An in-record chat channel halved telephone calls to the duty radiologist

Design

Single-centre retrospective before-and-after study

Population

20 matched weekdays before and after introducing EMR chat in a tertiary radiology department

Primary outcome

In-hours telephone calls per weekday to the duty radiologist

Effect

Median 181 to 82 calls/day; workload-adjusted contacts rate ratio 0.56 (95% CI 0.53-0.59)

A tertiary academic radiology department introduced an electronic-record chat function for referrers, supported by targeted education, and compared 20 matched weekdays before and after (JACR, 1 October 2026).

Median telephone calls to the duty radiologist fell from 181 to 82 a day. Total contacts, calls plus messages, fell from 181 to 104, and contacts per 100 studies protocolled fell from 205 to 114 (rate ratio 0.56, 95% CI 0.53-0.59). The number of studies protocolled was unchanged (92 vs 97 a day). Median time to read a chat was 8 minutes and to reply 14 minutes.

Interruptions are a recognised source of error and fatigue for the reporting radiologist. An asynchronous channel moved non-urgent queries out of the phone queue without losing productivity, and it did not simply replace each call with a message.

• Offer referrers an asynchronous messaging route for non-urgent protocol and booking queries.
• Keep the telephone for urgent clinical discussions and critical results.
• Train referrers on what belongs in chat versus a call; the education was part of the intervention.
• Set and monitor a response-time standard for messages.
• Measure calls before and after so the change can be judged locally.

Why it matters

Each interruption breaks a radiologist's concentration on a scan, and most calls do not need a voice.

Don't overread it

This was a before-and-after study in one department, so other changes over the same period could contribute.

The statistics, in plain English

A rate ratio of 0.56 means contacts per 100 studies fell by about 44% after the change.

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