Automated PACS-based alerts communicate unexpected findings

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An electronic alert system integrated into a PACS can aid in the communication of reports and reduce the risk that reports containing significant or unexpected findings will remain unread, according to a study of one such system.

The study appeared in the August issue of the Journal of the American College of Radiology.

Authors Sara A. Hayes, MD, of Cork University Hospital in Cork, Ireland, at the time of the study, and colleagues wrote that the alert system at their institution helped protect patients moving across hospital departments, especially those moving from the emergency room, who are vulnerable to poor communication of test results.

The alert system, which used automated e-mail as well as text messages from the radiology department to the referring physician for unexpected findings, did not replace the requirement for a radiologist to call a referring physician if immediate action were required. It also didn’t replace standard report transmission and verification.

An automated PACS-based alert system also could help physicians manage the load of radiology reports, according to the authors. “In recent times, the volume of such investigations has increased enormously, resulting in an additional administrative burden on referring clinicians to ensure results and reports are reviewed and appropriate actions are taken.” Failure to communicate results is the fourth most common reason for litigation against radiologists, they noted.

During a 14-month study of the system, 57.6 percent of the referring physicians responded within 24 hours, while the average response was 3.1 days.  Out of 39,665 chest radiograph reports transmitted using the alert system, 158 were red flagged using key words in e-mails or in text messages.

Almost half (46.2 percent) of the 158 alerts issued were from the emergency department, while 30.3 percent were for outpatients, 21.5 percent were for inpatients, and 1.9 percent were family doctor referrals. The final diagnosis included malignancy (13.9 percent), benign lesion (49.4 percent), and no abnormality (20.2 percent).

“Radiologists can no longer assume that their duty of care has been discharged once the images have been reviewed and interpreted and the report has been finalized,” wrote Hayes and colleagues.