ER Discordance

BRIT Systems’ Roentgen Works Discordance Tool (RWDT) is a pure browser based solution that supports the interaction of the reporting and ordering clinicians when the ordering clinician makes an initial diagnosis. The ER can give a preliminary diagnosis of Normal, Abnormal non-critical and Abnormal critical with comments on any abnormal findings. The reading physician can agree with the initial diagnosis in RW and RW contact the ER via phone, Fax or email. If the reading physician disagrees or strongly disagrees, then “BRIT Phone” calls and/or faxes the ER. Then the ER “acknowledges” the diagnosis by phone or on-line. The findings and history of the communications can be viewed and updated by all involved users on the browser interface. RWDT can send messages by a format chosen by the user, such as email, fax, or a proactive call or text to the ordering clinician. The auto call feature converts the reporting clinician’s text to an audio message that can be acknowledged on the fly by the recipient. The recipient can also select a button to call the reading physician in which case BRIT Phone places the call. All updates performed within RW to the diagnosis are instantaneously available and immediately updated on all browsers via AJAX techniques across the enterprise. RWDT can effectively communicate in the browser findings in accordance to ACR guidelines and JCAHO initiatives.


RWDT can be readily implemented within any workflow environment: it builds a patient worklist via either an HL-7 interface to a department’s order entry system or via DICOM by regenerating order information from a study’s DICOM header meta data. Reading clinicians log in through any Internet browser and enter their diagnosis, which automatically triggers a choice of agrees, disagrees or strongly disagrees. Based on whether there is agreement or disagreement, the ER is contacted via phone, FAX or email. The recipients of a message are determined from the ordering physician and patient location in the order. Each have a log-on to the system where they can manage their own contact information and establish the rules for how to contact them based on the severity of the test or test results. All messages and actions by all clinicians are recorded in the history log.

    Why you'll love this system:
  • Meets JCAHO National Patient Safety Goal Objective #2
  • One of the fastest interfaces in the industry; driven by AJAX Web technologies, all systems update in real-time. Can easily and quickly flag results between ordering and referring physicians.
  • Can interface with department’s HL-7 ordering system or via DICOM
  • or converted to audio and auto-calls the ordering physician – lets the computer do the dialing.
  • 100% Browser-based, no installation on users’ computers.
  • BRIT Phone can connect clinicians with the Radiologist
  • End-users responsible for setting up their own contact policy.
  • Easily customized screens for individual users.
  • Audit trail – available to all users
  • Also runs BRIT’s Critical Results Reporting Tool to communicate urgent findings.