Solo practice management: value of a computerized reporting system.

Abstract

OBJECTIVE. A computerized reporting system based on keyed entry of acronyms and eponyms was developed to reduce transcription delays and speed report output for a solo radiology practice that covers several community hospitals in a large region. The purpose was to improve practice outcomes, quality assessments, continuing medical education, and billing efficiency. SYSTEM AND APPLICATIONS. Over a 10-year period, problems in accurate reporting, transcription delays, slowed report deliveries, and incomplete or lost billings were described to computer programmers. These programmers composed 31,000 lines of computer code designed to address the problems. The resultant program was applied to 100,000 imaging procedures. Entry of commonly used clinical acronyms, eponyms, and other symbol strings chosen by the interpreting radiologist triggered the immediate printing of a report's text at the radiologist's desk. After the reports were proofread, electronically authenticated, and/or hand signed, they were sent to distant locales by facsimile transmission. During new case interpretations, potentially erroneous statements of fact or judgement were prevented by enabling the interpreter to instantly review old reports, informative elements of a patient's history, and pertinent medical literature, all of which was placed in various caches of the computer's memory. Billing labor was reduced by automatically providing the number identifying each procedure and the diagnoses made during image interpretation. OPERATION. The acronym/eponym-based reporting system was time- and cost-effective. The new system reduced typing strokes by 84%, and reports were generated in 1 min, while the studies were being interpreted. With the retrieval and monitoring techniques operating on old, stored information, new reporting errors, as well as some diagnostic oversights, were reduced by 50%. Counting the acronyms and symbols representing imaging quality and technical problems showed an 11% mistake rate. Modem transmission of automatically included current procedural terms and disease classification numbers reduced billing labor by 50% and reduced lost charges to zero. The same messaging mechanism of the program sent the text of interpretations to remote clinics and hospitals a few minutes after the radiologist's interpretation was made. CONCLUSION. My experience suggests that a computerized reporting and messaging system based on acronyms and eponyms is a time- and cost-effective technique for managing a solo radiology practice. By using a programmable relational data base, one can modify the system to include educational, quality improvement, and billing functions.