Opportunities for Enhanced Medical Data Access and Communication – An Inspiring Discussion with Resident Doctors

Any successful community, including the medical industry, relies on effective communication. Effective communication is more than a desirable trait in the complicated and dynamic world of healthcare; it is a fundamental requirement. The value of clear and efficient communication within the medical community cannot be understated, as it supports patient care, collaboration among healthcare workers, and the overall performance of healthcare systems.

In a brief conversation, I will share the perspectives of two resident physicians from the same city, but with different contractors. Physician A is a fourth-year resident doctor in radiology, while Physician B is a fifth-year resident doctor in pulmonary medicine. I greatly admire their pragmatic attitude.

1. How do you currently collaborate on medical imaging data with your fellow residents and other healthcare professionals? Are there any challenges you face in terms of accessibility, sharing, or coordination of this crucial information?

Resident Physician A: Traditional and digital communication methods are used in our medical imaging department to collaborate on medical imaging data. Our main tool is the Picture Archiving and Communication System (PACS), which makes it easy for residents and medical staff to access and share medical images. We can effectively store, retrieve, and disseminate medical images, including MRIs, CT scans, and X-rays, thanks to this technology, but we continue to burn CDs. We have trouble opening medical images that come from different labs or hospitals.

Resident Physician B: In our medical department, we also use PACS, and it's helpful for analysing the medical imaging that our department has taken. However, because the PACS is not inter-connected, I am unable to discuss images with coworkers who work at the other county hospital, even though we are only 500 meters apart in the same city. Essentially, we walk to retrieve the CD if our patient is at another hospital. Indeed, there are issues with opening the imaging data that is sent to us from other imaging labs. Radiant is the primary program used to access radiological images; however, some investigations, including PET-CT, are difficult to open.

2. Can you share an instance where the lack of interoperability hindered effective collaboration or coordination in patient care? What improvements or features would you envision to address such issues?

Resident Physician A: We had a patient with a possible stroke, which was basically an immediate situation. And he was investigated at the other hospital two days ago. But we couldn’t access the medical files or see previous investigations. So we took a full-body CT to exonerate as many pathologies as possible. After a few hours, the medical files arrived, and we could compare the investigations to see if it was spontaneous or chronic. The good news is that he did not have a stroke; the bad news is that he had 2 CT scans in less than 3 days. It is also a problem that the medical files are not available on a common platform. Most people think that being a radiologist means seeing some images and describing them, but no, we need to analyze the medical environment of our patients to be more specific and guide our clinicians to the right diagnosis.

Resident Physician B: I can still recall a case from a few weeks ago. This patient was from a different county. We conducted the anamnesis; we reviewed the medical records he carried; he informed us that an "abdominal echography" had been performed, but he had misplaced the files; additionally, the patient was unable to provide a detailed account of the study. He visited our facility due to a chronic cough that wouldn't go away. He experienced hematemesis the following day; therefore, we made a consultative call to gastroenterology (investigating the cause, making calls, and spending time describing the situation). After bringing our patient to gastroenterology, an endoscopy revealed that ulcerative duodenal gastritis was the cause of the bleeding. After receiving treatment, he returned to our clinic. ”They did the same "ecography," he informed me, when the patient arrived. Essentially, a gastro-duodenal endoscopy was performed to examine him at his county hospital. We called his county hospital and asked them to email as many records as they could so that his chronic care could continue.

3. In your experience, how important is real-time access to medical imaging data for collaborative decision-making during patient rounds or consultations? Have you encountered situations where delayed access to such information impacted patient outcomes or slowed down the decision-making process?

Resident Physician A: From what I've seen in my job so far, waiting too long to get medical scan data has unfortunately led to real problems with patient care. In one example, a patient with a suspected cardiac condition required immediate attention. However, due to a technical issue in the imaging system, access to the required scans was delayed. This delay in receiving key imaging information hampered the cardiology team's ability to make timely decisions during the patient consultation. It not only lengthened the diagnostic process but also delayed the start of suitable treatment. The fact that the patient's outcome suffered as a result of the delay in receiving crucial imaging data demonstrates how crucial real-time access is in medical situations where time is of the essence.

Resident Physician B: It is crucial. Most of the time, when we have a critical patient, we need to see investigations performed as fast as possible. In a critical care case, for example, the patient's state changed quickly, so the treatment plan had to be changed right away. The medical team was able to see how things were changing and make important choices quickly by looking at recent imaging scans in real-time and lab findings. The immediate availability of information made it easier for team members to talk to each other and work together, which led to a coordinated and timely reaction that improved the patient's outcome. In contrast, when real-time access was lost, the decision-making process eventually began to take longer. We weren't able to respond quickly to changing clinical situations because it took too long to get imaging data, which could have been caused by technical problems or complicated procedures. These events showed how important it is to have easy access to medical imaging data during rounds with patients so that everyone can work together well and, eventually, patients have better outcomes.

4. How do you currently communicate findings or insights derived from medical imaging data to your colleagues across different departments or specialties? Are there any gaps or inefficiencies in the current system that an interoperable platform could address to enhance cross-disciplinary collaboration?

Resident Physician A: At the moment, medical imaging data results or insights are shared with coworkers from different departments or specialties through a variety of channels, such as emails, written reports, and face-to-face meetings, as well as PACS when we talk about the same hospital. Traditional ways of communicating have their uses, but they also have flaws and gaps that make it harder for people from different fields to work together easily. Plus, since there isn't a standard platform, each area may have its own favorite software or tools for looking at and understanding medical images. It can be hard for colleagues from different fields to understand the imaging data in a way that is consistent and unified because of the wide range of systems available. These errors can make it take longer to make decisions as a group and can affect patient care. An interoperable platform that gives everyone a central, standardized way to share medical imaging findings could solve these issues. Professionals from different departments would be able to access, study, and talk about imaging data consistently and efficiently if there was such a platform.

Resident Physician B: I agree with my colleague. It will be much easier to have common access to an interoperable system. For example, one big problem is that the shared information isn't always easy to find or understand. Medical imaging files are typically large, especially those with high resolutions or representations in three dimensions. They might not be easy to send through regular email systems. This makes it hard for coworkers from different areas who might need to look at and analyze these images together. 

5. As a medical resident, how do you envision an ideal interoperable platform for medical imaging data that facilitates seamless collaboration and coordination? What specific features or functionalities do you believe would significantly improve your workflow and contribute to better patient care?

Resident Physician A: If I were to dream about it, I would have access to it from any location. As an illustration, I might be able to access a CT remotely, generate a description thereof, and subsequently forward it to my residency program coordinator for review and approval. As previously stated, perhaps a platform would allow me to view all of my patients' investigations to assist the clinician in arriving at a particular diagnosis. That will certainly conserve time.

Resident Physician B: That sounds fantastic. To maintain the ability to monitor a patient at any given moment. Moreover, if a patient travels a considerable distance, an interoperable platform could prove advantageous in assessing the situation, determining one's capability to resolve the problem, and potentially offering a recommendation in this particular instance.

6. Do you use any apps or websites in order to enhance collaboration and communication within the healthcare community?

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