Development and Implementation of a Multisite Registry Using Structured Templates for Actionable Findings in the Kidney |
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| Affiliation: | 1. Director, 3D and Advanced Imaging Laboratory, and Director, Center for Practice Transformation in Radiology, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;2. Center for Research and Innovation, American College of Radiology, Philadelphia, Pennsylvania;3. Lead Statistician, Center for Research and Innovation, American College of Radiology, Philadelphia, Pennsylvania;4. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;5. Director, Software Engineering, American College of Radiology, Reston, Virginia;6. Medical Director, Jefferson Outpatient Imaging-Collegeville and Washington Township, Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania;7. Chief, Division of Abdominal Imaging, Medical Director, MRI, and Co-Director, Division of Radiology Innovation and Value Enhancement, Department of Radiology, Penn State Hershey Medical Center, Hershey, Pennsylvania;8. Associate Vice Chair Quality, Radiology, Perelman School of Medicine, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania;1. Chair, Commission on Quality and Safety, ACR; Member, Board of Chancellors, ACR; and Vice Chair, Education and Clinical Operations, Department of Radiology, Stanford University School of Medicine, Stanford, California;2. Chair, Commission on Patient- and Family-Centered Care, ACR; Member, Board of Chancellors, ACR; and Chief, Division of Body Imaging, Department of Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Virginia;3. Vice Chair, Informatics, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York;4. Member, Board of Directors, RSNA, and Associate Chair, Information Systems, Department of Radiology, Stanford University School of Medicine, Stanford, California;5. Chair, Commission on Informatics, ACR; Member, Board of Chancellors, ACR; and Chair, Department of Radiology, Lahey Hospital and Medical Center, Burlington, Massachusetts;6. Tufts University Medical School, Boston, Massachusetts;1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York;2. Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York;3. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York;4. Assistant Program Director, Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York;5. Deputy Physician-in-Chief for Strategic Partnerships and Vice Chair, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York;6. Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York;1. Associate Section Chief, Breast Imaging and Intervention Section, Associate Program Director, Breast Imaging Fellowship, and Associate Program Director, Diagnostic Radiology Residency, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;2. Assistant Professor, Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;3. Associate Dean of Team Science and Interdisciplinary Research and Deputy Executive Director of the Institute for Clinical and Translational Research, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;4. Chief, Breast Imaging at Magee-Womens Hospital of UPMC, Director, Quality in Breast Imaging, and Vice Chair of Quality Assurance and Strategic Development, Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania;5. Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania;6. Executive Vice President for Quality and Safety, American College of Radiology, Reston, Virginia;7. Peer Learning Lead Long Island Division Breast Imaging NYU, Department of Radiology, NYU Langone Health, New York, New York;1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;2. Radiology Quality and Patient Safety Officer, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts;3. Vice Chair for Quality, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;4. Associate Chair for Enterprise Informatics/IT, Department of Radiology, Massachusetts General Hospital, Harvard Medical School Boston, Massachusetts;1. Roslyn, New York;2. Einstein Healthcare Network, Philadelphia, Pennsylvania |
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| Abstract: | PurposeThe aim of this study was to scale structured report templates categorizing actionable renal findings across health systems and create a centralized registry of patient and report data.MethodsIn January 2017, three academic radiology departments agreed to prospectively include identical structured templates categorizing the malignant likelihood of renal findings in ≥90% of all adult ultrasound, MRI, and CT reports, a new approach for two sites. Between November 20, 2017, and September 30, 2019, deidentified HL7 report data were transmitted to a centralized ACR registry. An automated algorithm extracted categories. Radiologists were requested to addend reports with missing or incomplete templates after the first month. Separately, each site submitted patient sociodemographic and clinical data 12 months before and at least 3 months after enrollment.ResultsA total of 164,982 eligible radiology reports were transmitted to the registry; 4,159 (2.5%) were excluded because of missing categories or radiologist names. The final cohort included 160,823 examinations on 102,619 unique patients. Mean template use before and after addendum requests was 99.3% and 99.9% at SITE1, 86.5% and 94.6% at SITE2, and 91.4% and 96.0% at SITE3. Matching patient sociodemographic and clinical data were obtained on 96.9% of reports from SITE1, 94.2% from SITE2, and 96.0% from SITE3. Regulatory, cultural, and technology barriers to the creation of a multisite registry were identified.ConclusionsBarriers to the adoption of unified structured report templates for actionable kidney findings can be addressed. Deidentified report and patient data can be securely transmitted to an external registry. These data can facilitate the collection of diverse evidence-based population imaging outcomes. |
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| Keywords: | Structured reporting actionable kidney imaging findings clinical radiology registry |
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