The Next Wave – The Royal Australian and New Zealand College of Radiologists

The Next Wave – The Royal Australian and New Zealand College of Radiologists

Julie McCrossin:

Ladies and gentlemen, we are turning now to colleges who were involved right from the beginning, and I do want to emphasise the national nature of the campaign we’re talking about.

I’d like to welcome up Professor John Slavotinek, who's the Dean of the Faculty of Clinical Radiology, and he’s representing today the Royal Australian and New Zealand College of Radiologists. Would you please make a radiologist welcome?

(Applause)

Audience:

Whoo-hoo!

Julie McCrossin:

I think that was a very good sign. They seem very keen to meet you. Your college has been involved right from the start. Why? Why are you so keen on all of this?

Professor John Slavotinek:

There are several reasons for this. I guess the first and simplest is there’s been a successful initiative overseas, initially begun by the American Board of Internal Medicine in 2012, and it’s spreading internationally.

The other thing by way of background is there's been a rapid increase in the number and complexity of medical imaging tests, and this, I guess, drives a need for the College of Radiologists to improve the appropriate use of those tests so that resources are used as effectively as possible.
In terms of that, one of the elements of the college mission statement, in fact, is around driving the proper, safe and appropriate use of medical imaging.

Thirdly, we also are involved for quite some time in a number of initiatives directed at improving appropriateness of imaging. This includes websites that are directed at consumer information, two examples being Inside Radiology, which is aimed at the radiology side of our college, and the other being Targeting Cancer, aimed at the radiation oncology side of our college. And these provide information to consumers, but they also, where appropriate, encourage conversations between health providers and consumers.

And finally, and perhaps the most important is, I think it's the right thing to do.

Julie McCrossin:

You've progressed to some new work, and I think particularly tools to help implementation of this campaign within health services. Tell us a little bit about that.

Professor John Slavotinek:

So, the initial six recommendations that the college put forward at the initial launch in April of 2015 are now supported through two broad processes.

The first is development of educational modules directed at junior doctors and medical students, to help them understand what is a clinical decision rule and how is it applied in certain circumstances where a decision is needed about whether imaging, in this case, is necessary.

So those rules provide a simple, straightforward and evidenced-based means of making that decision, and each of these modules is linked to the six Choosing Wisely recommendations we put forward.
More recently, at the end of last year, we launched an app which is available on smart or mobile phones for both Apple and non-Apple devices. This provides a simple and transparent means of delivery at the point of care to follow a clinical decision rule, so a doctor in practice can follow this and, I guess, essentially come up with the correct decision about the appropriateness for imaging.

Importantly, because it’s simple and transparent, it also facilitates a conversation with patients or consumers about why we might do this, or perhaps why an imaging test is not appropriate.

Julie McCrossin:

And what’s the College of Radiologists planning to do in the future? What are your next priorities with this campaign?

Professor John Slavotinek:

So, initially, the modules and apps were developed under the leadership of Professor Stacy Goergen at Monash, and that was the first site to deploy. We've deployed now at 15 sites in terms of the educational modules, and the obvious first step is to continue that roll-out.

We also want to assist radiologists, who are often in the initial phase of those local conversations with either universities or healthcare institutions, to try and increase the uptake of this initiative. And I think, to keep the answer short, the other very important component of this is we are well advanced in development of the initiative for additional recommendations in the sphere of radiation oncology, an important part of our college. And so we anticipate those recommendations will be forthcoming at the next time that there's a launch at this entity.

Julie McCrossin:

I have a stepdaughter who's just started her first job as a graduate doctor, and the amount of information hurling at those young doctors, who of course don't sleep for the first few years, despite all the improvements in that area… You wouldn't have slept probably for decades when you trained.

(Laughter)

Julie McCrossin:

But my point is, they are inundated with information. So is this reference to things like smart phone apps, to brevity, critical in punching through?

Professor John Slavotinek:

Absolutely. So, if we can have the app, which is easy to download either from the iTunes Store or from Google Play, or from the RANZCR website, it follows a simple series of yes/no questions and answers that allows the correct decision to follow from that. So it doesn't require individuals to remember, to retain knowledge; it makes the process easier, as you're suggesting.

Julie McCrossin:

And so could interested patient advocates or individual patients download it too?

Professor John Slavotinek:

They certainly could. And again, that would perhaps prepare them for the conversations and understanding that there’s a clear basis behind the process for decision-making.

Julie McCrossin:

Thank you so much, sir. That was fascinating. Thank you. Would you give him a round of applause?

(Applause)