Law change alone not enough to close abnormal imaging-findings care gap, study finds
A recent legislative change in Pennsylvania has done little to close the loop when a radiologist discovers abnormal imaging findings.
That’s according to a new analysis of care at one imaging department undertaken after the Keystone State passed Act 112 in 2018. The law requires diagnostic imaging providers to directly notify outpatients within 20 days about any significant abnormalities that might require care in the next three months. However, the University of Pennsylvania has seen little benefit from the change, and it believes further interventions are needed to address this issue.
During the one-month study period, only about 3% of the 235 imaging-finding discussions were initiated by a patient. And just one of those (0.4%) could be directly tied to the “Patient Test Result Information Act,” experts detailed Sunday in JACR.
“Act 112 had a small impact on improving completed follow-up for abnormal imaging findings,” concluded Govind Mattay, with the Perelman School of Medicine, and colleagues. “Health systems could amplify the impact of Act 112 by designing interventions to encourage ordering providers to discuss abnormal findings with patients in a timely manner,” the team added.
To reach their conclusions, Mattay et al. analyzed any findings flagged for patient notification at their own institution, along with any documented follow-up discussions and medical care. All told, providers documented such discussions in 87% of findings, with the conversations occurring within six days after the imaging exam, on average. Providers delivered any follow-up treatment for 74% of those findings at an average of about 31 days after exams.
The research team said one “major factor” contributing to the low impact of the legislation is that most follow-up discussions (about 86%) occurred in six days or less, before Act 112 letters even went out at the 10-day mark.
Mattay and colleagues also noted that the length of time between imaging and follow-up care was shorter when discussions were initiated by a clinician, rather than a patient. Provider-led discussion also occurred earlier in the care process, which previous analyses have shown to reduce “scanxiety” stemming from abnormal results, the research team noted.
“Taken together, our findings suggest that the impact of Act 112 could be amplified through designing interventions to improve the timeliness of patient-provider discussions of abnormal imaging findings and to facilitate radiologist communication of these findings to providers,” the team noted. “The impact of these interventions can be maximized through coproduction by radiologists, ordering providers and even patients,” they added.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.