Thursday, May 19, 2016

How Montage Made Me a Better Radiology Resident

People who know me know that I am a huge fan of Montage. For those of you who don't know, Montage is a software for radiology. It's used by many institutions for business intelligence tools, but since I'm a radiology, I use it for other purposes (outlined below). Montage collects all the radiology reports and builds a database which is searchable. The company pitches the service as "Google for radiology". I first learned about it 5 years ago at a radiology conference and when I found out UCLA got license to it a year ago,  I was super thrilled. Today, I'm going to share my experiences with Montage and why I love it so much.

1.  Figure out how to report a study you haven't seen in the past: Many times, I will pull up a CT or MR of a case that I have not seen in the past. I see the abnormality, but I'm not sure how to report the salient positive and negative findings. I'll search Montage and review prior studies with the findings.  By going through this exercise, it helps me think about the differential diagnosis. Once I have a working diagnosis, I can use a prior report to then dictate a relevant report. This is invaluable asset because my reports are better. It's also an opportunity for me to learn about similar appearing diseases and to review prior exams. Also, I can see the respective attending style of reporting and put together a report that s/he is more likely to appreciate.

2.  Quantitative metrics for my productivity: Before Montage, I had no idea how many studies I've read and how I compare against my colleagues. But after Montage, I can see the number studies, type of exam and volume over time. This provides an objective gauge of my own performance. This is a powerful motivator because it's all entirely objective (can't argue against numbers). For example,  I queried Montage in June 2015 and found out that I was among the lowest tier for volume among my classmates. So,  I picked up my pace and now,  I have the highest volume among my classmates for this past year.  My total volume is about 6700; over the past year,  it was 2200,  which is one third of of the total volume.  I also learned that while residents read at a rate of 10-20 cases per day,  attendings read 50-100 /day.  It was a huge eye opener because if I want to do well in the real world,  I really needed to pick up my pace!  It's great because I know where I am and where I need to be. As result, I can take an active approach to make the most out of my training and experience. I see it as a data driven strategy.

3. Put together the best interesting case conference: As a resident, I have many opportunities to give case presentations to the faculty/residents. Sometimes it can be difficult because you don't have a representative case(s). But that is not an issue anymore with Montage. Recently, I put together an interesting case conference for MSK radiology service on stress fracture. I was able to use Montage to identify all the different types of stress fractures I wanted to talk about.  Montage database is like the ultimate interesting case log of all the attendings combined.

4. Research: OMG...this is one of my favorite application. Using Montage, you can quickly identify all the cases with a specific disease or procedure that you might be interested in doing a research project in! In the past, I had to comb through PACS and waste so many hours. Now, I can get all the information in seconds! It's fantastic. I can do quick searches and get a feel of the magnitude of the project.

Disclaimer: I have no financial conflicts with Montage (although I wish I did because I think it's a great company that provides a lot of value).

My prior post on Montage and Data Analytics.

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