If Radiology is accountable for quality imaging, then the provider should be equally accountable to follow the radiologist’s recommendations. Assume for a moment that Radiology is black box. There’s the ‘order’ and the ‘result’.
In an ACR Select enabled imaging world, consultations are performed when it matters. Radiologists and ordering physicians regularly communicate. Imaging shares in the reward of creating impact in the continuum of care for selecting the right order and disseminating an actionable, track-able report such that all parties are held accountable to the guidance.
Accountability matters, and, it’s a two way street. A few simple additions to the reporting workflow bring quality alive.
Actionable Reporting is an important next step in the implementation of Appropriate Imaging. The concept is simple. Close the loop! Make your findings and recommendations measurable.
Make your reports “actionable”. One way is include a structured finding and recommendation code with each report. For example:
- Is the finding consistent with the reason the exam was ordered?
- Is the recommendation for more imaging a result of the wrong exam being ordered?
- Is there an incidentialoma (sic)? If so, what’s the severity? Is it critical?
Ensure the provider is held equally accountable:
- Was the exam really the right one opposite the selected reasons for exam?
- Were the reasons for exam “right”?
- It’s also possible that there was a better exam opposite the conditions, and that’s worth knowing, recording and acting on.
- Was there a prior exam that would have dis-intermediated this exam?
- Are your recommendations, (which was requested as a result of the ordered exam) being followed? If not, why?
Often, radiologists work with no clinical correlation for the advice they are giving. Producing an actionable, track-able report is the starting point for demonstrating the radiologist’s value in the care continuum.