For the entirety of the specialty of radiology's history, the written radiology report has been the primary vehicle for diagnostic radiologists to deliver their professional services. Today, the vast majority of radiology interpretive reports remain word-only, unstructured documents. But this may be changing.

This week, the Healthcare Information and Management Systems Society (HIMSS) and the Society for Imaging Informatics in Medicine (SIIM) published a white paper addressing those possible changes in the Journal of Digital Imaging. The HIMSS-SIIM Enterprise Imaging Community work-group outlined the current and desired future clinical applications of interactive multimedia reporting (IMR).

Today, diagnostic radiologists most commonly create reports to answer diagnostic questions posed by patients' treating physicians. The work-group notes that most PACS systems used by radiology departments for diagnostic reporting allow radiologists to annotate images and tag “key” images the interpreting radiologists feel are especially noteworthy.  Direct launch from a report to relevant images with measurements and other annotations eases image and text consumption, as reviewers need not launch and log into a separate viewer, scroll through lower yield images, or exert time and effort to visualize the findings of concern.

The work-group believes that radiologists could increase their own professional value by embracing IMR, but reporting that incorporates new interactive features is rare in radiology despite the benefits of integrating images into text reports (which can include adding hyperlinks, tables, timelines, annotations, and other tools.) The most common barriers to radiology IMR include compatibility issues with the dominant EHR system, the significant number and types of radiology images used in the industry, limited utilization of structured reporting, and overcoming real or perceived disincentives to create interactive multimedia reports.

The HIMSS-SIIM Enterprise Imaging Community work-group did not ignore the economic barriers to the full integration of IMR into diagnostic radiologists' practices. Healthcare reimbursement is still largely fee-for-service and productivity-based, and any activity impairing productivity, even minimally, faces resistance. In addition, the personnel and technology needed for the necessary image capture, storage, and curation can be cost-prohibitive. Nevertheless, the work-group believes that IMR may become a competitive advantage for practices with interoperable systems that facilitate it, especially if the value of improved communication and patient care can be quantified.