User Roles & Permissions
Introduction
Welcome! This guide will help you understand how user roles, report statuses, and workflows function within the RADPAIR system. By the end of this manual, you'll have a clear understanding of:
The different user roles and their specific permissions
Report statuses and how they transition
Common workflows for different scenarios
How RADPAIR integrates with external systems
Let's get started!
1. Understanding User Roles
RADPAIR offers several user roles, each with specific permissions designed to support efficient radiology workflows while maintaining appropriate clinical oversight.
1.1 Attending Radiologist
Key Capabilities:
Create and sign final reports directly (bypassing preliminary steps)
Sign preliminary reports
Create and sign addendums
Access any report regardless of status
Take over reports from lower-level users when necessary
Share drafts with residents and report drafters
Example Scenario:
Dr. Smith, an Attending Radiologist, receives an urgent case. She can open the case, dictate her findings, and immediately sign the final report without requiring a preliminary signature step.
1.2 Resident
Key Capabilities:
Create draft reports
Sign preliminary reports
Cannot sign final reports
Can only access drafts they created or that were shared with them by an Attending
Example Scenario:
Dr. Johnson, a Resident, reviews a chest X-ray. After dictating and processing his findings, he can sign the report as "preliminary," but it will require an Attending's review and final signature before being distributed.
1.3 Report Drafter One
Key Capabilities:
Create new drafts from unread studies
Edit only the Transcript box
Cannot process reports or edit the Final Report box
Cannot sign reports (neither preliminary nor final)
Can only access drafts they created or that were shared with them
Example Scenario:
Maria, a Report Drafter One, can open an unread study and transcribe the dictation into the Transcript box. She cannot process the report or make changes to the Final Report box.
1.4 Report Drafter Two
Key Capabilities:
Create new drafts from unread studies
Edit both Transcript and Final Report boxes
Process reports
Cannot sign reports (neither preliminary nor final)
Can only access drafts they created or that were shared with them
Example Scenario:
Carlos, a Report Drafter Two, can transcribe dictation and also process the report, formatting it into the Final Report box. However, he cannot sign the report in any capacity.
1.5 Radiologist Admin
Key Capabilities:
All clinical capabilities of an Attending Radiologist
Administrative overrides (unlock reports, discard reports on behalf of others)
Access to administrative functions
Example Scenario:
Dr. Williams, a Radiologist Admin, notices that a report has been locked by a user who is now unavailable. She can use her administrative privileges to unlock the report so another radiologist can complete it.
2. Report Statuses Explained
Reports in RADPAIR progress through various statuses that reflect their current state in the workflow.
2.1 Status Overview
unread
Initial state when a study is ready for reporting
draft (locked)
Being actively edited by a user
draft (unlocked)
Saved but not currently being edited
prelim_signed
Signed in a preliminary capacity
signed
Officially signed by an Attending
addendum_prelim_signed
Addendum with preliminary signature
addendum_signed
Finalized addendum
discarded
Report has been discarded
cancelled
Study cancelled by external system
2.2 Status Transitions
Common Transitions:
unread → draft (locked)
Occurs when: Any user with appropriate permissions opens an unread study
Example: A Resident selects an unread chest X-ray from the worklist
draft (locked) → draft (unlocked)
Occurs when: User saves and exits without signing
Example: A Report Drafter saves their work but needs to complete it later
draft → prelim_signed
Occurs when: Resident or Attending performs a preliminary signature
Example: A Resident completes their assessment and preliminary signs the report
prelim_signed → signed
Occurs when: Attending reviews and provides final signature
Example: An Attending reviews a Resident's preliminary report and signs it
signed → addendum_prelim_signed
Occurs when: Additional information needs to be added to a signed report
Example: A Resident creates an addendum when new clinical information becomes available
addendum_prelim_signed → addendum_signed
Occurs when: Attending reviews and signs the addendum
Example: An Attending reviews and finalizes the addendum
3. Common Workflows
3.1 Attending Direct Workflow
Steps:
Attending selects unread study
System changes status to draft (locked)
Attending dictates findings
Attending processes report
Attending signs report (final)
System changes status to signed
Example:
Dr. Garcia opens an unread MRI, dictates her findings, processes the report, and signs it as final. The report is immediately available to referring physicians.
3.2 Resident Preliminary Workflow
Steps:
Resident selects unread study
System changes status to draft (locked)
Resident dictates findings
Resident processes report
Resident signs report (preliminary)
System changes status to prelim_signed
Attending reviews prelim_signed report
Attending makes any necessary edits
Attending signs report (final)
System changes status to signed
Example:
Dr. Kim, a Resident, reviews a CT scan, dictates findings, and preliminary signs the report. Later, Dr. Johnson, an Attending, reviews the preliminary report, makes minor edits, and provides the final signature.
3.3 Report Drafter Workflow
Steps:
Report Drafter selects unread study
System changes status to draft (locked)
Report Drafter transcribes dictation
If Report Drafter Two, they can process the report
Report Drafter saves and exits
System changes status to draft (unlocked)
Radiologist opens draft
Radiologist reviews, edits as needed
Radiologist signs report (preliminary or final)
Example:
Sarah, a Report Drafter Two, opens an unread X-ray, transcribes the radiologist's dictation, processes the report, and saves it as a draft. Later, Dr. Martinez reviews the draft, makes a few edits, and signs the final report.
