Dhruv Chopra, MBA, Collaborative Imaging Chief Executive Officer

From the detection of a bulging blood vessel to a blocked artery to a suspicious mass, the advancements in modern medical imaging save lives. However, there are many times when medical imaging tests are being performed for one reason, and the radiologist detects an unexpected anomaly that is completely unrelated. In those cases, the radiologist usually recommends additional imaging.

Unfortunately, the number of the recommendations that actually translate into additional imaging (RAIs) tests being performed is low. This non-compliance can cause poor outcomes for patients, and it could have negative downstream effects for a practice, as well. In some cases, a patient could file a malpractice lawsuit, resulting in the radiology practice or department being found legally liable for some of a patient's damages.

New Research Indicates Adherence to Recommendations for Additional Imaging is Low

New research gathered during a six-month study shows that whether the follow-up exams a radiologist recommends are performed depends greatly on the type of provider who receives the recommendation and the care setting in which that provider treats the patient.

The Goal of This Study: Determining Why RAI Adherence is Low

The only way to increase the number of providers adhering to the recommendations for additional imaging is to discover the factors affecting adherence rates.

Factors Affecting Adherence to Recommendations for Additional Imaging of Incidental Findings in Radiology Reports

. Conducted by doctors at the University of California’s Davis Medical Center, this study focused on the reasons why providers disregard RAIs. To answer this question, researchers reviewed 539 reports of computed axial tomography scans that, due to incidental findings, had recommendations for additional imaging. Since these reports were studied retrospectively, the researchers used the patients’ medical charts to determine if providers adhered to the RAIs.

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Study results indicate that outpatient sites and primary care providers (PCP) were most likely to follow additional imaging recommendations. However, according to study researcher Shan S. Hansra, M.D., from the Sacramento, California, institution, it is the referring physician who is usually responsible for managing radiology report recommendations.

Nevertheless, if the referring physician neglects to follow-up on the incidental findings, the consequences are likely to trickle down, detrimentally affecting the radiology practice or department.

Factors Affecting Recommendations for Additional Imaging Adherence Rates

Ascertaining adherence rates and, then, recognizing the factors that affect these rates can help determine the reasons that RAIs are not being addressed.

Overall, the recommendations for additional imaging were performed in 39.1 percent of the 539 cases. However, when the patient’s primary care provider was at the institution where the CT scan was performed, the compliance rate increased substantially to 56.8 percent.

Adherence Rates Based on the Type of Patient Being Treated When the PCP is at the Same Location

The adherence rate when the patient is seen as:

A patient in the emergency department, 46 percent.

Adherence rates based on the part of the body that requires additional imaging tests:

At 3.5 percent, chest imaging had the highest rate of adherence. After chest imaging, providers adhered to 3.1 percent of the RAIs for the neck, abdomen and pelvis.

The lowest adherence rates involved an extremity (0.3 percent), the spine (0.8 percent), the head (0.1 percent) and the face (0.1 percent).

For outpatients, the specialty of the provider ordering the CT scan made a difference in the percentage of providers following up, as well:

PCPs adhered to the recommendations 67 percent of the time.

Surgeons followed up 37.7 percent of the time.

Internal medicine subspecialists adhered to the RAIs 50 percent of the time.

Noncompliance to RAIs is Mainly Due to a Lapse in Communication

According to the authors of this study, lapses in communication serve as the main reason for the failure to follow-up on RAIs. While documenting the need for follow-up imaging in the discharge summary does boost adherence rates, these details are often absent from the patient's discharge summary. In addition, many times, the patient only receives the test results once they are released.

There are numerous gaps that must be addressed to make sure that there is a good line of communication between the radiologist, the ordering physician, the PCP, and the patient.

Neglecting to follow-up on a recommendation for additional imaging can result in diagnosis and treatment delays, which may lead to poor patient outcomes. Poor patient outcomes due to this negligence can lead to a malpractice lawsuit, resulting in the practice’s or department’s legal liability. 

