title: The RADCAT-3 system for closing the loop on important non-urgent radiology findings: a multidisciplinary system-wide approach.
abstract: The goal of this project was to create a system that was easy for radiologists to use and that could reliably identify, communicate, and track communication of important but non-urgent radiology findings to providers and patients. Prior to 2012, our workflow for communicating important non-urgent diagnostic imaging results was cumbersome, rarely used by our radiologists, and resulted in delays in report turnaround time. In 2012, we developed a new system to communicate important non-urgent findings (the RADiology CATegorization 3 (RADCAT-3) system) that was easy for radiologists to use and documented communication of results in the electronic medical record. To evaluate the performance of the new system, we reviewed our radiology reports before (June 2011-June 2012) and after (June 2012-June 2014) the implementation of the new system to compare utilization by the radiologists and success in communicating these findings. During the 12 months prior to implementation, 250 radiology reports (0.06 % of all reports) entered our workflow for communicating important non-urgent findings. One-hundred percent were successfully communicated. During the 24 months after implementation, 13,158 radiology reports (1.4 % of all reports) entered our new RADCAT-3 workflow (3995 (0.8 % of all reports) during year 1 and 9163 (1.9 % of all reports) during year 2). 99.7 % of those reports were successfully communicated. We created a reliable system to ensure communication of important but non-urgent findings with providers and/or patients and to document that communication in the electronic medical record. The rapid adoption of the new system by radiologists suggests that they found it easy to use and had confidence in its integrity. This system has the potential to improve patient care by improving the likelihood of appropriate follow-up for important non-urgent findings that could become life threatening.
authors.affiliation: Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, 3rd Floor Main Building, 593 Eddy Street, Providence, RI, 02903, USA. edibble@lifespan.org.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Dibble
authors.affiliation: Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, 3rd Floor Main Building, 593 Eddy Street, Providence, RI, 02903, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Swenson
authors.affiliation: Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, 3rd Floor Main Building, 593 Eddy Street, Providence, RI, 02903, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Cobb
authors.affiliation: Information Services, Lifespan Corporation, Providence, RI, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Paul
authors.affiliation: Information Services, Lifespan Corporation, Providence, RI, USA.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Karn
authors.affiliation: Department of Emergency Medicine, The Warren Alpert Medical School of Brown University/Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Portelli
authors.affiliation: Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, 3rd Floor Main Building, 593 Eddy Street, Providence, RI, 02903, USA.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Movson
mesh_terms: D057286:Electronic Health Records; D006747:Hospital Communication Systems / Q000458:organization & administration*; D006801:Humans; D011873:Radiology Information Systems / Q000458:organization & administration*; D013997:Time Factors; D057188:Workflow
keywords: Follow-up imaging; Incidental findings; Information technology solutions; Practice management