This month we sat down with Chris Mitchell, Network Radiation Safety Officer at Kettering Health, one of the sites that utilizes ZapIT, Enzee’s quality control (QC) workflow and data management tool for radiology and radiation oncology. Chris, who has spent more than two decades in radiation safety, oversees that function for eight hospitals and five cardiac clinics, as well as 55 additional sites with radiation generating equipment. In other words, Chris has a lot of responsibility.
Enzee: How much hands-on management is required for a network of the size you manage?
Chris: QC/QA at Kettering Health is a huge undertaking, just between the number of sites and people involved. We also lead accreditation for radiology and nuclear medicine, and oversee MR safety across the network. To answer your question, there’s a lot of hands-on management, especially because I do a lot of auditing in addition to managing the team.
Enzee: Tell us a bit about the auditing across your network (and bravo for making that part of your management, by the way.) CEO Bryon Murray talks about how making audits a regular thing instead of a fire drill is one of the best ways to ensure organizations remain inspection ready!
Chris: Before we implemented ZapIT a couple of years ago, we had two ways of performing QC. The first was on paper, which made audits very difficult, because I had to physically go to every single site. Even if that part wasn’t a chore, the actual auditing of paper records was also time consuming, since you have everything from sloppy handwriting to missing records to contend with. The second way it was being done was in Excel spreadsheets. With both of these methods, the images weren’t attached, so we had to trust the measurements the technologists had taken and entered–there was no way to double check the numbers.
Enzee: So you’re dealing with everything from personnel shortages to simple human error when it comes to paper data management.
Chris: Right. And beyond staffing shortages, which we’re suffering just like everyone else across the country, it was usually third shift that entered in that QC data. And those were frequently agency staff, not full time techs, so there was a learning curve in terms of the way we did things.
Enzee: Tell us about how you’re doing things now in terms of QC in radiology at Kettering.
Chris: We wanted a solution to move away from paper quality assurance, and I’d had some experience with Enzee’s ZapIT, so that is what we chose. We also use the auto analysis program, which allows us to send in the QC images and the application analyzes those for us, which saves the techs a lot of time and also reduces the potential for human error. The application sends the results back, and the technologists just input the results. By utilizing ZapIT, we’ve seen our QC compliance percentage increase from 90% to consistently over 99%.
"By utilizing ZapIT, we’ve seen our QC compliance percentage increase from 90% to consistently over 99%." - Chris Mitchell, Kettering Health
Enzee: We love to hear that, that’s great. Let’s shift gears a bit. Where else are you finding workflow improvements for data management in healthcare?
Chris: One of the other places we’re automating data management in radiology is in dose tracking and reporting. The state of Ohio requires that we do a dose review on an annual basis. Just like we saw in radiology QC, when humans are the ones inputting data, you get mistakes. You get a decimal point in the wrong place, or just data that’s missing entirely, which skews the results. Our dose track system allows us to automate all of that.
We get structured dose reports from each scanner that go directly into our dose track product. We can easily pull those reports, and they go directly to the American College of Radiology (ACR) and their dose index registry, which allows us to benchmark our dose against everyone else in the country. This system made our annual dose review much easier this year, and it saved me at least four days of digging through data, since the report was generated automatically and plopped on my desk.
We use this process for angiographic fluoroscopy, the cath lab, interventional radiology–basically any area where we’re using high-dose fluoro.
Enzee: That’s great, and it definitely makes things easier on the workflow and hands-on side. Do you think this kind of healthcare automation has a benefit to the quality of patient care?
Chris: Absolutely. As an example, we’re able to get information in real time, rather than months later when I’m running a report. This means that if a patient has a side effect from an interventional fluoroscopy procedure after a prolonged exposure–a burn, or some other issue–we can get dosage information to the physician immediately. The doctor can follow up with the patient, and within CT, we can adjust protocols immediately if necessary, rather than just revisiting the issue annually. That directly impacts the quality of care we’re offering to patients.
Enzee: That’s great. Where else are you managing data electronically?
Chris: A few other places. Lead apron tracking, actually. Having that managed electronically has made it so much easier, and been a huge help. The next thing we’d really like to get on board is credentialing. Staff credentialing, physician credentialing. Right now we have a database for equipment management through ZapIT, and I could see something similar with credentialing.
Enzee: We’re working on it! Talk a little about equipment reporting, because not all of our sites actually employ this feature, and it is really very useful.
Chris: Definitely. The equipment reporting within ZapIT has been awesome because we can track required service on a piece of equipment, and track follow ups. It’s been a game changer, honestly. Instead of going into ten different file boxes to track down a report, it’s right there in the application.
Enzee: Great. So in your opinion, would you say the future of healthcare is paperless?
Chris: There’s a difference between paperless and paper LESS, right? There are some things for which I still like to have a piece of paper, a report or something I’ve printed, like a rule I need to study. But in terms of data management, less paper is a good thing, and yes, I think we’re moving that way. But I don’t believe there will be a time when I never print something out. I’m an old school guy.
Enzee: So we’ve chatted a lot about automation and the move toward a “less paper” future in healthcare. What are your thoughts on the increasing reliance on AI and where do humans fit in?
Chris: There are things that from a staffing perspective sound great. But I think we need to keep in mind the overall risk versus the benefit of something like having a CT scan run remotely by a technologist who’s sitting three states away from where the patient is actually on the table. That worries me.
In terms of AI and the trajectory of healthcare, I think it’s critical to remember that there are no real substitutes for human skills. But AI is a valuable tool for humans to use, and if we can employ technology to expedite inefficiencies and mundane tasks, then that’s a win.
Enzee: Thank you for spending time with us today. Do you have any additional words of wisdom to leave us with?
Chris: I guess it would be this: If you haven’t gotten your QC program into some kind of electronic application, you need to. Especially if you have multiple sites that you’re responsible for. It makes auditing and compliance so much easier.
Enzee: Thank you!
You can see some of our actual talk with Chris on our LinkedIn page here. Follow us here!
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