Implementation and Validation of PACS Integrated Peer Review for Discrepancy Recording of Radiology Reporting.

The purpose of this work is to demonstrate the possibility of implementation of a PACS-integrated peer review system based on RADPEER™ classification providing a step-wise implementation plan utilizing features already present in the standard PACS implementation and without the requirement of additional software development. Furthermore, we show the usage and effects of the system during the first 30 months of usage. To allow fast and easy implementation into the daily workflow the key-word feature of the PACS was used. This feature allows to add a key-word to an imaging examination for easy searching in the PACS database (e.g. by entering keywords for different kinds of pathology). For peer review we implemented a keyword structure including a code for each of the existing RADPEER™ scoring language terms and a keyword with the phrase "second reading" followed by the name of the individual radiologist. The use of the short-keys to enter the codes in relation to the peer review was a simple to use solution. During the study 599 reports were peer reviewed. The active participation in this study of the radiologists varies and ranges from 3 to 327 reviews per radiologist. The number of peer review is highest in CT and CR. There are no significant technical obstacles to implement a PACS-integrated RADPEER™ -system based on key-words allowing easy integration of peer review into the daily routine without the requirement of additional software. Peer review implemented in a non-random setting based on relevant priors could already help in increasing the quality of radiological reporting and serve as continuing education among peers. Decisiveness, tact and trust are needed to promote use of the system and collaborative discussion of the results by radiologist.