, a new study in the Journal of the American College of Radiology examined the quality impact of switching from a general structured report for chest CT to a disease-specific template for CT angiography for suspected pulmonary embolism. Specifically, researchers measured the percentage of complete reports—reports that included all desired information on the suspected pulmonary embolism—before and after implementing the disease-specific reporting template. According to the study, switching to the disease-specific template increased the report-completeness rate from 69.4% to 94.4%.

The study authors attributed this huge jump in report quality in part to how the disease-specific templates were created and implemented. In designing the templates, the researchers created a picklist for each subsection of the read—an approach that standardized language in the report, reducing the amount of free text radiologists needed to enter. And to ensure usage of the new template, the researchers made it automatically load when a radiologist pulled up a CT angiography for suspected pulmonary embolism.

Creating these new report templates with standardized language not only ensured radiologists covered every necessary subsection, but it also provided a new data source for the researchers. After looking closely at the data, researchers found that there were a larger-than-expected number of cases being described as "indeterminate" due to image quality. In response, the researchers created a standard document describing how to properly perform a CT for suspected pulmonary embolism and distributed the document among technologists for additional training. According to the researchers, data collected for three months after these new trainings demonstrated a significant drop in "indeterminate" exams.

Ultimately, these disease-specific structured reporting templates improved both radiologist and technologist quality. In today's competitive imaging landscape, such quality gains can provide a leg-up for programs willing to adopt more advanced structured-reporting templates, both disease-specific and otherwise.

How to incorporate structured-reporting templates at your organization

Interested in implementing these disease-specific templates or more general structured-reporting templates? Here are some key steps you can take to ensure radiologists utilize these new tools:

  1. Include radiologists in the development process;
  2. Leverage existing reporting templates that radiologists already use;
  3. Utilize technology or artificial intelligence software to improve the accessibility and utility of reporting templates;
  4. Conduct an initial rollout of templates with a subset of radiologists;
  5. Track adherence across radiologists and subspecialties; and
  6. Increase utilization via scorecards and tie utilization of templates to radiologist bonus compensation.

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