Digital information exchange in healthcare, particularly in diagnostic disciplines, is a high priority. The College has been working for some years with others in the digital health space, to develop procedures that can meet these priorities, build on radiology's long track record in digital initiatives and interoperability, and help to further improve our service to patients and clinicians.
Our priorities have been based on the RANZCR ADIA Digital Health White Paper – Toward Interoperability which we published as a roadmap to reach our vision for several national digital radiology systems that would be required to optimise radiology care in Australia. In brief, these areas that we are focusing on are:
A similar white paper is being developed for Aotearoa New Zealand which covers the following priorities:
The results of the 2021 Landscape Analysis showed SNOMED-CT is the preferred RRS candidate, assessed by the developed criteria. The recommendation to adopt SNOMED-CT as the terminology for RRS is pragmatic but also ambitious. There is no perfect candidate that already meets every requirement, and thus any recommendation also creates an expectation that future work will be necessary to deliver on the promise that a standardised RRS offers.The work needed to implement and adopt the RRS is closely tied to the broader national data interoperability work being done as part of Sparked, a FHIR Accelerator for AU Core and eRequesting. The RRS will be the basis of the ValueSet for eRequesting for Diagnostic Imaging.
RRS resources:
RANZCR ADIA Radiology Referral Set Landscape Analysis Workshop Discussion Paper
Radiology Referral Set Stakeholder Workshop slides
Radiology Referral Set Position Statement
Radiology Referral Set Landscape Analysis Supplementary Material
Standardised Terminology for Radiology eReferrals
The College is an active participant in the Sparked eRequesting Clinical and Technical Design Groups to ensure the work being at a national level is clinically lead, safe and appropriate for Radiology. The current focus is around Radiology and Pathology with later expansion to other sectors for requests and referrals. The Radiology Referral Set is a key component to this piece of work.
The College believes that this should be:
The College has exclusive rights to iRefer in Australia and New Zealand which can be used as part of a CDS solution and can be accessed directly from the website, API or via a 3rd party for integrated solutions into clinician's workflow. The iRefer guidelines are aimed at all healthcare professionals to help determine the best, safest and most appropriate imaging investigations. This includes ensuring the test is the most appropriate for the symptoms, reducing exposure to radiation, and considers the evidence. More information available at irefer.org.au
The College acknowledges the issues surrounding access to images and is actively working with other key stakeholders to define the problem and scope out parameters for potential solutions.
The written radiology report is evolving in response to clinical advances, technological changes and social/regulatory developments like greater patient access. “Structured” or “Standardised” reporting is one way that radiologists are trying to address these challenges. The structured reporting working group have developed guidelines for structured reporting. These set out criteria for assessing the quality and ease of implementation of existing structured report templates or software, and should also help RANZCR members develop new reports and software for use in the region and internationally. The guidelines include technical specifications based on current RIS/PACS capabilities, and pending requirements for interoperability with the evolving digital health systems in Australia and New Zealand.