DI Community Meeting Agenda - Friday October 20th

Draft Use Case for call today.

User case scenario for Peer Review



One billion radiology studies are performed annually with an error rate of approximately 4%, which translates in 40 million errors per year. The leading cause of malpractice law suits against radiologists is the incorrect interpretation of studies.

There has been a series of high profile ­reviews of radiologists in Canada, with media coverage, which resulted in loss of confidence in the profession and serious damages to the radiologists involved. This has raised awareness among radiologists that they have to engage actively in quality control to avoid situations where large scale reviews are mandated by local or regional authorities.

The first peer review solution for radiologists was released in 2002 by the American College of Radiologists (ACR), as a retrospective, passive process where a radiologist reporting a study will review the previous study and score it on a scale from 1 to 4. In recent years, this approach has been challenged as it doesn’t answer to the requirements of effective patient care. Better suited are timed retrospective or ideally prospective peer review.

The regulatory landscape has changed, after a large scale review in British Columbia . Following this review, the report released by Dr. Cochrane in 2011 has issued a number of recommendations, one of them, number 16, being the necessity to implement a standardized retrospective peer review process.

Physician Peer-Review is a requirement for the American College of Radiology (ACR) - voluntary with no penalty other than refusal of accreditation.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Accreditation Council for Graduate Medical Education (ACGME) require all staff to participate in peer review approximately 5% of cases.

The radiologists expect that the peer review process:
Reveals opportunities for quality improvement
Is non-punitive
Helps ensure competence
Helps improve individual outcomes
Is a fair, unbiased, consistent process
Allows trends to be identified
Ensures the opinions of both the reviewers and the radiologists being reviewed are recorded.
Allow assessment of the agreement of the original report with subsequent review (or surgical or pathology findings).
Allows easy participation


The Canadian Association of Radiologists in a white paper released in September 2011 gave its recommendations for a peer-review electronic system:
Include a reactive or proactive double reading with 2 physicians interpreting the same study.
Allow for random selection of studies to be reviewed on a regularly scheduled basis.
Examinations must be representative of each physician’s subspecialty.
Approved classification of peer-review findings with regard to level of quality concern.
Has minimal effect on workflow
Fair, unbiased, consistent process ensuring confidentiality for all aspects of peer review and anonymity for reporting and reviewing radiologists when possible.
Summary statistics can be generated and comparisons shown for each physician by modality to help the coordinator assess performance standards.
Summary data for each facility or practice by modality can be obtained to aid the departmental QA program.


There is a need for a standardized approach to electronic peer review within and between institutions, to ensure that implemented peer review programs provide essential functionality as listed above. This would also allow organizations that are engaging in a process to purchase or otherwise implement a peer review system to have a defined standard to require, so that they have confidence in the system that they will be selecting.

Hi All -

The agenda for today's meeting is listed below:

DI Working Group Agenda: October 20, 12pm-1pm EST

Thanks,
J