Radiologist Collaboration Impacts Patient Care

Collaborative radiology utilization management programs have substantial impact on patient care, regardless of provider specialty, according to a study published in the American Journal of Roentgenology.

Researchers from the Sidney Kimmel Medical College at Thomas Jefferson University, in Philadelphia, PA, undertook a five-year project to evaluate the impact of such programs on the disposition of cases according to provider specialty. They reviewed 168,915 studies to determine the rates of study approved by consensus, study changed by consensus, study not performed by consensus, study approved (no consensus), and study administratively not performed (no callback).

The effect of provider-radiologist collaboration was determined by the aggregated rates of study changed or not performed by consensus. The rate of no callback was used to assess sentinel effect. The combined rate of withdrawals and no callback represented the overall impact of radiologist participation.

The results showed that more than half of the studies (58.6%) were approved. Other findings showed:

• 6.8% of were changed

• 13.5% were withdrawn by consensus

• 6.0% were approved without consensus

• 15.2% were withdrawn because of no callback

• 35.5% of studies initially ordered were not performed at the time they were ordered

Highest aggregated rates of study changed or withdrawn by consensus:

 • Family practice: 25.3%

• Internal Medicine: 23.8%

Lowest aggregated rates of study changed or withdrawn by consensus:

• Thoracic surgery: 13.3%

• Neurosurgery: 11.2%

• Orthopedic surgery: 9.3%

Highest rates of study withdrawn owing to no callback:

• Internal medicine: 18.0%

• Neurology: 17.7%

• Family practice: 17.4%

Lowest rates of study withdrawn owing to no callback:

• Pediatrics: 7.1%

• Ophthalmology: 7.3%

“The overall impact was greatest for family practice (42.7%), internal medicine (41.8%), and neurology (33.4%) and least for orthopedic surgery (22.8%) and neurosurgery (24.0%),” the authors wrote.

The study showed that participation by radiologists had substantial impact on patient care, regardless of provider specialty. The impact was greatest on primary care providers who are heavier users of radiology.