Numerous examples demonstrate where incidental findings go unnoticed due to a gap in communication and lack of patient tracking – these mishaps can lead to patient fatalities and lawsuits. A recent settlement in Illinois makes it clear how important good communication is.

In November 2017, Mark James had a CT scan for potential venous stenosis in one of his kidneys. This scan was performed on James' pelvis and abdomen. While the radiologist was reading the scan, he found a mass on James’ lung. The radiologist gave a recommendation for additional imaging; however, this information was not shared with James.

In May 2019, James began experiencing inflammation and pain in his chest and shoulder. He had another CT scan – it revealed that the mass found in 2017, which he was never informed about, had metastasized. James passed away in July of 2019.

Due to the delayed cancer diagnosis, James’ family received a $7.5 million settlement from the University of Illinois Hospital.

Patients who miss their follow-up appointments or choose another provider for their care are vulnerable. Often, incidental findings and recommendations are altogether missed by the referring provider. It is essential that patient contact information and preferences on how to be contacted are captured accurately to ensure the continuity of care. Otherwise, the patient may never know there is a recommendation for additional imaging. Consider implementing the practice of informing the patient how important his or her follow-up visit is. Doing so may increase the likelihood that the patient keeps this appointment.

Texas Radiology Associates, a group of 150 radiologists based in Plano, Texas, also has a unique solution to combat the lack of follow-ups through technological advancements.

John Kim, M.D., managing partner of Texas Radiology Associates explains how technology has helped them better communicate.

“We have deployed technology that identifies studies that require follow-ups based on the patient’s case. This technology can also ensure the same information has been relayed and received by the referring physician, and creates an alerting mechanism to take action should the particular patient not have the recommended study, such as following up with the patient, or the referring physician to inform them of a recommendation not being adhered to,” he said. “This has resulted into a significant decrease in missed recommendations.” 

Texas Radiology Associates also allows patients to have access to their radiology reports, thereby allowing them to play a critical role in their continuity of care. In the healthcare space, innovative technology can address several gaps and is ever-growing and evolving.

The American College of Radiology is Addressing Gaps in Care

Currently, a consensus for guiding classification of the incidental findings discovered on imaging tests is nonexistent. However, the American College of Radiology (ACR) is in the process of creating a quality measure for addressing these potentially dangerous gaps in care.

Recently, the ACR received a grant in the amount of $341,000 for work that was previously done with a large group of radiologists. Now, the researchers are requesting that physicians give questionnaires to patients and their families with the goal of attaining additional information related to incidental findings. Furthermore, the American College of Emergency Physicians is working in conjunction with the ACR to create guidance related to following up on anomalies found during emergency situations.

Once a coordinated process is implemented to prevent gaps in care, patient morbidity and mortality rates should drop. Consequently, the likelihood of litigation due to poor communication related to CT scans and other imaging test results will drop.

Articles

Collaborative Imaging’s Dhruv Chopra, MBA, takes a deeper look into how many follow-up recommendations are ignored and what can be done to reverse the trend, leading to better patient care.

Communication Critical to Providers Adhering to Follow-Up Recommendations

Continued digitization has brought tremendous benefits to healthcare, making the industry more connected and efficient than ever. However, with an overwhelming number of data and patient records located on interconnected networks, the importance of actively protecting it all cannot be overstated. Hackers have continually evolved and adapted with technology. They are always seeking new sectors to attack, including in the healthcare space.

For radiology departments, the risks of experiencing cyber-attacks has increased over the past several years with widespread industry consolidation and the profession becoming a mainly digital practice. With many radiologists now working remotely due to COVID-19, hackers are more likely than ever to jump at the opportunity to breach private data with employees working on less secure mobile devices and wireless networks.

Practices must begin to invest in and strengthen their cybersecurity immediately to prevent the possibility of an attack. As our industry transitions to a more virtual environment, taking immediate action may save the future of your practice and, more importantly, the future of your patients’ health information.

