R&D Spotlight: Matthew Lee considers improvements to radiology workflow interruptions
In the reading room, phone calls and electronic messages disrupt complex workflows that include image interpretation, consultation, and communication with ordering providers.
Although these forms of communication are often necessary, particularly in urgent situations, frequent disruptions during cognitively demanding work can contribute to inefficiency, rework, and potential errors. Motivated by this challenge, Matthew Lee, MD set out to study the unintended consequences of increasingly frequent electronic communication.
“Interruptions in radiology can have profound implications for patient safety, physician wellbeing, and the clinical and academic missions of our academic radiology practice,” Dr. Lee said. “Radiologists perform complex, cognitively demanding work, and disruptions to those processes can contribute to increased workload, workflow inefficiencies, and potential errors that can ultimately affect patient care.”
With support from departmental research and development (R&D) funds, Dr. Lee collaborated with Shanmugapriya Loganathar, PhD who applied a human factors engineering approach to identify the topics and contextual factors driving communication through an electronic messaging platform. The goal was to identify opportunities to reduce unnecessary interruptions while preserving essential communication.
Research and Development Funds
The UW Department of Radiology’s research and development (R&D) program supports new directions in imaging research, educational initiatives, and the development of promising early-stage projects.
“There’s no questions that the project would not have been possible without the R&D funding because it supported Dr. Loganathar’s time and involvement,” Dr. Lee said. “We needed someone with expertise in healthcare workflows and human factors engineering to help us understand these communication patterns.”
The R&D program supports innovative imaging research, educational initiatives, and promising early-stage projects. In Dr. Lee’s case, this project focused on improving internal workflows, patient safety, and physician wellbeing.
The research team analyzed one year of electronic communications instant messaging data (WebEx), 39,448 messages in total, and conducted interviews with technologists and residents. Their results, published in Academic Radiology in 2025, showed that exam protocol clarifications, contrast and allergy, exam appropriateness, and exam and patient complexity were the most common CT-modality-specific topics in the electronic communications.
“In the abdominal section, we have specific protocols designed for different clinical scenarios,” Dr. Lee said. “One of the unintended consequences that we identified is that the complexity can be confusing for the different members of the care team. A practical application of doing this type of project is identifying opportunities to simplify processes and reduce unnecessary complexity.”
Based on the study’s key findings, Dr. Lee proposed several interventions to minimize unnecessary interruptions from instant messaging, including creating standards for electronic communication platforms and conducting workshops to improve communication and collaboration.
Learn more about Dr. Lee’s research in this Q&A, which has been edited for clarity and brevity.
What inspired you to focus on this topic?
One of the most rewarding projects I worked on as a resident was a quality improvement initiative examining reading room interruptions in neuroradiology. During my final year of residency, I partnered with my friend and classmate, Andrew Schemmel, MD, under the mentorship of John-Paul (JP) Yu, MD, PhD, to study the frequency and impact of interruptions in the neuro reading room.
We also collaborated with experts in human factors engineering in the College of Engineering. Together, we were able to quantify the frequency and nature of interruptions that radiologists experience within an academic neuroradiology practice. We also determined how much time our radiologists were dedicating to image interpretive and non-image interpretive tasks.
What did you take away from this experience?
It was my first experience seeing how a project could directly drive meaningful change in a department. There’s something incredibly rewarding about identifying a need or perceived problem, studying it, and showing how the evidence can translate into meaningful changes and improvements in clinical practice.
What happened after your residency?
Following residency, I practiced as an active-duty radiologist for five years before returning for fellowship. A great deal changed during that time, including a global pandemic. Radiology was uniquely positioned through the pandemic because we could be agile and many aspects of our work could be adapted to a virtual environment more readily than other specialties. As a result, our communications methods evolved rapidly.
As a resident, one of the most disruptive aspects of our work was receiving numerous phone calls while trying to perform highly demanding cognitive work. Over time, many of those interruptions shifted to electronic communications platforms. That prompted us to study electronic communication patterns and identify opportunities to develop more effective communication practices and protocols.
What did you notice about communicating via instant messaging on electronic communication platforms?
Instant messaging through electronic communication platforms makes communication faster and more convenient, but it also creates new challenges. It’s easy to send a quick message without fully considering its urgency or necessity. Many non-urgent, ad hoc messages became frequent sources of interruption, creating high volume communication that could negatively affect workflow and, potentially, patient safety. From that, we’re thinking more intentionally about best practices for communication using these important electronic messaging platforms.
What did you learn from this research?
The key takeaway is that high volumes of electronic communication and unnecessary interruptions can be disruptive. However, this project also shows that targeted workflow improvements are possible. By understanding and optimizing communication practices within a single imaging modality, we can identify strategies that may be applied more broadly across radiology.
More broadly, this project exemplifies a culture of continuous improvement. By continually evaluating and refining the way we work, we can improve our practices, enhance patient care, and create a work environment where all members of the team can thrive and feel empowered to do their best work.