Bruce I Reiner

Greater Baltimore Medical Center, Baltimore, Maryland, United States

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Publications (153)208.62 Total impact

  • Bruce Reiner
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    ABSTRACT: One of the greatest challenges facing healthcare professionals is the ability to directly and efficiently access relevant data from the patient's healthcare record at the point of care; specific to both the context of the task being performed and the specific needs and preferences of the individual end-user. In radiology practice, the relative inefficiency of imaging data organization and manual workflow requirements serves as an impediment to historical imaging data review. At the same time, clinical data retrieval is even more problematic due to the quality and quantity of data recorded at the time of order entry, along with the relative lack of information system integration. One approach to address these data deficiencies is to create a multi-disciplinary patient referenceable database which consists of high-priority, actionable data within the cumulative patient healthcare record; in which predefined criteria are used to categorize and classify imaging and clinical data in accordance with anatomy, technology, pathology, and time. The population of this referenceable database can be performed through a combination of manual and automated methods, with an additional step of data verification introduced for data quality control. Once created, these referenceable databases can be filtered at the point of care to provide context and user-specific data specific to the task being performed and individual end-user requirements.
    No preview · Article · Apr 2015 · Journal of Digital Imaging
  • Bruce Reiner
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    ABSTRACT: In current medical practice, data extraction is limited by a number of factors including lack of information system integration, manual workflow, excessive workloads, and lack of standardized databases. The combined limitations result in clinically important data often being overlooked, which can adversely affect clinical outcomes through the introduction of medical error, diminished diagnostic confidence, excessive utilization of medical services, and delays in diagnosis and treatment planning. Current technology development is largely inflexible and static in nature, which adversely affects functionality and usage among the diverse and heterogeneous population of end users. In order to address existing limitations in medical data extraction, alternative technology development strategies need to be considered which incorporate the creation of end user profile groups (to account for occupational differences among end users), customization options (accounting for individual end user needs and preferences), and context specificity of data (taking into account both the task being performed and data subject matter). Creation of the proposed context- and user-specific data extraction and presentation templates offers a number of theoretical benefits including automation and improved workflow, completeness in data search, ability to track and verify data sources, creation of computerized decision support and learning tools, and establishment of data-driven best practice guidelines.
    No preview · Article · Apr 2015 · Journal of Digital Imaging
  • Bruce Reiner
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    ABSTRACT: Data overload is a burgeoning challenge for the medical imaging community; with resulting technical, clinical, and economic ramifications. A primary concern for radiologists is the timely, efficient, and accurate extraction of imaging and clinical data, which collectively are essential in determining accurate diagnosis. In current practice, imaging data retrieval is limited by the fact that imaging and report data are de-coupled from one another, along with the non-standardized and often ambiguous free text data contained within narrative radiology reports. Clinical data retrieval is equally challenging and flawed by the lack of information system integration, paucity of clinical order entry data, and diminished role of the technologist in providing clinical data. These combined factors have the potential to adversely affect radiologist performance and clinical outcomes by diminishing workflow, report accuracy, and diagnostic confidence. New and innovative strategies are required to improve and automate data extraction and presentation, in a context- and user-specific fashion.
    No preview · Article · Feb 2015 · Journal of Digital Imaging
  • E.A. Krupinski · L. MacKinnon · B.I. Reiner
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    ABSTRACT: We have been investigating the impact of fatigue on diagnostic performance of radiologists interpreting medical images. In previous studies we found evidence that eye strain could be objectively measured and that it correlates highly with degradations in diagnostic accuracy as radiologists work long hours. Eye strain however can be difficult to measure in a non-invasive and continuous manner over the work day so we have been investigating other ways to measure physiological stress and fatigue. In this study we evaluated the feasibility of using a commercially available biowatch to measure galvanic skin response (GSR), a well known indicator of stress. 10 radiology residents wore the biowatch for about 8 hours during their normal work day and data were automatically collected at 10 Hz. They completed the Swedish Occupational Fatigue Inventory (SOFI) at the start and finish of the day. GSR values (microsiemens) ranged from 0.14 to 38.27 with an average of 0.50 (0.28 median). Overall GSR tended to be fairly constant as the day progressed, but there were definite spikes indicating higher levels of stress. SOFI scores indicated greater levels of fatigue and stress at the end of the work day. Although further work is needed, GSR measurements obtained via an easy to wear watch may provide a means to monitor stress/fatigue and alert radiologists when to take a break from interpreting images to avoid making errors.
    No preview · Article · Jan 2015
  • Bruce I Reiner
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    ABSTRACT: Medical analytics relating to quality and safety measures have become particularly timely and of high importance in contemporary medical practice. In medical imaging, the dynamic relationship between medical imaging quality and radiation safety creates challenges in quantifying quality or safety independently. By creating a standardized measurement which simultaneously accounts for quality and safety measures (i.e., quality safety index), one can in theory create a standardized method for combined quality and safety analysis, which in turn can be analyzed in the context of individual patient, exam, and clinical profiles. The derived index measures can be entered into a centralized database, which in turn can be used for comparative performance of individual and institutional service providers. In addition, data analytics can be used to create customizable educational resources for providers and patients, clinical decision support tools, technology performance analysis, and clinical/economic outcomes research.
    No preview · Article · Nov 2014 · Journal of Digital Imaging
  • Bruce I. Reiner

    No preview · Article · Sep 2014 · Journal of the American College of Radiology
  • Bruce I Reiner

