Jonathan S. Movson MBChB, Presenter: Nothing to Disclose

Timothy Paul, Abstract Co-Author: Nothing to Disclose

Cynthia M. Cobb, Abstract Co-Author: Nothing to Disclose

Daniel M. Golding MD, Abstract Co-Author: Nothing to Disclose

Andrew Karn, Abstract Co-Author: Nothing to Disclose

It is well known that non-urgent but important findings “fall through the cracks” of patient care. This is particularly likely to happen in the emergency room setting. To ensure that these results are always communicated either to the patient’s primary care physician or to the patient, our radiology department worked with our IT group to develop a solution to identify and communicate these findings.

When a radiologists makes a finding that is considered to be important to patient care but not immediately life-threatening, they insert a macro at the end of the report using our voice dictation system (Nuance:Powerscribe). Specific characters in the macro designated by a radiology report category system (RADCAT) are recognized by the Cloverleaf interface engine and a copy of the report is sent to the TIBCO iProcess (The Information Bus Company) application. The TIBCO iProcess has a web based front end that is used by dedicated personnel at three affiliated hospitals to review and process these reports. They contact the patient’s primary care physician or if necessary the patient, and document that communication of the finding has taken place. A copy of the "closed report" is sent to the EMR for reference and medico-legal reasons. 

We are able to audit the TIBCO system to determine how often the communication loops is closed. Results: Between June 2012 and August 2013, 3956 radiology reports were noted by our radiologists to contain important non-urgent findings.  We have documented that 99.5% of these findings were successfully communicated to physicians and/or their patients. The 0.5% of patients whom we were unable to contact generally are either homeless or provided false information at the time of registration.

The system we created was rapidly adopted by our radiologists due to its ease of use. The web front end of the TIBCO application allows for the efficient use of the human resources in a multi-facility insitution like ours. We believe that we have virtually eliminated the risk of failure to communicate  important but non-urgent findings at our institution.

Using the combination of an interface engine and an application  like TIBCO, it is possible to create novel solutions to complex patient care problems without disrupting the workflow of the radiologists.

Movson, J, Paul, T, Cobb, C, Golding, D, Karn, A, Important Non-urgent Radiology Findings. A Novel Solution Using a Voice Dictation Macro and the TIBCO Application Integrated within the Soarian EMR (Siemens Medical) to Prevent These Findings from Falling through the Cracks.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006316.html