Radiology Quality-Improvement Program Reduces Risks and Costs

Leesburg, VA, November 14, 2017—An innovative quality-improvement program has demonstrated improved communication between health care providers, reducing the risk of delay in diagnosis related to inconsistent communication and tracking of radiology follow-up recommendations, according to a study published in the November 2017 issue of the American Journal of Roentgenology (AJR).

A three-stage system known as the “Backstop” system was developed to track recommendations for follow-up radiologic imaging studies and image-guided interventional procedures, said authors Ben Wandtke of the University of Rochester Medical Center and Sarah Gallagher of F.F. Thompson Hospital of Canadiaigua, New York.

Radiologists flagged reports with unconditional recommendations meeting the inclusion criteria at the time of dictation, and these reports were then entered into a database tracking system.

The researchers’ results showed that over 13 months completion of recommended follow-up increased by 52 percent. The number of patients at risk for delay in diagnosis was reduced by 74 percent. The article noted that F.F. Thompson Hospital now identifies appropriate follow-up compliance for more than 86 percent of all radiology recommendations, which would place it higher than any other health system has reported in medical literature.

In addition to reducing the risk of patient harm and limiting medical legal liability, tracking recommendations resulted in the added benefit of increased fee-for-service revenue, the authors stated.

“More than 72 percent of additional examinations completed after tracking intervention were either CT or MRI,” they said. “The technical revenue generated from the 18.2 percent of examinations completed after tracking intervention was 5.2 times the labor cost of the clerical navigator position, which was the primary expense associated with the program. Most of this revenue was captured at our hospital, resulting in an annual return on investment that was 4.1 times greater than the labor cost, discounting the variable costs of imaging.”

To further increase the value added by tracking recommendations, the effectiveness of new information technology tools, such as point-of-care clinical decision support for evidence-based recommendation generation, should be investigated, the authors stated.

Founded in 1900, ARRS is the first and oldest radiology society in the United States, and is an international forum for progress in radiology. The Society's mission is to improve health through a community committed to advancing knowledge and skills in radiology. ARRS achieves its mission through an annual scientific and educational meeting, publication of the American Journal of Roentgenology (AJR) and InPractice magazine, topical symposia and webinars, and print and online educational materials. ARRS is located in Leesburg, VA.