Radiologists reveal ‘RADCAT’ system to categorize imaging reports, convey important findings

Radiologists face the challenge of not only accurately interpreting exams but efficiently communicating their findings to care teams. Experts recently proposed a structured reporting system to help ease this burden.

Physicians with Rhode Island Hospital outlined their radiology report categorization system, or RADCAT, Wednesday in JACR. In the same vein of reporting systems like BI-RADS, this tool organizes imaging documents and relays findings using an automated communication system.

Physicians assign each document at least one category ranging from 1 (normal) to 5 (critical findings), which ultimately triggers two electronic health record-based alerts. One is determined by the report score and another disseminates the study findings. So far, it’s been a success.

“Although the five-category design of RADCAT is novel, with brief training, radiology and clinical physicians demonstrated substantial interobserver agreement when assigning RADCAT categories to radiology report narratives,” Eric L. Tung, MD, and colleagues with the Providence hospital’s imaging department wrote. “Our study confirmed our hypothesis that RADCAT could be appropriately implemented across all healthcare settings with successful communication of important, nonurgent results to ordering providers and patients.”

Tung et al. decided to use the system after discovering multiple instances in which incidental findings were not properly communicated at their institution. In October 2017, they launched RADCAT at three of the system’s hospitals and by November it was active across the entire enterprise.

In the 18 months post-implementation, more than 740,000 radiology reports were categorized using RADCAT, with most (42%) coming from the emergency department.

And over the course of 2019, of the 38,701 studies with nonurgent imaging follow-up guidance, nearly 100% were successfully conveyed to providers or patients.

This is not the only system to categorize and communicate findings, the authors noted, but it does have some advantages. Those include using five categories, rather than three, which helps distinguish between urgent and routine studies. Additionally, a radiology quality assurance team manually ensures RADCAT-3 results are communicated, eliminating the potential for missed follow-up exams.

In the future, the researchers want to survey radiologists and ordering providers to understand each groups’ experience using the system and where improvements are needed.

Read the entire study in the Journal of the American College of Radiology here.