Understanding Cyber-Attacks on Healthcare Practices

The incredible growth of industry technology has enhanced the medical profession, making data and information instantaneously accessible. However, this immediate access to private data also creates opportunities for hackers to invade organizations’ systems, majorly affecting the entire industry.

Cyber-crimes cost the healthcare industry around 

, with organizations individually losing an average of $3.7 million. There are also many other costs organizations could face with cyber-crimes, including post-breach costs, potential fines from HIPAA and even lawsuits. What’s more, employees can be major contributors to potential network breaches, as well. According to a 2016 report from BakerHostetler, 24 percent of healthcare data breaches were the fault of employee errors.

 Avoiding Hacked DICOM Images – What Can You Do?

Organizations are not the only ones affected by cyber-attacks, however. Their patients suffer just as much, and in some cases, even more so. In 2019 alone, 

 were affected by healthcare data breaches, doubling the amount recorded in 2018. This trend is expected to increase as more data and protected healthcare information (PHI) becomes digitized on network servers across the industry.

It’s hard to predict where hackers will attack next and how they will do so. Cyber-crimes can stretch from breaching systems for patients’ PHI, infecting networks in malware attacks, or deliberately tampering with images and scans in ransomware attacks. This uncertainty can make securing data and preparing systems for attacks a challenging process.

While there is uncertainty in exactly how hackers will attack, they have been pretty consistent in targeting small- and medium-sized medical practices. This is because many of these specific practices do not have the manpower nor financial resources to field a full cybersecurity team, making their data less secure and easier to breach.

Hackers have also become interested in targeting healthcare networks consisting of consolidated practices. With imaging, patient information and other data streamlined across multiple networks and facilities, there are more opportunities for hackers to breach, steal, and manipulate private data.

Figuring Out How Practices Can Prevent Cyber-Attacks

Practices can take many different avenues to bolster their cybersecurity efforts. One of the most important steps is implementing proper security systems, such as artificial intelligence (AI) solutions. These systems are designed to constantly understand patterns and protect data automatically while anticipating and identifying any nefarious activity. In a time where hackers can attack systems in various forms at various times, AI solutions will intuitively protect your network and patient data.

Another step, especially in this remote era of healthcare, is to have added protection for any mobile devices used by employees. While the amount of mobile devices at our disposal is helpful to radiologists and their practices, they also pose a great threat to network privacy and security. With the pandemic forcing many radiologists and physicians to work remotely, they have relied on their mobile devices and wireless networks at home to accomplish their work. These devices and networks are much less secure than those at their practices or hospitals, increasing the vulnerability for hacking. 

To decrease the possibility of hackings or any unauthorized access, all used mobile devices must be equipped with stronger authentication and access control settings. Regularly changed passwords, further authentication steps and even limiting the amount of mobile devices used are a few ways to increase protection when utilizing mobile devices. Implementing these settings can be a major step in keeping all data and private information secure as remote work could be the future of the industry, at least for the rest of this pandemic, and maybe even beyond.

Network breaches can be detrimental to practices and their patients in numerous ways. It is important that practices improve, and maybe even overhaul, their cybersecurity efforts. The expansion and evolution of industry technology only increases the chances of network hackings and practices losing invaluable data and information. As many practices struggle to survive during these turbulent times, one network hacking could be the ultimate kiss of death for an organization and affected patients.

Anticipating where hackers might strike and determining how to prevent attacks can be critical.

The Importance of Cybersecurity in This Era of Radiology

The business of radiology continues to evolve, including the interactions between practices and their patients. Patients are now seeking tighter control of their own healthcare and are becoming more educated with the pervasiveness of technology and information they get at their fingertips.

As patients continue to evolve, radiology practices have had to adjust their patient interaction methods to become more sensitive and empathetic to their individual situations – something patients yearn for in their physicians and radiologists. According to a 2016 study done by the Massachusetts General Hospital department of orthopedic surgery, 65 percent of patient satisfaction was directly correlated with physician empathy, highlighting the importance of professionals’ behaviors when interacting with their patients.

