Simple IT tweak fuels same-day radiologist reads and clinic visits

Radiology researchers are detailing how a simple IT tweak helped Harvard-affiliated physicians provide image interpretations the same day as related on-site clinic visits. 

Radiologists often read images in the order they’re received with no knowledge of how to prioritize worklists and align them with when patients are meeting their provider to go over results. Experts aimed to shift this paradigm, rearranging radiologists’ queues in real-time to prioritize those related to clinic visits occurring in the next 4 hours over others in the 4- to 8-hour range. 

With this practice change, about 56% of radiology reports had “actionable communication” available at the time of the corresponding clinic appointment, experts wrote in the Journal of the American College of Radiology. That’s compared to about 45% prior to the intervention—a 24.3% improvement. 

“It is probable that our results led to an improvement in the quality of clinic appointments due to the impact of result availability,” Pamela J. DiPiro, MD, an associate Harvard professor and radiologist with Brigham and Women's, and colleagues wrote Jan. 30 “Moreover, many patients travel large distances to see providers at our [academic medical center] or take time off from work or family responsibilities for care, and timely imaging results are highly desirable to patients. Additionally, for referring providers, being able to share imaging results and determine treatment plans at the time of clinic appointment is likely more efficient than making follow-up communications to patients post-visit once imaging results become available.”

Those involved implemented the IT intervention across 21 clinics in January 2021. The study analyzed diagnostic radiology exams among patients with a subsequent same-day clinic visit. It covered a three-month, pre-intervention period at the end of 2020 (6,391 exams) and compared it against the same three months in 2023 after the change (8,025 more exams). They found that post-intervention reports were “significantly” more likely than others to have actionable communication available at the time of a clinic appointment (odds ratio = 1.56). 

Most post-intervention reports (about 71%) were related to examinations ordered by cancer center providers.

“Although improved reporting timeliness may be particularly relevant to oncologists who rely on imaging markers to assess response to therapy and adjust treatment plans, our work exemplifies a worklist reprioritization effort that could be applied to a variety of specialties within the AMC setting, especially those with a high volume of same-day visits,” the authors noted. 

Post-intervention reports with actionable communication available at the time of the appointment had a “significantly” longer time from exam end to clinic arrival (157 minutes) than reports without such communication (80 minutes). 

“Thus, other factors including adequate radiologist staffing and ensuring sufficient time between radiology and clinic appointments are also critical in increasing report availability at a subsequent clinical appointment,” the authors noted. “Additionally, it is possible that examination end to clinic appointment times were longer for examinations without a same-day clinic appointment after the intervention due to the increased allocation of resources toward encounters with same-day appointments.” 

Read more about the results, including potential study limitations, in JACR.