Correlate: A PACS- and EHR-integrated Tool Leveraging Natural Language Processing to Provide Automated Clinical Follow-up

Abstract

A major challenge for radiologists is obtaining meaningful clinical follow-up information for even a small percentage of cases encountered and dictated. Traditional methods, such as keeping medical record number follow-up lists, discussing cases with rounding clinical teams, and discussing cases at tumor boards, are effective at keeping radiologists informed of clinical outcomes but are time intensive and provide follow-up for a small subset of cases. To this end, the authors developed a picture archiving and communication system-accessible electronic health record (EHR)-integrated program called Correlate, which allows the user to easily enter free-text search queries regarding desired clinical follow-up information, with minimal interruption to the workflow. The program uses natural language processing (NLP) to process the query and parse relevant future clinical data from the EHR. Results are ordered in terms of clinical relevance, and the user is e-mailed a link to results when these are available for viewing. A customizable personal database of queries and results is also maintained for convenient future access. Correlate aids radiologists in efficiently obtaining useful clinical follow-up information that can improve patient care, help keep radiologists integrated with other specialties and referring physicians, and provide valuable experiential learning. The authors briefly review the history of automated clinical follow-up tools and discuss the design and function of the Correlate program, which uses NLP to perform intelligent prospective searches of the EHR. RSNA, 2017.

Use, Impact, Weaknesses, and Advanced Features of Search Functions for Clinical Use in Electronic Health Records: A Scoping Review

“…Kovacs et al described an integrated search function in a clinical setting and focused mainly on the system's performance; 82% of the 170 queries that returned results over 22 months were clinically relevant. 40 …”

“…Hanauer39 ; Hanauer et al42 ; Yang et al43 ; Zheng et al44 ; Zheng et al45 Relate to clinical aspects of EMERSE (collaborative search bundles, query analysis, personalization usage) aHasan et al38 Brazilian Portuguese semantic search engine evaluated on clinical summarization tasks to determine effect on the time taken to perform tasks by two medical students and two nursing students Kovacs et al40 Noninstantaneous search engine for radiologists to search the EHR for retrieving data for clinical follow-up a The Electronic Medical Record Search Engine (EMERSE) has both clinical and research applications; for this review, we excluded articles discussing only the research applications of EMERSE.…”

The Adoption and Impact on Performance of an Automated Outcomes Feedback Application for Tomosynthesis Screening Mammography

“…As early as 1978, computer systems have been used to provide daily feedback reports to radiologists about their patients' subsequent pathology diagnoses [16]. The last two decades have seen the development of multiple systems providing pathology and clinical outcomes feedback to radiologists [17][18][19][20][21][22][23][24][25]. These systems are being used by radiologists for continuing medical education (CME) and peer learning [20][21][22][23][24].…”

Neurological Dashboards and Consultation Turnaround Time at an Academic Medical Center

“…Such solutions include note templates, such as that provided by Epic SmartPhrases (Epic Systems Corporation, Verona, Wisconsin, Unites States), 30,31 strategic menu design, 32,33 and order sets. 34 Automationcentric innovations also exist, such as automated problem list generation 35 and follow-up determination after radiographic testing, 36 as well as clinical decision support, alerts for risk stratification 37 and drug-disease interactions. 38 A study by Arndt et al of ambulatory family practitioners in the United States showed that clinicians devote nearly 50% of their total daily time in their EHR performing clinical documentation and chart review, with chart review comprising nearly 75% of EHR tasks related to direct medical care.…”