Mikhail Nekhline MD, Presenter: Nothing to Disclose

Safwan Halabi MD, Abstract Co-Author: Nothing to Disclose

Automation of the follow-up “tickler file” and alerting system can augment the delivery of appropriate health care, reduce the follow-up burden on the referring clinician, and catalyze the education and experience of the radiologist.

The radiologist is responsible to offer the referring clinician an impression and recommendation at the conclusion of the image interpretation. An additional or follow-up diagnostic imaging examination may be recommended for the patient to further characterize an abnormality or to exclude/confirm a suspicious finding. Historically, the radiologist would manually maintain a “tickler file” to make sure the recommendation is acted upon. An alert application within the PACS at Henry Ford Hospital simplifies this process to promote patient safety, relieve some of the burden on the referring clinician, and educate the radiologist.

The Illuminate Plugin (Softek Solutions, Inc., Kansas City, KS) for iSite Radiology PACS (Philips, Foster City, CA) allows radiology attendings and residents to flag examinations in which follow-up recommendations are provided. The radiologist will receive a notification when the follow-up study is rendered. The radiologist can customize the alert and notification in the following ways: follow-up can be limited to a certain modality triggering the alert; expiration date of an alert can be applied to notify the radiologist if a follow-up examination is not rendered; and the radiologist can choose to receive the alert via plugin inbox, e-mail, pager, or SMS. A detailed description of the radiologist flagging, alerts, and communication workflow will be presented.

It is imperative for the radiologist to keep track of imaging follow-ups to ensure appropriate delivery of care. While many radiologists keep this list of patients on a piece of paper or in electronic format, the automation of this documentation by alerting saves significant time and helps the radiologist and referring clinician close the follow-up imaging loop. This PACS application can decreases the number of patients lost to follow-up, and may educate the radiologist on whether the follow-up was warranted with the overall goal of reducing inappropriate imaging.

Nekhline, M, Halabi, S, The Tickler File: PACS Application Alerts Radiologists When Recommended Additional or Follow-up Examinations Are Rendered.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005031.html