James V. Rawson

Social media in radiology: Early trends in twitter microblogging at radiology's largest international meeting

PURPOSE Twitter is a social media microblogging platform that allows rapid exchange of information between individuals. Despite its widespread acceptance and use at various other medical specialty meetings, there are no published data evaluating its use at radiology meetings. The purpose of this study is to quantitatively and qualitatively evaluate the use of Twitter as a microblogging platform at recent RSNA annual meetings. METHODS Twitter activity meta-data tagged with official meeting hashtags #RSNA11 and #RSNA12 were collected and analyzed. Multiple metrics were evaluated, including daily and hourly Twitter activity, frequency of microblogging activity over time, characteristics of the 100 most active Twitter users at each meeting, characteristics of meeting-related tweets, and the geographic origin of meeting microbloggers. RESULTS The use of Twitter microblogging increased by at least 30% by all identifiable meaningful metrics between the 2011 and 2012 RSNA annual meetings, including total tweets, tweets per day, activity of the most active microbloggers, and total number of microbloggers. Similar increases were observed in numbers of North American and international microbloggers. CONCLUSION Markedly increased use of the Twitter microblogging platform at recent RSNA annual meetings demonstrates the potential to leverage this technology to engage meeting attendees, improve scientific sessions, and promote improved collaboration at national radiology meetings.

Strategies for Managing Imaging Utilization

Imaging represents a substantial and growing portion of the costs of American health care. When performed correctly and for the right reasons, medical imaging facilitates quality medical care that brings value to both patients and payers. When used incorrectly because of inappropriate economic incentives, unnecessary patient demands, or provider concerns for medical-legal risk, imaging costs can increase without increasing diagnostic yields. A number of methods have been tried to manage imaging utilization and achieve the best medical outcomes for patients without incurring unnecessary costs. The best method should combine a prospective approach; be transparent, evidence based, and unobtrusive to the doctor-patient relationship and provide for education and continuous quality improvement. Combining the proper utilization of imaging and its inherent cost reduction, with improved quality through credentialing and accreditation, achieves the highest value and simultaneous best outcomes for patients.

The Cost of Disruptive and Unprofessional Behaviors in Health Care

RATIONALE AND OBJECTIVES In an era of decreased reimbursements and rising expenses, academic health care systems are seeking alternative sources of funding. We hypothesized that the costs associated with disruptive physician behavior represented a source of potential savings and hence a possible financial stream which could be redirected to support other academic activities. MATERIALS AND METHODS To test this hypothesis, we reviewed costs associated with disruptive behavior in clinical and education settings and estimated their savings in academic health care systems. RESULTS In a 400 bed hospital, the combined costs for disruptive physician behaviors (due to staff turnover, medication errors and procedural errors) exceed

Professional Social Networking in Radiology: Who Is There and What Are They Doing?

1 million. CONCLUSIONS Reducing disruptive physician behavior in academic health care systems is a potential funding stream with the added benefits of improved patient safety, reduced medical errors and improved medical student/resident education.

Roots of Health Care Reform

RATIONALE AND OBJECTIVES Although it is perceived that the use of social media professionally is increasing among radiologists, little is known about the habits and demographics of this subspecialty. This study aims to compare radiologists who use social networking for professional purposes to those who do not with regard to their characteristics, habits, and attitudes. MATERIALS AND METHODS Radiologists were invited by e-mail and through posts on social networks to participate in a survey on the use of social media platforms. Questions included type of user, pattern of use, and benefits and barriers. Professional users and professional nonusers were compared. RESULTS One hundred eighty-six radiologists responded. One hundred ten (59.1%) used social networking for professional purposes, 34 (18.2%) for personal-use only, and 42 (22.6%) denied using social media. LinkedIn was the most common platform among all professional users, and Twitter was the most commonly used platform among highly active professional users. Trainees comprised 52 out of 110 (47.3%) professional social networking users compared to 18 out of 76 (23.7%) nonusers (P < 0.01). A subgroup analysis on Twitter use for professional purposes revealed a significant gender difference: 15 out of 66 (22.7%) professional Twitter users were female compared to 48 out of 120 (40.0%) non-Twitter users (P < 0.05). The greatest barrier to professional social media use for nonusers was confidentiality. CONCLUSION Nearly 60% of radiologist respondents use social networking for professional purposes. Radiology is likely to see growth in the role of social networking in the coming years as nearly half of professional users are radiology trainees. Twitter use for professional purposes among radiologists was disproportionately male. It is important to be cognizant of gender imbalance and to improve visibility of female leaders on social networking.

How to Critically Appraise the Clinical Literature

The health care reform legislation of 2010 was a response to chronic issues in the US health care system that had been unresolved for decades. Whether health care reform is implemented in its current form or in a variant, the issues to address remain the same. In addition, those issues that have not been specifically addressed in national legislation remain areas of potential future policy.

Patient- and Family-Centered Care: A Primer

Recent efforts have been made to standardize the critical appraisal of clinical health care research. In this article, critical appraisal of diagnostic test accuracy studies, screening studies, therapeutic studies, systematic reviews and meta-analyses, cost-effectiveness studies, recommendations and/or guidelines, and medical education studies is discussed as are the available instruments to appraise the literature. By having standard appraisal instruments, these studies can be appraised more easily for completeness, bias, and applicability for implementation. Appraisal requires a different set of instruments, each designed for the individual type of research. We also hope that this article can be used in academic programs to educate the faculty and trainees of the available resources to improve critical appraisal of health research.

Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination

Patient- and family-centered care is a model of providing care in which the patient and family are partners with the provider and care team. A resurgence of interest in patient- and family-centered care is due, in part, to increasing consumerism in health care and the linking of reimbursement to the patient experience. Individual radiologists, practices, enterprises, and radiology professional societies have been engaged with patient- and family-centered care in varying degrees for many years. Understanding the roots and evolution of this care model will encourage further application of these principles in radiology.

Balancing the Three Missions and the Impact on Academic Radiology

PURPOSE The aim of this study was to examine the referral pattern of imaging studies requested in a single state compared with the potential location of interpretation. METHODS Analysis of Medicare patients in a DocGraph data set was performed to identify sequential different physician services claims for the same patient for which the second claim was for services provided by a radiologist. RESULTS In the 2011 Medicare population, radiology referrals from physicians practicing in Georgia resulted in 76.5% of radiology interpretations by radiologists inside the state of Georgia. The states bordering Georgia accounted for 11.6% of interpretations in the Georgia market. The remaining interpretations were distributed throughout the remainder of the country. CONCLUSIONS A significant proportion of routine imaging interpretation occurs outside the state in which an examination is performed. Additional studies are needed to identify complex drivers of imaging referral patterns, such as patient geographic location and demographics, radiologist workforce distribution, contractual obligations, and social relationships.

Impact of Patient Protection and Affordable Care Act on Academic Radiology Departments' Clinical, Research, and Education Missions

The three missions of academic radiology compete with one another for time and funding. Revenue for the clinical mission often subsidizes education and research. Given the internal and external drivers/pressures on health care and, more particularly, on academic health centers, the current model is unsustainable. Trends seen in other industries are entering academic health care. The radiology department of the future will need to be more efficient with increasingly fewer resources while meeting its missions at higher levels of expectation.