Asynchronous messaging and targeted education initiatives could reduce disruptions by telephone calls, suggest findings published October 1 in the Journal of the American College of Radiology. 

A chat platform integrated within the electronic medical record (EMR) with targeted referrer education initiatives reduced telephone call volume by 55% in a tertiary academic radiology department, wrote a group led by Subhashaan Sreedharan, MD, from the Royal Melbourne Hospital in Parkville, Victoria, Australia. 

“These findings support a scalable strategy to reduce communication-related interruptions in high-volume radiology departments,” Sreedharan and colleagues wrote. 

Telephone-related disruptions can lead to inefficiencies within radiology departments. These can also lead to declining task performance and burnout for radiologists who are responsible for triaging and protocolling imaging requests. 

Asynchronous messaging integrated within an EMR could represent a more efficient communication pathway, the researchers highlighted. 

Sreedharan and co-authors studied how an EMR-integrated chat function, supported by targeted education initiatives, could affect communication volumes and protocolling workflow. They called their study the REducing Disruptive and Unnecessary Calls with Education and Electronic Chat for Asynchronous Liaison with RadioLogy (REDUCE-CALL) Study. 

The chat platform (Epic Secure Chat, Epic Systems Corporation) helps with asynchronous, non-urgent communication between referrers and the duty radiologist. Messages are encrypted, linked to the patient medical record, and can include attachments such as images or reports. The platform allows clinicians to respond asynchronously when clinically appropriate while maintaining a documented communication trail, with the intended benefit of minimizing task interruption. The study period took place in July 2025. 

The researchers reported the following findings: 

• Median telephone calls to the duty radiologist decreased from 181 to 82 per day (p

• Total communication events decreased from 181 to 104 per weekday (p

• The number of studies protocolled was unchanged (92 vs. 97 per day; p = 0.29).  

• Workload-adjusted communication events decreased from 205 to 114 per 100 studies protocolled (rate ratio 0.56; p

• Median time-to-read and time-to-reply for chat were eight minutes and 14 minutes, respectively. 

The findings support a structured transition from synchronous to asynchronous communication to reduce disruptive communication events while maintaining protocolling throughput, the study authors wrote. 

“Synchronous telephone communication inherently requires immediate interruption of ongoing tasks and results in negative cognitive impacts of task switching, whereas asynchronous messaging permits responses within a clinically appropriate timeframe while minimizing workflow disruption,” they added. “In the setting of rising imaging demand and increasing pressure on radiology services, such interventions may represent a practical strategy to improve efficiency and reduce unnecessary interruptions.” 

Read the full study here.