Communicating Learning Opportunities in Interventional Radiology: Initial Experience with a PACS Embedded Peer Learning Tool

Wednesday, March 8, 2023

3:18 PM – 3:27 PM

Location: Phoenix Convention Center, 221C

Presenting Author(s)

Daniel I. Glazer, MD, FSAR (he/him/his)

Assistant Professor of Radiology, Harvard Medical School
Brigham and Women's Hospital

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

MS

Matthew Schenker, MD

Chief, Division of Angiography and Interventional Radiology
Brigham and Women's Hospital
KB

Kristine Burk, MD

Staff Radiologist
Brigham and Women's Hospital
NV

Nicole Vetrano, MHA

Program Manager - Center for Evidence Based Imaging
Brigham and Women's Hospital
Dania Daye, MD, PhD

Assistant Professor of Radiology
Massachusetts General Hospital/ Harvard Medical School
Sanjeeva Kalva, MD, FSIR, FCIRSE, FACR (he/him/his)

Professor
Massachusetts General Hospital
RK

Ramin Khorasani, MD, MPH

Vice Chair, Department of Radiology
Massachusetts General Hospital

Disclosure(s):

Daniel I. Glazer, MD FSAR: No financial relationships to disclose

Dania Daye, MD, PhD: medtronic: Consultant (Ongoing)

Sanjeeva Kalva, MD, FSIR, FCIRSE, FACR: BD Bard: Consultant (Ongoing); Biogen Inc, Clover Health Investments Corp, Inovio Pharmaceuticals, Moderna Inc, Pfizer Inc, Novavax Inc, Orphazyme, Cassava Sciences Inc, Vivos Therapeutics Inc, Ardelyx Inc, Althea Health, Sarepta Therapeutics, Clover Health Investments Corp, CureV: Ownership Interest (Ongoing), Stocks (Ongoing); Boston Scientific Corp: Consultant (Ongoing); Canon Medical: Consultant (Ongoing), Speaking and Teaching (Ongoing); Covidien/Medtronic: Consultant (Ongoing); Instylla, Inc.: Consultant (Ongoing); Okami Medical: Consultant (Ongoing); Penumbra Inc.: Consultant (Terminated), Speaking and Teaching (Terminated); Sirtex Medical: Consultant (Ongoing); Varian: Consultant (Ongoing)

Purpose: To evaluate the usage of a PACS embedded peer learning tool (IR-PEER) designed for interventional radiology (IR).

Materials and Methods: This retrospective study was performed at a large academic medical center 3/8/21-5/15/22. IR-Peer is a PACS-integrated information technology tool that provides closed-loop radiologist to radiologist feedback regarding IR procedures. Feedback is provided via the initiation of an electronic alert entered by radiologists. Alerts were reviewed by two radiologists who determined if they were related to IR and if they were clinically meaningful. All cases of disagreement were resolved by a 3^rd radiologist. Primary outcome was percentage of IR alerts that were clinically meaningful. Secondary outcome was proportion of liver biopsies resulting in a learning opportunity alert with IR-PEER compared to the traditional safety reporting system. Additionally, a natural language processing (NLP) tool was utilized to identify adverse events following liver biopsy documented in radiology reports. Proportions were compared using a Chi-Square test and inter-reader agreement assessed by Cohen’s kappa statistic.

Results: 483 alerts were entered into the reporting system regarding 34,689 IR procedures. Of these, 375 (77.6%) were appropriately filed while the remaining 108 were unrelated to IR. Inter-reader agreement for meaningfulness was excellent (k=0.91) with the two radiologists only disagreeing on 3.3% (16/483) of alerts. Of the 375 IR related alerts, 98.4% were determined to be meaningful (369/375). Learning opportunities were reported following 8.1% (47/583) of liver biopsies in IR-PEER and 2.2% of liver biopsies (13/583) using the traditional safety reporting system (p< 0.001). NLP search of radiology reports identified an adverse event following 1.0% (6/583) of liver biopsies, fewer than the proportion of learning opportunities generated by IR-PEER (p< 0.001) but not different from the traditional safety reporting system (p=0.16).

Conclusion: Initial pilot with a peer learning tool for IR demonstrates that nearly all alerts were clinically meaningful. More learning opportunities were captured with IR-PEER than the traditional safety reporting system.