    No preview · Article · Sep 2014 · Journal of Digital Imaging
  • Bruce I Reiner
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    ABSTRACT: Although the potential for adverse clinical outcomes related to medical radiation have been well documented for over a century, several relatively recent trends have increased awareness of radiation safety in medical imaging. These include expanded CT applications and utilization, increased patient attention on radiation carcinogenesis, and a wide array of legislative and societal radiation initiatives, created partly in response to media reports of CT-induced radiation complications. With this heightened radiation awareness and scrutiny comes a unique and timely opportunity for the collective medical-imaging community to incorporate comparative radiation metrics and analysis directly into routine workflow and reporting. If properly performed, a number of benefits could in theory be derived, including improved clinical outcomes, creation of data-driven best practice guidelines, opportunities for enhanced education and research, dose-reduction technology innovation, and reversal of existing commoditization trends.
    No preview · Article · Aug 2014 · Journal of the American College of Radiology: JACR
  • Bruce I Reiner
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    ABSTRACT: Although image quality is a well-recognized component in the successful delivery of medical imaging services, it has arguably declined over the past decade owing to several technical, economic, cultural, and geographic factors. To improve quality, the radiologist community must take a more proactive role in image quality analysis and optimization; these require analysis of not just the single step of image acquisition but the entire imaging chain. Radiologists can benefit through improved report accuracy, diagnostic confidence, and workflow efficiency. The derived data-driven analyses offer an objective means for provider performance analysis, which can help combat commoditization trends and self-referral by nonradiologist providers.
    No preview · Article · May 2014 · Journal of the American College of Radiology: JACR
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    ABSTRACT: The question of whether radiology report format influences reading time, comprehension of information, and/or scannig behavior was examined. Three radiology reports were reformatted to three versions: conventional free text, structured text organized by organ system, and hierarchical structured text organized by clinical significance. Five radiologists, 5 radiology residents, 5 internal medicine clinicians and 5 internal medicine residents read the reports. They then answered a series of questions about the report content. Reading time was recorded. Participants also reported reading preferences. Eye-position was also recorded. There were no significant diffrences for reading time as a function of format, but there was for attending versus resident, and radiology versus internal medicine. There was no significant difference for percent correct scores on the questions for report format or for attending versus resident, but there was for radiology versus internal medicine with the radiologists scoring higher. Eye-position results showed that although patterns tended to be indeosynchratic to readers, there were differences in the overall search patterns as a function of report format, with the free text option yielding more regular scanning and the other two formats yielding more "jumping" from one section to another. Report format does not appear to impact viewing time or percent correct answers, but there are differences in both for specialty and level of experience. There were also differences between the four groups of participants with respect to what they focus on in a radiology report and how they read reports (skim versus read in detail). Eye-position recording also revealed differences in report coverage patterns. The way that radiology reports are read is quite variable as individual preferences differ widely, suggesting that there may not be a single format acceptable to all users.
    No preview · Article · Feb 2014 · Proceedings of SPIE - The International Society for Optical Engineering
  • Bruce I. Reiner
    [Show abstract] [Hide abstract]
    ABSTRACT: Although image quality is a well-recognized component in the successful delivery of medical imaging services, it has arguably declined over the past decade owing to several technical, economic, cultural, and geographic factors. To improve quality, the radiologist community must take a more proactive role in image quality analysis and optimization; these require analysis of not just the single step of image acquisition but the entire imaging chain. Radiologists can benefit through improved report accuracy, diagnostic confidence, and workflow efficiency. The derived data-driven analyses offer an objective means for provider performance analysis, which can help combat commoditization trends and self-referral by nonradiologist providers.
    No preview · Article · Jan 2014
  • Bruce I Reiner
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    ABSTRACT: The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.jacr.2013.10.022. The duplicate article has therefore been withdrawn.
    No preview · Article · Dec 2013 · Journal of the American College of Radiology: JACR
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    Bruce I Reiner

    Preview · Article · Dec 2013 · Journal of Digital Imaging
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    Bruce I Reiner

    Preview · Article · Oct 2013 · Journal of Digital Imaging
  • Bruce I Reiner

    No preview · Article · Sep 2013 · Journal of Digital Imaging
  • Bruce I Reiner

    No preview · Article · Aug 2013 · Journal of Digital Imaging
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    Bruce I Reiner

    Preview · Article · Aug 2013 · Journal of Digital Imaging
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    Bruce I Reiner

    Preview · Article · Jun 2013 · Journal of Digital Imaging
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    Bruce I Reiner

    Preview · Article · Jun 2013 · Journal of Digital Imaging
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    Bruce I Reiner
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    ABSTRACT: The goal in radiology service delivery is to improve and expand communication of report findings to the broad and diverse community of radiology consumers, requiring innovation at both the levels of the radiology report and communication schema.
    Preview · Article · Jun 2013 · Journal of Digital Imaging

Publication Stats

2k Citations
208.62 Total Impact Points

Institutions

  • 2004-2015
    • Greater Baltimore Medical Center
      Baltimore, Maryland, United States
  • 2012-2014
    • University of Maryland, College Park
      Maryland, United States
  • 2006-2013
    • United States Department of Veterans Affairs
      Бедфорд, Massachusetts, United States
  • 2007
    • Minneapolis Veterans Affairs Hospital
      Minneapolis, Minnesota, United States
  • 1996-2006
    • University of Maryland, Baltimore
      • Department of Diagnostic Radiology and Nuclear Medicine
      Baltimore, Maryland, United States
  • 2005
    • Johns Hopkins University
      Baltimore, Maryland, United States
    • The University of Arizona
      • Department of Electrical and Computer Engineering
      Tucson, AZ, United States
  • 2002-2003
    • Medical College of Wisconsin
      Milwaukee, Wisconsin, United States
    • Loyola University Maryland
      Baltimore, Maryland, United States
    • U.S. Department of Veterans Affairs
      • Department of Radiology
      Washington, Washington, D.C., United States
  • 1997-1998
    • University of Maryland Medical Center
      Baltimore, Maryland, United States