Subspecialization in radiology: effects on the diagnostic spectrum of radiologists and report turnaround time in a Swiss university hospital

Abstract

Purpose To analyze the changes in the work profiles of radiologists and the reporting time after the implementation of professional subspecialization in the radiology department of a Swiss university hospital. Methods In a retrospective analysis, the overall number of different radiologic examinations performed in the department of radiology of the largest Swiss university hospital was documented for 2014 and 2016 before and after the implementation of subspecialized reporting (subspecialities: abdominal, musculoskeletal, cardiothoracic, emergency, and pediatric imaging) in May 2015. For six selected radiologists, the number and types of reported examinations as well as the related radiology report turnaround times (RTATs) were analyzed in detail and compared between the two 1-year periods. Results Overall, there was a significant increase of 10.3% in the total number of examinations performed in the whole department in 2016 compared with 2014. For four of the six radiologists, the range of different types of examinations significantly decreased with the introduction of subspecialized reporting (p < 0.05). Furthermore, there was a significant change in the subset of the ten most commonly reported types of examinations reported by each of the six radiologists. Mean overall RTATs significantly increased for five of the six radiologists (p < 0.05). Conclusions Implementation of subspecialized reporting led to a change in the structure and a decrease in the range of different examination types reported by each radiologist. Mean RTAT increased for most radiologists. Subspecialized reporting allows the individual radiologist to focus on a special field of professional competence but can result in longer overall RTAT.

Subspecialized radiological reporting reduces radiology report turnaround time

“…In contrast to the results of Meyl et al [ 3 ], the current study showed particularly that the RTAT for medium-challenging/time-consuming reports, represented by the 80th percentile RTAT, decreased significantly; this is especially true of the RTAT for the subspecialization of musculoskeletal radiology. In the other subspecializations, however, the trend tended towards increased RTATs (Tables 3 and 5 ), which was also observed by other recent studies [ 3 ].…”

“…Similarly, to other recently published surveys, the present study demonstrated an annual increase of 3.9% in the number of radiology reports and imaging examinations during the evaluation period in 2018 compared to 2017 (Table 1 ) [ 3 , 12 , 13 ]. Interestingly, there was an increase from 37,247 to 38,754 reports but a decrease in reports with a second signature from 16,632 to 15,967 reports (Table 1 ).…”

“…Recent literature revealed conflicting data regarding the RTAT: Change of reporting system from decentralized/modality-based radiology to centralized/subspecialized radiology demonstrated both a decrease of the RTAT, as shown by the results of Stern et al [ 14 ], and, conversely, an increase of the RTAT, as shown by the results of Meyl et al [ 3 ]. In the present study, the change to a centralized/subspecialized system of radiological reporting leads overall to a significant decrease of the RTAT (Tables 1 and 4 ).…”

“…In daily practice, further subspecialization is more common in the USA [ 1 ] than in most European radiology departments [ 2 ]. Subspecialized radiology has been implemented in academic centers [ 3 ] but also at larger private and public institutions [ 1 ]. Growing radiology networks and teleradiology services are major trends in radiology, which have resulted in significant changes in radiology [ 4 ].…”

Subspecialized radiology reporting: productivity and impact on the turnaround times for radiology reports in a middle-income country

“…Our results are in line with those of previous reports (1,8) . In a study conducted by Stern et al (1) , a change from general to subspecialized radiology reporting resulted in a significant decrease in the median TAT, which dropped from 17.04 h to 3.38 h. In another study, subspecialized reporting led to an increase in productivity of approximately 7.0% at one year after implementation (8) . In comparison, we found a 19.70% increase in productively after one year of subspecialized reporting.…”