3.4 Addendum Workflow
Steps:
User opens a signed report
User selects "Create Addendum"
System creates addendum in draft (locked) status
User adds additional information
User signs addendum (preliminary or final based on role)
If preliminary signed, an Attending must review and sign
Example:
A referring physician calls with additional clinical information. Dr. Lee opens the previously signed report, creates an addendum with the new information, and signs it.
3.5 Forced Takeover Workflow
Steps:
Higher-level user attempts to open a locked report
System displays takeover confirmation dialog
User confirms takeover
Original user receives notification
Report is unlocked from original user and locked to new user
Example:
Dr. Wilson, an Attending, needs to urgently review a report currently locked by a Resident who is unavailable. Dr. Wilson initiates a takeover, confirms the action, and gains access to the report.
4. Integration with External Systems
RADPAIR communicates with external worklist systems to maintain synchronized workflows.
4.1 Status Communication
From External System to RADPAIR:
unread status (new studies)
cancelled status (studies no longer needed)
From RADPAIR to External System:
draft status updates
prelim_signed status
signed status
addendum statuses
discarded status
4.2 Integration Scenarios
Scenario 1: New Study
External system sends new study with unread status
RADPAIR displays study in worklist
User selects study in RADPAIR
RADPAIR updates external system with draft (locked) status
Scenario 2: Completed Report
Radiologist signs report in RADPAIR
RADPAIR sends signed status to external system
External system updates its records and distributes report
Scenario 3: Cancelled Study
External system cancels a study
RADPAIR receives cancelled status
If study is open in RADPAIR, user is notified
RADPAIR closes study and prevents further interaction
5. Best Practices
5.1 For Attending Radiologists
Review preliminary reports promptly to maintain workflow efficiency
Use the sharing feature when appropriate to facilitate resident education
Communicate clearly when making significant changes to a resident's report
5.2 For Residents
Be thorough in your assessments before preliminary signing
Review Attending modifications to learn from their expertise
Only access drafts you've created or that have been shared with you
5.3 For Report Drafters
Save drafts frequently to prevent data loss
Notify radiologists when drafts are ready for review
Understand the limitations of your role to maintain proper workflow
5.4 For Administrators
Regularly audit user roles to ensure appropriate access
Monitor locked reports to prevent workflow bottlenecks
Provide clear communication when system changes occur
6. Troubleshooting Common Issues
6.1 Locked Reports
Issue: A report remains locked after a user has finished working on it.
Solution:
Contact the user who has the report locked
If unavailable, a Radiologist Admin can force unlock the report
Check for system issues if this occurs frequently
6.2 Status Discrepancies
Issue: Report status in RADPAIR doesn't match external system.
Solution:
Check integration logs for communication errors
Verify report status in both systems
Contact system administrator if discrepancy persists
6.3 Permission Errors
Issue: User unable to perform an action they believe they should have permission for.
Solution:
Verify user's assigned role
Check if the report status allows the attempted action
Review the permissions matrix for the specific role
Contact administrator for role adjustments if needed
7. Quick Reference Guides
7.1 Role Permissions Matrix
Create Draft
✅
✅
✅
✅
✅
Edit Transcript
✅
✅
✅
✅
✅
Process Report
✅
✅
❌
✅
✅
Edit Final Report
✅
✅
❌
✅
✅
Preliminary Sign
✅
✅
❌
❌
✅
Final Sign
✅
❌
❌
❌
✅
Create Addendum
✅
✅
❌
✅
✅
Force Unlock
✅
❌
❌
❌
✅
Discard Report
✅
✅
✅
✅
✅
7.2 Status Transition Quick Reference
unread
draft (locked)
All clinical roles
draft (locked)
draft (unlocked)
Current user, Admin override
draft (unlocked)
draft (locked)
Original author, Attending, Radiologist Admin
draft (locked/unlocked)
prelim_signed
Resident, Attending, Radiologist Admin
draft (locked/unlocked)
signed
Attending, Radiologist Admin
prelim_signed
signed
Attending, Radiologist Admin
signed
addendum_prelim_signed
Resident, Attending, Radiologist Admin
addendum_prelim_signed
addendum_signed
Attending, Radiologist Admin
Any
discarded
All roles
8. Glossary of Terms
Addendum: Additional information added to a previously signed report.
Draft: A report that is in progress and has not yet been signed.
Lock: The state of a report when it is being actively edited by a user.
Preliminary Sign: A signature indicating the report has been reviewed but requires final approval.
Process: The action of converting dictated text into a formatted final report.
Sign (Final): The official signature that completes a report and makes it available for distribution.
Unlock: The action of releasing a locked report so it can be edited by another user.
Conclusion
Understanding RADPAIR's user roles, permissions, and report statuses is essential for efficient workflow management in radiology reporting. This training manual has provided you with the knowledge needed to navigate the system effectively and understand how different roles interact with reports throughout their lifecycle.
For additional assistance or to report issues, please contact your system administrator or RADPAIR support.
Last Updated: March 21, 2025
Last updated