Evan Johnson MD, Presenter: Nothing to Disclose

Andrew B. Rosenkrantz MD, Abstract Co-Author: Nothing to Disclose

Joseph J. Sanger MD, Abstract Co-Author: Nothing to Disclose

The workflow of both radiologists and clinicians could benefit from a system to assist the communication of imaging findings that require further action but that do not pose a risk of immediate patient harm. In this study, our aim is to evaluate the usage and associated outcomes of such a tool that provides a hybrid digital/administrative solution for communication of important non-urgent imaging findings.

This retrospective study was IRB-approved. The tool developed and implemented by our department allows the radiologist to click a button in the dictation software during study interpretation to mark a case for clinician follow-up. After report sign-off, a departmental secretary then faxes the report to the physician’s office, calls to confirm receipt, and electronically logs these actions. We reviewed the tool’s log for a two-week period in January 2013 for various factors relating to its usage and associated outcomes.

Of 229 entries, 84.7% occurred from 7am-5pm, and 16.3% overnight. 99.6% were successfully faxed with phone confirmation; 85.1% were confirmed by the next business day. For 31.1% confirmed on the same business day, the average delay until confirmation was 222±130 minutes. 59.4% were for “in-network” patients whose care is tracked within our EMR. Of these, 33.1% had evidence in the EMR of a subsequent action taken by the patient’s provider (median delay of 3 days; action occurring on date of ticket entry in 15/45 instances). Most common studies for which the tool was used were chest radiograph (25.8%), chest CT (19.2%), bone radiograph (14.0%), and abdominal ultrasound (11.4%). Most common reasons for usage were lung nodule/mass (32.8%), other lung parenchymal abnormality (11.4%), and osseous fracture (10.05%). 66.8% contained a recommendation for additional imaging, which was performed in 49% of those cases (median delay 21 days). 45% of the performed follow-up imaging had findings warranting further action.

Our data show the effectiveness of the tool in assisting the communication of important imaging findings, thereby frequently facilitating early clinician action, as well as in providing documentation of this notification.

The communication tool enhances patient care with minimal workflow disruption, thus assisting radiologists in adding value to their practice.

Johnson, E, Rosenkrantz, A, Sanger, J, Important Non-Urgent Imaging Findings: Use of a Hybrid Digital/Administrative Support Tool for Facilitating Clinician Communication.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045449.html