IT's role varied in delivering actionable imaging findings

Information technology can be used to facilitate nonroutine communications of imaging findings to appropriate providers, but the method will vary depending on the urgency and severity of those findings, according to a report from the American College of Radiology's Actionable Reporting Work Group.

According to ACR's Imaging 3.0 initiative, an actionable, comprehensible and appropriately communicated report is the most import product radiologists can deliver; the Actionable Reporting Work Group was tasked with addressing the potential role IT can play in delivering such reports.

In the report, which recently was published online in the Journal of the American College of Radiology, the group defines three categories of findings: those that required communication and clinical decisions within (1) minutes; (2) hours; or (3) days.

Category 1 findings are those that could lead to death or significant morbidity if not addressed promptly. Consequently, there is a limited role for IT here, since imaging findings must be directly communicated to ordering providers. IT systems, however, can be used to identify and locate providers with whom it's necessary to communicate. An IT system may also be able to prompt a radiologist that a specific diagnosis falls within Category 1.

In the case of Category 2 findings--since they probably won't be communicated directly to ordering providers--an IT system must contain a mechanism that enables a provider to confirm that he or she has received an imaging report.

A Category 3 finding, the work group says, "has the most need and potential for IT support." For example, because these findings are not immediately necessary for patient care, radiologists instead may move on to interpret studies of a more pressing nature, leading to the possibility that those Category 3 findings will "fall through the cracks."

An IT solution, according to the group, could enable radiologist to issue a final report but indicate that it contains important, but nonurgent findings, which should be highlighted from other less significant findings. The IT system also could enable a referring provider to acknowledge receiving the report.

It's probable, the group says, that vendors won't be able to develop a one-size-fits-all solution to the question of reporting actionable findings. The group recommends that vendors develop platforms that can be customized on the basis of local preferences and needs, and adds that whatever system is used must be highly reliable and fit seamlessly into a radiologist's workflow. 

"There is a great opportunity for radiologists and vendors to develop and refine information systems to optimize communication of all imaging findings, especially when nonroutine communication of actionable findings is required and when long-term follow-up imaging is indicated," the group concluded.

Radiology reports remain the most common method through which radiologists communicate with referring physicians, but the way in the which such reports are produced hasn't changed much in the last century, according to an article published in the December issue of Academic Radiology. To that end, the authors said, the creation of accessible, readable, and automatic multimedia radiology reports can improve and enhance the practice and satisfaction of referring physicians and improve patient care.

To learn more:
- see the study's abstract in the Journal of the American College of Radiology
- read up on ACR's Imaging 3.0 initiative

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