Value based care is driving radiologists to increase their focus on quality and outcomes that relate to patients’ overall wellbeing. MACRA contains several performance criteria for radiology, and quality metrics represent the largest component. With recent attention on the low rate of follow-up on radiologist recommendations, it isn’t surprising that many of these metrics relate to the process of screening exams and incidental findings follow-up.
One area where radiologists can directly impact both cost and outcomes is in incidental findings management. The increased volume and improved quality of images mean that radiologists detect more incidental findings that are unrelated to a patient’s current complaint. Managing these findings can require a considerable amount of time and incur significant cost for follow up.
There is a demonstrated need for hospitals to find a way to manage these events, as shown in this study where two university-affiliated emergency departments found 514 incidental findings over a two-month period. If you extrapolate that data to the rest of the country, this type of event could easily occur tens of thousands of times per year.
As I discussed a few weeks ago, in a “Tale of 2 Patients”, workflow orchestration solutions can have tremendous positive impact on individual patients. That situation examined improved communication between the ED and Radiology, but a rules engine can be used to close communication gaps for other scenarios as well, including management of incidental findings.
Here are two scenarios that demonstrate how an incidental finding might be processed:
In the second example, an automated workflow management system lets the radiologist communicate the finding to the ED before the patient leaves the hospital, which increases the likelihood that that the finding receives appropriate follow-up.
The ongoing transition to value-based care is pushing radiologists to go beyond reading studies in isolation and asking them to prove their value as an integral part of the health system. Using automated, intelligent workflows helps them achieve this goal by letting them use their clinical expertise to address all aspects of a patient’s condition. Additionally, automated workflows can close the loop with a patient’s entire care team. When that expertise is matched with an intelligent workflow management solution that tracks and monitors the results, it can lead to improved wellbeing for individual patients and improved quality across the health system.