While many practices have created suitable programs to be understanding of and responsive to their patients’ wishes, there’s still more to be done to be on par with the patient-centric trend we’re seeing throughout health care. With that, here are three ways radiology practices can become more patient-friendly.

Much of the relationship between a radiologist or referring physician and their patient consists of the radiologist giving consultation to the patient on the best possible treatment options. While this part of the process will not and should not change, we often forget about where the patient’s perspective lies in this.

It’s a best practice to empower patients by letting them share input and what they feel is right for them, along with guidance from their radiologist or physician. After all, it is the patient’s right to make his or her own decisions and that should never be interfered with. It’s important to make patients feel comfortable at all times and to encourage them to share any vital specifics about their medical history, as it could have a major impact on image diagnosing accuracy and the subsequent treatments.

Allowing patients this opportunity will give them more confidence to initiate conversations with their physician or radiologist, which can build a stronger relationship between both sides moving forward.

Maintaining a Fluid Line of Communication with Patients

Maintaining constant and informatory communication with patients is paramount throughout the diagnosing and treatment process when radiologists are called to interact with patients. No matter the news – good or bad – patients deserve to be readily updated on their scans and what those scans mean in terms of treatment from their physicians. Keeping patients regularly updated can calm any fears they may have while going through the process, no matter if it’s from their referring physician or radiologist.

Keep in mind you must do your best to explain everything in layman’s terms for patients, as some patients may be new to radiology and what it all entails. Using complex industry terminology could cause confusion and misinterpretation, which can affect patients’ decisions and their understanding of treatment steps. Some patients may still not fully comprehend all the information, no matter how clear and concise it was presented to them. The next step would be to refer them to physical or digital resources that may explain their situation differently. Again, making patients feel comfortable and knowledgeable of what all is transpiring is paramount.

Practices can also enhance their patient communication methods by utilizing the vast capabilities of modern technology. Some groups, such as 

, have adopted and innovated technological solutions, such as instant messaging, image annotation, full directory of referring physicians and phone apps to consolidate patients’ appointment schedules.

These solutions allow the conversation between both parties to remain fluid and informatory. This technology has aided patients and radiologists during the COVID-19 pandemic, as many practices and facilities have moved toward remote work and telehealth visits. Implementing this technology can greatly improve the communication between your radiologists and patients in this virtual era of health care and beyond.

The third – and maybe most important step – practices can take to become more patient-friendly is to be as transparent as possible with patients at all times. Patients deserve clear and honest communication, no matter the nature of the dialogue. This builds trust between both sides, which can pay dividends in terms of patient loyalty and patient engagement. It also emphasizes your practice’s obligations to providing the best possible patient care and emulates the values the entire practice strives by which to operate.

Not being empathetic and transparent with your patients could have numerous ramifications that could affect the future of your business. Legal issues, loss of current and future patients, and damage to your practice’s brand are just the few of the complications that could occur if you are operating dishonestly with patients.

Interactions between patients and their referring physicians will continue to evolve as patients will look to have direct input and tighter control of their health care. Radiology practices need to embrace the changes in patient behavior and incorporate these three principles, along with others, to properly adapt in this new industry era. If not, patients will leave lagging practices behind for those who listen to them and attend to their wants and needs accordingly.

Three strategies to keep your patients at ease and satisfied with your performance.

How Practices Can Become More Patient-Friendly

While data and analytics reporting has grown immensely throughout other industries, it is still highly underutilized in radiology. Practices are often intimidated by transitioning into new data systems for fear of using them incorrectly. However, radiological analytics and reporting can be a major asset for any practice, especially in weathering the turbulent times of the coronavirus 2019 (COVID-19) pandemic.

Incorporating analytics and reporting into your practice can enhance clinical care and operations, fix billing errors and cut costs. This will not only improve your practice, but will also help it to stay afloat in the ever-evolving industry and for the remainder of this pandemic. Below, I dive deeper into three benefits of implementing analytics and reporting and how each can positively impact your practice.

