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Restarting non-urgent imaging in a post-pandemic world

by John R. Fischer, Senior Reporter | July 20, 2020
Business Affairs X-Ray
From the July 2020 issue of HealthCare Business News magazine

Diagnostic screenings in the U.S. have plummeted since the outset of the COVID-19 pandemic. Now, as states gradually begin emerging from lockdown, radiologists are preparing for a surge in patients seeking elective and non-urgent scans. The Hippocratic Oath commands physicians to “first do no harm” and that means these services must not come at the risk of exposing healthy patients and staff to COVID-19. Fortunately, the American College of Radiology has put forth guidelines to help imaging professionals walk that tightrope.

Have a strategy
According to the ACR, resuming non-urgent radiology exams requires a comprehensive plan that can be distilled into one overarching, general principle:

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If the risk of illness or death to a healthcare worker or patient from healthcare-acquired COVID-19 is greater than the risk of illness or death from delaying radiology care, the care should be delayed; however, if the opposite is true, the radiology care should proceed in a timely fashion

Many variables make an accurate risk-benefit analysis of postponing versus performing a given routine radiology examination or procedure difficult, if not impossible, so the ACR recommends a number of actions for weighing – and mitigating – risks. Screening patients and healthcare workers for COVID-19 symptoms upon arrival, developing a tiered plan for reengagement of non-urgent radiology care, and ensuring sufficient supplies of personal protective equipment (PPE) are all important bases to cover.

“As a physician who has taken this oath and as chair of the ACR Commission on Quality and Safety, I can’t overemphasize that safety measures for both patients and healthcare workers must be prioritized,” Dr. Jacqueline A. Bello, FACR, told HCB News. “These include screening patients and healthcare workers for signs (temperature) and/or symptoms (cough or shortness of breath), making sufficient PPE and appropriate testing available, focusing on infection control, and optimizing social distancing by streamlining scheduling and patient flow.”

Any effective plan requires all stakeholders to work together, from hospital leadership and radiologists to security personnel and the patients themselves.

"The patient's responsibility is to make sure if the healthcare system has a rule about wearing masks, they should wear a mask," said Dr. Matthew Davenport, FASR FSABI, lead author of the ACR statement, service chief of radiology at Michigan Medicine, and an associate professor at the University of Michigan. "If the radiology department has a rule about making sure patients are effectively distanced, they should enforce those rules. If the health system is coordinating delivery of care so that all the tier strategies are ramping up simultaneously, the system has a responsibility to oversee that the tier strategy is working the way it is supposed to. Everyone should play their role to make sure the patients and healthcare workers are safe."

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