- Call the result to the ordering clinician. They love it when I do this, but you just can't call each and every case and still have time to read the day's stack/pile/worklist.
- Yell it out to your secretary/aide/resource person so they can call it in for you.
- Dictate it and press some sort of priority key which, in theory, is connected to a buzzer or electroshock equipment somewhere in the vicinity of your transcriptionists to alert them to drop everything and transcribe your study first. They are then to fax it or read it over to the phone to the illustrious ordering physician, or at least to one of his/her minions.
- Dictate into a voice-recognition system, edit the report, autofax it to said illustrious clinician.
- Type a brief preliminary report into the appropriate field in the PACS system; the clinician knows to look here as soon as the exam is toggled as "read".
Of all these wonderful options, I like the one where I yell at my helper, but good helpers are hard to find these days, especially if you yell at them constantly. From various threads on the VR topic, I am firmly convinced that it is not ready for prime time, and has the potential for administrative abuse in replacing transcriptionists with radiologists who are forced to do all the editing themselves. Sorry, I have enough going on during the day that I don't need yet another job-title. I suppose the absolute ideal would be a transcription pool so vast, fast, and accurate that the minute I press "end", the report is en route to its destination. All that takes is a tremendous amount of money, right? No problem. Oh well, it looks like Option 5 seems to be the best compromise, at least for stat call reports to the ER and to others similarly equipped with PACS viewers.
This should be a simple task, but alas, it isn't as easy as it looks. The big question is where do you put this "comment window", and how do you signal the docs that there is something to be read? Rather than give you the blow-by-blow (or the yawn-by-yawn) of which company does what, let me create the image in your mind of the perfect woman, oops, I mean perfect comment system...had you going there, yes? Personally, I'm a one-stop shopper. Give me the Mall of America with a zillion stores under one roof rather than Michigan Avenue where I have to walk outside in Chicago weather, which ain't pretty around RSNA time. I want a complete, combined demographic and comment window, with a field for me to type in my own, well, comments. There should be a flag on the worklist to show if there are comments from the technologists and/or the radiologist. If your worklist doesn't take up the entire screen, it would be nice for this window to live below the worklist, and be populated with the proper information for the active study. Otherwise, it could be a floating window that appears when you click the study for display. Simple enough, yes? OK, someone go program this and let me know when its done. I'm going to go yell at my helpers.
I think I need to flesh this out just a little more. We are having a bit of a discussion with Amicas about whether or not this Super Duper Whiz Bang Master Comment, Demographic, and Preliminary Report window should pop up all by itself or not. My PACS admin thinks it should, but frankly, I really am not all that concerned. I like to have the option to do it myself. The auto-pop-up thing acts too much like a pop-up ad for my taste, plus it usually ends up covering something I want to see anyway. I would just as soon click a button to get it. BUT, I would like to see a flag on the worklist to show if there is a technologist or a radiologist comment to be viewed.
Agfa has a potentially useful addition to its comment field: precanned preliminaries. This saves you from typing the same thing 5,000 times a day. It's a good idea, but their implementation is typically harder to use than it has to be. (Are you listening, Waterloo?) You click in the comment window which spawns a second comment window which in turn has three panes (as in window panes). The top pane has the precanned report selection, the middle is a free-form area to write your own, and the bottom shows the conglomerate of your selections. The odd thing is, you can type directly into the bottom, final pane, so why the middle one? I must be missing something. When finished, you must click Save, which places your beautiful prose back into its proper field in the information window. Ducky. Why can't we just type straight into that area, huh? Doesn't allow for precans you say? Well, how about making the precans available by via right-clicking in the field? I like it, although if you have too many precans you might end up with a famous case of Dalai's Right-Click-O-Rrhea. It's worth the risk in my opinion. All systems need to autostamp with ID, time, and date, and that has to be permanent. No fair going back and changing all of your partner's preliminaries to "normal" or "31 week gestation". OK, guys and gals...get programming!