The more radiological data becomes available, the more responsibility you have with managing it, especially across multiple platforms. Today’s radiologists often use multiple data systems – possibly one for each partnering hospital they work with – which could lead to massive operational headaches depending on how many partners these systems are spread across. If they are not streamlined consistently, errors, such as failing to visualize and predict trends, detect gaps, or draw accurate correlations, could arise.

Thankfully, advanced reporting tools that simultaneously manage multiple radiology systems and workstations can effectively handle information overload within practices. Leveraging these tools allows data to be aggregated and consolidated from various platforms into one common system. This converts the data into a more easily functional format that improves radiologists’ overall productivity.

In relevance to the COVID-19 pandemic, widespread implementation and utilization of these advanced tools can play a pivotal role in a practice’s pandemic response and beyond. Providing deep insights into COVID-19 symptoms and tracking for departments treating infected patients – along with managing high volumes of patients once business influx returns – could be an invaluable tool in navigating the complexity of the current industry.

Correct Billing Inaccuracies While Eliminating Waste

Revenue cycle management (RCM) processes have become increasingly complex over time, which can lead to severe complications if not maintained properly. Incomplete information, missing prior authorization or lack of documentation are just a few examples that can lead to significant subsequent issues if left unchecked in your RCM processes.

For example, let’s say a radiologist filed a claim for imaging services to their billing company. When the claim is submitted, the practice’s software accidentally attaches the imaging service to three other patient claims instead of just one. In this instance, the system shows the patients received additional imaging services that were never completed – causing a major quagmire in the revenue management cycle. An error like this could result in intensive, time-consuming billing nightmares that eventually delay reimbursement.

These errors in claims cost industry insurers billions of dollars annually. Furthermore, given the sheer volume of claims submitted each day, the price of capturing and reconciling billing discrepancies without the use of rich analytics systems is extremely ineffective and time-consuming.

Rich analytics systems identify poor data quality and fix mistakes automatically, resulting in more accurate claims and higher reimbursement rates while avoiding crucial errors that could lead to wasteful spending. In a time where many radiologists are working remotely due to recent federal regulations, implementing these systems in your practice can ease complex billing processes and avoid any possible billing complications.

Enhance Patient Care Through Detection and Prioritization

According to a 2018 report published in Nature Reviews Cancer on artificial intelligence (AI) in radiology, the massive rise in available radiological data and analytics has outgrown the number of industry professionals who are able to read and analyze them. To compensate for this disproportionate growth, healthcare providers have increased radiologist workload. Radiologist burnout is already extremely high, and increasing their workload can lead to increased human error.

Fortunately for referring providers and their radiologists, utilizing rich analytics in conjunction with AI offers the benefit of reading and interpreting multiple images at a more proficient pace. They also enforce deep learning models that are trained for specified image recognition tasks.

For example, a rich analytics system can recognize abnormalities in an image and place it higher in the order of images needed to be read. This allows radiologists to view images based on reading priority. Also, if images are accidentally sent to the incorrect physician, the data can be automatically re-routed to the appropriate referring physician, so an immediate plan of action can be determined for the sake of the patient’s health. Overall, this utilization of rich analytics and AI together drastically speeds up reporting and improves patient outcomes, lessening the overall workload for radiologists and enhancing the practice’s overall patient care.

Implementing analytics and reporting systems – such as those offered by Collaborative Imaging to its partners – can greatly improve your practice in the current digital age of radiology. Enhancing operational efficiency, fixing billing errors and improving patient care are just a few of the many benefits these systems can provide any practice looking to move forward in the industry. Radiology has always been extremely competitive, but in times like these, incorporating analytics and reporting systems may be what keeps your practice afloat for the remainder of the COVID-19 pandemic -- and what sets it apart once business returns.

While data and analytics reporting has grown immensely throughout other industries, it is still highly underutilized in radiology. 

