Reducing Disruptive and Unnecessary Calls With Education and Electronic Chat for Asynchronous Liaison With Radiology: The REDUCE-CALL Study.

Abstract

Objective: Frequent telephone calls to radiology departments are a major source of workflow interruption and inefficiency. Asynchronous messaging integrated within an electronic medical record may provide a more efficient communication pathway. This study evaluated the impact of implementing an electronic medical record-integrated chat function, supported by targeted education initiatives, on communication volumes and protocolling workflow in a tertiary academic radiology department.

Methods: A retrospective pre- and post-intervention study compared workflow metrics across 20 matched weekdays before and after implementation. The primary outcome was in-hours telephone calls per weekday to the duty radiologist. Secondary outcomes included studies protocolled per day, time to protocol, total communication events (telephone calls plus messages), workload-adjusted communication events (communication events per 100 protocolled studies), and chat responsiveness. Comparisons were performed using the Mann-Whitney U test, with workload-adjusted contact rates analyzed using a Poisson model.

Results: Median telephone calls to the duty radiologist decreased from 181 (interquartile range [IQR] 166-220) to 82 (IQR 60-103) per day P < .001). Total communication events decreased from 181 (IQR 166-220) to 104 (IQR 87-134) per weekday (P < .001). Number of studies protocolled was unchanged (92 [IQR 88-101] versus 97 [IQR 89-108] per day; P = .29). Workload-adjusted communication events decreased from 205 to 114 per 100 studies protocolled (rate ratio 0.56, 95% confidence interval 0.53-0.59; P < .001). Median time to read and time to reply for chat were 8 min (IQR 2-24) and 14 min (IQR 5-34), respectively.

Discussion: Implementation of asynchronous messaging, supported by targeted education initiatives, was associated with a substantial reduction in both telephone calls and total communication volume (calls plus messages) without affecting protocolling productivity. Chat messages were reviewed and answered in a timely manner. These findings support a scalable strategy to reduce communication-related interruptions in high-volume radiology departments.