The Department of Radiology and Imaging Sciences at Emory University School of Medicine partnered with Carestream to seek out the perceived value of using multimedia-enhanced radiology reports (MERR) vs. the traditional text reports. The results overwhelmingly favored the MERRs.

1. Traditional Text-only vs. Multimedia Enhanced
Radiology Reporting:
Referring Physicians’ Perceptions about Value
Gelareh Sadigh MD1, Timothy Hertweck BA2, Cristine Kao BSc 3,
Paul Wood BA2, Danny Hughes PHD4, Richard Duszak, Jr. MD1,4
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
2 IDR Medical GmbH, Boston, MA
3 Carestream Health, Inc., Rochester, NY
4 Harvey L. Neiman Health Policy Institute, Reston, VA

2. Disclosures
Gelareh Sadigh: Nothing to disclose.
Timothy Hertweck: Vice president of IDR Medical.
Cristine Kao: Vendor partner that supplies the technology for the research.
Paul Wood: Director of IDR Medical.
Danny Hughes: Nothing to disclose.
Richard Duszak: Nothing to disclose.

3. Traditional Text-only Reports
Historically, radiology reports have
been generated in traditional text-
only format, probably partly related
to cultural inertia and the lack of
widely available enabling software
platforms.

4. Multimedia-Enhanced Radiology Reporting (MERR)
With technological
advances, a transition
to commercially
available PACS-
integrated technology
such as MERR is now
feasible.
*Patient names in images are fictitious.

5. *Patient names in images are fictitious.
With MERR, referring
physicians and radiologists
are more easily able to
assess the measurements
of a mass/lesion/nodule
and its changes over time
in form of Tables…

6. …and in the
form of Graphs…

7. *Patient names in images are fictitious.
…or by viewing
relevant
comparison
images
themselves.

8. Additionally, data and
key images can be
printed without a
computer viewer for
physicians who prefer to
receive reports in a
paper format.

9. Purpose
• To explore referring specialist physicians’ satisfaction with the
format of traditional text-only radiology reports.
• To study their perceptions of the value of an early MERR
platform and its potential impact on their referral behavior.

10. Methods
A web-based survey was created for:
a) Medical oncologists
b) Radiation oncologists
c) Neurosurgeons
d) Pulmonologists
Practicing in the United States.

11. Inclusion Criteria:
• > 2 years in practice after residency/fellowship training.
• Personally referring ≥10 patients/week to a radiology
department.
Enrollment terminated when qualifying responses from 50
physicians for each of the four included specialties were
obtained (total of 200).

12. 22-question survey with questions on:
• Participant demographics.
• Opinions on the format of currently received radiology
reports and level of satisfaction.
• Perceived value of MERR as an alternative reporting
mechanism.

13. Results
• 200 survey respondents
• Mean age: 46 years
• Mean post training practice: 15 years
• 85% male
• 47% from academic medical centers

14. Current Radiology Reports Format
Paper vs. Electronic
2% 6%
12%
2% 6%
26%
26%
24%
32% 27%
72% 68% 64% 66% 68%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Medical
Oncology
Neurosurgery Radiation
Oncology
Pulmonary
Medicine
Total
Only Paper Only Electronic Electronic and other formats
Text only vs. Text & Image
40%
60%
46% 50% 49%
60%
40%
54% 50% 51%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Text Only reports Reports including images

15. Satisfaction with Current Reports
4.9 5.7
0
2
4
6
Text only reports Text & Image
reports
Level of Satisfaction (1-7 scale)80% were satisfied (score > 5)
with the current format of their
radiology reports.
Satisfaction levels were higher
with combined text & image
reports vs. text-only (P <0.001).

16. Perceived Value of MERR
80% believed MERR would represent an improvement over current
format of radiology reports:
• Improved understanding of findings by correlating images to text reports
(86%)
• Easier access to images while monitoring progression of a condition (79%)
• Time saved trying to understand findings without supporting imaging
(66%)
• Easier access to images while planning treatment (64%)

17. Perceived Value of MERR
28% had concerns regarding
implementation of MERR:
• Too time intensive (15%)
• Clinic workflow does not allow
itself to view reports in such a
fashion (12%)
Information
overload;
multimedia reports
are very "busy“
– Pulmonologist
Resistance to
adopt by less
tech-savvy
colleagues
– Pulmonologist
Radiologists will
not spend the time
to make the
annotations as
even now they do
not write good
reports
– Pulmonologist
The amount of computer space
needed may be too much/time to
retrieve or upload may be too long
– Pulmonologist
Data overload
– Radiation
Oncologist
It will take too long to
load everything –
Radiation Oncologist
Will likely involve even
longer wait at terminal
waiting for report images
to appear
– Medical Oncologist
I don't want that up in the
OR when I am operating-
need the studies only
– Neurosurgeon

18. Impact of MERR on Referring Behavior
• 80% indicated an increased likelihood of preferentially
referring patients to facilities that offer MERR.
• 79% indicated an increased likelihood of recommending
peers use facilities offering MERR.

19. Impact of MERR on Patient Communication
• 67% believed using MERR, they would be more likely
to review report text and images with patients.
• 65% believed using MERR, they would be more likely
to provide patients access to report text and images.

20. Conclusion
• Surveyed referring physicians strongly view image- and data-
embedded multimedia enhanced radiology reporting as an
improvement over traditional text-only radiology reporting.
• Large majorities of referring physicians indicate that they
would preferentially refer patients and peers to facilities that
adopt more interactive user-friendly enhanced reporting
practices.

21. Thank You!
Questions?
gsadigh@emory.edu