She noted that there are drawbacks and challenges with radiologist-led results delivery, such as higher costs, potential liability and more time required by radiologists. Additionally, referring physicians often want to retain full ownership of patient care and radiologists often have no prior relationship with patients.
Sznycer-Taub also said research shows that offering patient portals that include delivery of imaging-related content can provide more rapid delivery of exam results to patients. Health systems can build in a time delay on portal access in order to enable referring physicians to connect with patients first and can provide a brief explanation of the results in lay language in the radiology report.
“These approaches are not mutually exclusive and the radiologist, referring physician and the patient portal can play complementary roles,” she said. “Whether results are delivered by the referrer, a radiologist and/or a patient portal, institutions should consider the needs and wishes of all stakeholders involved.”
The third imperative is to ensure a successful patient handoff. Research indicates that 15 percent of electronic exam notifications are not ready by the referring physicians, Sznycer-Taub said, and she recommends radiology departments develop ways to confirm that referring physicians have received the results to be a safety net that helps to bridge the referrer-patient gap. “To be integrated into patient-centered care, imaging needs to close the loop as patients move to the next step of the process,” she said.
At the La Crosse, Wis.-based Gundersen Health System, which operates three hospitals, imaging leaders have implemented an incidental findings tracking initiative to ensure patient follow-up. As part of this initiative, the radiology department activated a query box in voice recognition software so radiologists can indicate the need for follow-up care on the report. Staff members run weekly reports, compile cases that need follow-up and send messages via Epic to referring physicians to confirm the report has been received. In that message, referring physicians are requested to indicate a follow-up plan and the radiology department documents the response to maintain a record of physician communication.
Additionally, if the referrer doesn’t respond after two weeks, the case passes is passed to a quality assurance radiologist to contact the referrer, and, as a last step, the QA radiologist alerts the department chairmen.
Additionally, at Gundersen, the radiology department matches emergency department patients who do not have a referring physician with internal medicine residents for follow-up care.
“There’s this gap between radiology and the referrer and someone needs to bridge the gap and radiology is best positioned to fill that void,” she said.
Essentially, Sznycer-Taub contends that imaging programs should take responsibility for follow-up care by confirming that referrers have acted upon radiology results. “In this way, radiology confirms that its product has been utilized as intended and adds value as a patient care coordinator,” she said.
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