The Importance of Implementing Analytics and Reporting Into Your Radiology Practice

The early eruption of the coronavirus prompted the federal government to urge a widespread halt of elective procedures in hopes of slowing the viral spread. For radiologists, this caused a massive decline in routine exams, which can result in a 40 percent-to-60 percent loss in revenue. Evolving health policies and industry environments keep revenue cycle leaders constantly seeking new strategies for improving the financial health of their practice. Now, radiology practices must maximize their ability to recover revenue and look into sufficient solutions during this down time of business.

Cutting costs and improving efficiencies within a practice is easier said than done. However, leaders need to be able to adapt to changing times in the industry, especially the current state we are in. Implementing the following strategies can help practices maneuver this business nadir and set them up for lasting revenue cycle management excellence throughout the rest of COVID-19 and long after it is neutralized.

Achieving revenue cycle efficiency is an immense challenge under normal circumstances with the rapidly moving parts in this industry. Now, more than ever, it’s important for practices to enhance their revenue cycles to avoid further complications in this current business decline during the pandemic.

Whether billing is done in-house or outsourced by a third-party, it is important to utilize readily available technology to internally “scrub” claims for the accuracy and completeness required for clean filing. Technology allows for a rules-based review of billing files that is not dependent on a person and triple checks for accuracy before submission. Technology can also help identify opportunities for process improvement to reduce future errors from occurring.

Identify gaps in your current billing service

As the revenue cycle management (RCM) process becomes increasingly complex, it is possible that gaps in your practice’s process can result in significant revenue loss or delays. Successful billing operations often address common gaps, such as incomplete information, missing prior authorization or lack of documentation. There are numerous other gaps, however, that can often go unnoticed. If left unchecked, these gaps can lead to significant subsequent issues and a negative financial impact.

The most successful RCM processes automatically focus on gaps in billing by addressing reasons that are not the fault of the billing function, but rather of the payor. These types of processes are technologically driven and not people-dependent or intensive in numbers. Throughout the pandemic, many in-house and third-party billing solutions have had to scramble to figure out how to decentralize the operation to homes, straining people's dominant operations as gaps are found. Proper billing services – such as those provided by Collaborative Imaging – focus on these gaps which can prevent any interruption in remote workflow.

Prepare for a business spike with automated workflow solutions

Enhancing and preparing your RCM processes is extremely valuable during COVID-19 when revenue is diminished, but it will prove to be even more valuable when the pandemic begins to slow and practices encounter an increased demand for services. It is best to prepare for this expected business increase now with automated workflow solutions.

Instead of having to work through claims one by one, practices can implement these advanced solutions which allows them to access information the revenue cycle needs with just a few clicks of a mouse. These automated processes monitor and manage the end-to-end billing solutions regardless of vendor, billing system or solution. Through this, they ensure clean and complete information is obtained on the front-end with real-time, data-driven revenue cycle analytics. The end result? Clean claims that generate faster payment and a high possibility of capturing reimbursement opportunities that might have been previously overlooked.

The healthcare industry – and its technology – is constantly changing and will no longer be the same after COVID-19. It is imperative in this pandemic period that practices review all RCM policies and processes to maximize revenue, which can help manage the remainder of the pandemic and help them be better prepared for the future that will follow.

Three strategies to help bolster your bottom line during the pandemic.

Recovering Revenue During COVID-19

As the coronavirus continues to impact nearly every aspect of our day-to-day lives, health care professionals are among the ones who are continuing to work around the clock to keep everyone else safe. While the number of confirmed cases continues to climb – with the United States having more cases than any other country in the world – healthcare professionals risk contracting and spreading COVID-19 every day.

Thankfully, advancements in medical technology – like telehealth – allow some industry professionals to work remotely, joining the millions of Americans in avoiding virus exposure and attempting to slow the overall spread. Telehealth makes healthcare and healthcare services accessible to people who are currently quarantined or practicing social distancing. Radiologists are one of the healthcare groups who can effectively conduct work from home with the use of teleradiology.

