Quality assurance: a system that integrates a digital dictation system with a computer data base.

One of the most challenging responsibilities for radiologists is assessment of the quality of care that they provide. Some parameters of quality, such as false-negative rate, are almost impossible to calculate with absolute precision. The issue is also complicated when one tries to determine exactly what constitutes a "discordant" interpretation. However, even when a radiologist discovers that a radiographic finding was missed, or that an inappropriate examination was done, the steps necessary to perform an analysis of the problem can be very disruptive to one's clinical focus at the moment. This suggests that a major obstacle to participation in quality assurance by radiologists is the lack of an adequate infrastructure. We have integrated our digital dictation system with a personal computer data base for tracking cases appropriate for quality assurance, thus allowing radiologists to log any examination from any dictation station in our department with minimal interruption to their clinical activities. Quality assurance and peer review are facilitated by using a personal computer for otherwise tedious aspects of information management. Radiology departments that have a convenient, department-wide method for entering cases--such as a digital dictation system--are ideal for this technique.