When it comes to professional certification, all radiology residents know the drill. They must successfully complete a prescribed number of exams across a range of specializations — brain, spine, mammography, etc. — and demonstrate proficiency using all the various technologies available today: MRI, CT, PET, etc. The entire training program must be completed within a given period and under the close supervision of a senior physician. The Accreditation Council for Graduate Medical Education (ACGME) sets the standards nationally through its Common Program Requirements.
The stakes couldn’t be higher. Not only does the resident’s professional future ride on reaching ACGME milestones, but the images reviewed are drawn from real patients with real health concerns. The results of the scans become part of patients’ electronic medical record.
For decades, tracking resident progress against these standards was a cumbersome task, consuming valuable time and resources tabulating, cataloging and transferring data to ACGME, resident by resident, rotation by rotation, exam by exam.
“It was not easy, but it had to be done. Now, with our new resident dashboard, I think we’ve improved on that workflow considerably,” says Lilja Solnes, associate professor and program director of the Diagnostic Radiology Residency Program, whose job it was to do the tracking. The electronic dashboard that she and a team of developers created provides an online resource that streamlines the ACGME certification process for residents in the Johns Hopkins radiology department.
The Resident Scorecard Dashboard provides an easy, central, highly visual way through which radiology residents can track progress toward the ACGME standards and against the high bar set by Johns Hopkins itself. Not only does it lay out all the exams a resident is required to complete, but it also charts progress over time and displays the resident’s performance in specific areas relative to their peers, in quantitative and qualitative terms.
ACGME might require, for instance, that a resident complete 300 MRI body exams during a residency. The dashboard shows the exact number completed to date, flags which exams need follow-up as determined by the attending physician and graphically illustrates with color-coded arrows how well the resident did compared to others in the peer group. If a resident needs to make up ground in a certain area or revisit certain exams, that information is laid out in clear, graphical detail.
For Solnes, the dashboard is an easier and more convenient way to grapple with a profound amount of data, but, more importantly, it is a way to provide immediate feedback.
“We’re teaching in real time,” Solnes says. “And that is a critical step in developing the best radiologists.”
The Resident Scorecard Dashboard replaces an aging and inefficient patchwork of third-party applications, handwritten notes and ad hoc spreadsheets used in prior years to track the certification information.
“Necessity is the mother of invention, right?” says Daniele Bananto, a business intelligence manager with The Johns Hopkins Hospital, of the decision to bring development in-house and create a custom solution. She helped design and create the back-end data source that drives the dashboard.
The development of the dashboard took Solnes, Bananto and team about six months, from start to finish.
Vamsi Nath, senior software engineer built the front-end interface using Tableau, a leading software for data presentation. “Residents once had to get these numbers manually,” Nath says. “Now, it’s all right there.”
The dashboard has two view modes, one for the residents and another for the attending physician. The dashboard is helpful to both types of users, Nath points out. The interface displays a remarkable breadth of information in an intuitive, easy-to-read format; provides one-click reporting capabilities; allows senior faculty members to review, annotate and flag certain exams for follow-up; and streamlines the process of uploading of data to ACGME’s master certification databases.
“We had all the data we needed in our electronic medical record system, so we built exactly what we needed for ourselves,” Bananto says. “It was efficient. It was cost-effective. And, in the end, we ended up with something better for the department.”
“It’s really very cool,” Solnes adds.
“It was not easy, but it had to be done. Now, with our new resident dashboard, I think we’ve improved on that workflow considerably.”
— LILJA SOLNES