Stark Reminder—Clinical Image Quality Is Paramount

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Despite—and partially because of—the fact that mammography is the most highly regulated procedure in health care’s medicine bag, it was reported this week that more than two thousand women received letters telling them to seek advice from their physician about whether they should be re-imaged.

The sad news that an imaging center in Western Illinois was shuttered after the ACR verified that there were serious image quality problems is a stark reminder that radiologists do not read images in a vacuum.  In this era of remote reading, it is imperative that practices be vigilant about what is and what is not an image of clinical quality.

Thanks to health IT, the imaging chain has become increasingly fragmented, opening a Pandora’s Box full of well-reported troubles for radiology, including undermining the relationship between radiologists and their referrers.

An edited excerpt from Robert Wachter’s “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age,” cannily deploys some of the most quotable meeting moments of the past decade (including Paul Chang, MD’s father’s insistence that PACS ruined his radiology).

Not to pick on PACS, but the practice of remote reading further removes radiologists from the acquisition portion of the imaging chain, with equal potential to negatively impact technologist–radiologist communication. Technologists need radiologist feedback on patient positioning, and to this end, information technology can be a friend as well as a foe.

One could argue that all reads are remote, whether done in the hospital or half a world away, but detachment is insidious. Communication is doubly important under these conditions.

Radiologists, remember: we may be out of sight, but please don’t forget that at the other end of the imaging chain, there is a living, breathing human being, not just a black-and-white picture of anatomy. If you are looking at an image that is not of clinical quality, raise a red flag.

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