Jaron Chong MD, Presenter: Nothing to Disclose

We believe this design pattern of a closed-loop feedback notification ticket system offers a general-purpose architecture for the development of a variety of valuable quality-assurance projects. Automated messaging allows for a ‘push’ instead of a ‘pull’ delivery model and the flexible notifications system permits both human and machine messaging to be performed yielding significant benefits beyond hard-coded dashboard implementations.

Report timeline search has the potential to query for sequences of clinical or radiological events. However, translating these queries into routine follow-up examinations and clinician verified notification requires a complete end-to-end ticket and messaging architecture. This project describes the practical implementation of a query and notification system to allow a free-form report search engine to implement examination follow-up planning, scheduling, and physician notifications.

Recurring scheduled nested SPHINX EXTENDED2 queries are utilized to execute report timeline queries on a real-time search index. Using report text, study meta-information, and timeline query result matches, open tickets are generated, continuously re-evaluated, and closed. Upon satisfying of query report criteria, ticket maturity, or chronic persistence of an open-loop, a notification is dispatched to machine and/or human recipients including the RIS, radiologists, referring physician/physician teams, or patients.

Using this general-purpose framework, we have been able to address commonly missed/near-miss clinical scenarios that lie below routine clinical practice thresholds and have been able to institute closed-loop quality assurance across a diverse variety of scenarios. We describe application examples involving (1) verification of scheduling of IVC filter retrieval, and (2) pulmonary nodule / incidental lesion follow-up, and (3) preliminary report discrepancy notification. Additionally, we describe multi-tiered notifications methods involving e-mail, SMS/FAX gateways, XMPP instant messaging gateways, and POTS Interactive Voice Response software (Asterisk) to allow for reliable verified message delivery in a heterogeneous operating environment.

Chong, J, End-Loop Feedback Notifying Ticketing System (ELFNTS): Applying Automated Free-form Report Timeline Queries for Follow-up Examination Planning, Scheduling, and Physician Notification.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016529.html