Teleradiology capability at home provides the same functionality for physicians as their hospital onsite workstations, allowing radiologists to read images and generate reports seamlessly. Through teleradiology, radiologists can continue to provide interpretations and communicate with referring physicians just as they would by being in the hospital, but without the contact. Without distractions that occur in the hospital reading room, radiologists can be much more productive.                       

As the fight against COVID-19 continues, there is a growing need to make teleradiology solutions more common, especially with radiologists’ instrumental role with the detection and early diagnosis of COVID-19 cases.
	
	

The impact of teleradiology during COVID-19

Teleradiology gives radiologists the opportunity to interpret images and communicate with physicians electronically while working remotely. For example, 

’s cloud-based workstations and mobile applications allow radiologists and physicians to access diagnoses, reports and images no matter their location via cloud-based PACS. This allows both radiologists and physicians to provide proficient and excellent care for the patient while reducing the risk of spreading or contracting COVID-19.

We’ve also seen the industry become a largely digital workforce. Many of Collaborative Imaging’s partnered radiologists have begun to view images at home, dictate reports with voice recognition and sign off on reports electronically. The first U.S. patient with lab-confirmed disease was diagnosed, in part, with chest radiography and the ongoing treatment regime includes additional chest radiography. As cases influx, COVID-19 case images can be analyzed remotely via teleradiology to help determine courses of treatment for infected cases.

The expansion of teleradiology during COVID-19

The federal government recognized the role telehealth technology could have during the COVID-19 pandemic, as the Department of Health and Human Services (HHS) announced a 

 that has broadened access to Medicare telehealth services. This regulation enhances patient care, as well as reduces the influx of people at physical medical facilities to restrict further COVID-19 spread. Additionally, there’s a temporary relaxation of mandatory in-state licensing requirement for radiologists that allows cross-state reading with teleradiology.

For Collaborative Imaging, this presents an opportunity to expand the teleradiology technology and gather volumes, which has been hard to come by in recent weeks. Previously, routine X-rays in outpatient settings and radiological volumes have decreased as more Americans follow stay-at-home orders. However, more radiological services will now be needed at facilities across the nation in detecting and treating COVID-19 cases. Implementing teleradiology into these facilities will allow more reads to be processed and offer quicker report turnarounds and better detections of the virus.

The future of teleradiology beyond COVID-19

Teleradiology may become the new industry norm long after the pandemic is neutralized. The proven accuracy, quality, and speed teleradiology brings will prompt radiologists and hospitals to implement these services throughout their practice patterns. Along with improving overall radiologist workflow and, thereby patient care, teleradiology is becoming the norm.
	
	Physicians will become more accustomed to working and communicating with radiologists via these services throughout the remainder of the coronavirus pandemic. Teleradiology’s capabilities streamlines communication between both sides while also improving physicians’ overall proficiency. Because of this, we can predict that it’ll be difficult to return to previous methods once things return to normal – another sign that teleradiology is the future of the industry.

Teleradiology services will become a solution to our current global pandemic and beyond. Making these types of services more accessible to radiologists will make a lasting impact on the industry. Overall, more reads will be interpreted and reported during this time while radiologists follow stay-at-home orders and work remotely to reduce viral exposure. Teleradiology isn’t the only solution to the COVID-19 crisis, but it can be an important step as it becomes more common throughout our health care systems.

Dhruv Chopra is the CEO of Collaborative Imaging, a radiologist-owned alliance. He previously spent 15 years as an executive with multiple billing companies in the radiology industry where he gained an appreciation for how much physician money is lost due to several inefficiencies. 

Technology for distance reading allows radiologists to remain productive during the outbreak – and it could help shape the future of the industry.

Teleradiology’s Role During COVID-19 

Among the many hurdles radiologists face, one of the most complicated challenges lies in communicating with referring physicians. Not only does successful communication enhance the delivery of patient care, but it also has shown to reduce the length of stay at the hospital, which results in significant cost reductions. Additionally, it helps ensure any incidental findings and recommendations made by the radiologist are not overlooked. As has been seen repeatedly, lack of communication or even miscommunication in many cases can cause major problems.

