In the never-ending quest to get referring physicians to follow radiologist recommendations for follow-up imaging, Massachusetts researchers in JAMA Network Open offer an IT-based solution: Structured reporting software that was found to triple the number of radiology reports judged to be complete.
A recent study found that 65% of radiologist recommendations for follow-up imaging aren’t followed by referring physicians. Authors of that study found that recommendations that were strongly worded and communicated directly to referring doctors had higher uptake.
But what if radiologists don’t follow this advice? In the new paper, researchers from Brigham and Women’s Hospital and Harvard Medical School offer a more structured solution thanks to software developed as part of their Addressing Radiologist Recommendations Collaboratively project.
The ARCC software is a closed-loop communication system that’s designed to channel radiologist recommendations into a structured format that’s clearly understood, while also tracking whether they were accepted and fulfilled. The ARCC tool runs separately from the radiologist’s dictation software, so while it asks them to include a standardized recommendation sequence in their report, it leaves the specific free-text language up to them.
Under the ARCC criteria, the main factors that make up a complete follow-up recommendation are:
- Reason for imaging study
- Timeframe when study should be completed
- Imaging modality to be used
The researchers implemented the ARCC software in October 2019 in thoracic imaging, and rolled it out to other departments through December 2020. Use of the software was “strongly encouraged but voluntary.”
In testing the ARCC software’s effectiveness, the researchers found that the number of follow-up recommendations considered to be complete – with all three key elements – rose from 14% to 46%. Even so, one-third of reports filed with ARCC “still contained ambiguous language” in the free-text section – indicating that old habits are hard to break.
Radiologists may hate it when their recommendations for follow-up imaging are ignored, but referring physicians are also frustrated with free-text radiology reports that are wishy-washy and contain vague impressions. The ARCC software could bridge the gap by steering radiologists toward recommendations that are more concrete and specific – and more likely to be followed.