Poor communication between healthcare professionals is one of the primary causes of medical mistakes. The last thing a health professional wants is a patient’s health in danger because of miscommunication. Closing the communication gap between these clinicians and the radiologist is essential to providing patients with effective and efficient medical care.

 – a radiologist-owned alliance – has noticed a clear need for new communication strategies across the entire industry. As the organization continues to collaborate with more radiology practices nationwide, it’s realized that radiologists are often stuck with tracking down referring physicians’ contact information. The reality of incorrect or altogether missing referring physician information creates a logistical nightmare for a radiologist, particularly when it comes time to abnormal or critical findings that must be communicated immediately. This clerical work comes at the cost of interrupting studies and cutting into valuable time and resources.

Radiology practices must find ways to navigate this problem. Below are a few best practices to follow when facing this issue.

 indicates that when a radiologist directly communicates with their referring doctor, the clinician is more than 25 percent more likely to follow up with the radiologist’s recommendations. While this can be easier said than done, overall compliance with follow-up recommendations will greatly improve within the practice.

Ideally, recommendations should be communicated over the phone or with an email. The same study showed that when this type of direct communication is performed, the direct communication compliance rate rose to 93 percent, according to the same study. This is 22 percent higher than the compliance rate was when the radiologist and the referring clinician had no direct communication.
	
	What’s more, this type of communication allows referring physicians to cut out any unnecessary middlemen and receive information as soon as the radiologists connect with them. The faster and more efficiently referring physicians can get radiologists’ recommendations for follow ups, the faster radiologists can pass that information to patients.

Direct communication with referring physicians should be standard across the entire practice. To accomplish this, you’ll need to ensure that all parties involved understand communication expectations, which will expedite the overall communication process.

Ideally, radiologist leaders should develop practice-wide initiatives so it’s easy to follow and incorporate into day-to-day communication guidelines. Radiology practices can, then, distribute materials to help employees work through the changes first. This can be as simple as a one-page checklist of steps or as complex as a medical group-wide database.

Once a strategy is established for the whole practice, it is important to share the new processes with the referring physicians the practice has previously worked with. Communicating these new processes on a semi-annual basis not only holds your practice accountable, but it also ensures transparency with the physicians moving forward. It also allows the referring physician an opportunity to share how they think the communication process is working.

There are many ways to implement technologies into your practice to improve efficiency, especially in communication. Groups like Collaborative Imaging have been working on consolidating and integrating contact information for its wide range of referring clinicians so that there’s a direct communication route between radiologists and physicians. In addition, by utilizing AI-based technologies, the systems are able to detect what next steps need to be taken on a specific report.

Technology like this consumes the radiology report and identifies abnormalities, critical findings and recommendations. This information is, then, passed on to the critical findings notification team to relay the results to the referring physicians who are able to view images and radiology reports with one touch.

The application also allows the referring physicians to initiate a real-time, secure video conference with either the radiologist who interpreted the study or sub-specialist of their choice. The physicians are, then, able to review the images in real-time, collaborative manner, as opposed to viewing the images independently.

Radiology practices that have been implementing these types of proprietary, integrated solutions have witnessed its impact on communication. For instance, it works wonders for incidental findings in addition to notifying referring physicians and clinical institutions when recommendations are not adhered to, as well. As we continue to move forward into the new decade, radiologists should have a steady pulse on what new technologies are being introduced and finding one that works best for their practice.

While there will never be a one-size-fits-all solution for direct communication with referring physicians, radiology practices should still take the appropriate steps to ensure their time is being used wisely. Finding the right communication strategies will ultimately provide patients with more effective medical care, which is always the primary goal.

Collaborative Imaging’s Dhruv Chopra explains how to overcome one of radiology’s biggest hurdles