Newswise — Medical imaging is one of the most widely used diagnostic tools in health care with providers ordering dozens of imaging studies for their patients every day. These studies are used to gain information about certain symptoms a patient has or a condition they are being treated for, but frequently have incidental findings unrelated to the original indication for the study.
While incidental findings are noted in the radiology report, these often go unnoticed by the ordering provider as they focus on addressing the original intent of the study. While many of these findings are benign, some may develop into malignancies making timely follow-up essential to prevent harm to the patient’s health long-term.
Delayed and missed follow-up on incidental diagnostic imaging findings is one of the most prolific problems in health care harming millions of patients across the country and driving up costs. Nationwide, hospitals and health systems spend an estimated $43 million annually to settle lawsuits for missed follow-up on lung findings alone.
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“This problem is a case study of preventable harm: there is a documented, but unrecognized finding that could have led to a meaningful intervention, but instead the patient’s disease develops unchecked,” said Mozziyar Etemadi, MD, PhD, medical director of advanced technologies at Northwestern Medicine.
Recognizing the serious threat to patient safety and financial risk, Northwestern Medicine mobilized a multidisciplinary team with members from Radiology, Quality, Patient Safety, Process Improvement, Primary Care, Nursing, Informatics and others to address the issue. The team created a system utilizing artificial intelligence (AI) integrated into the electronic health record (EHR) that runs on nearly every imaging studying ordered in the 11-hospital health system. When required, the AI triggers an alert in the EHR that clearly displays the findings and the recommended follow-ups directly in the ordering physician’s workflow.
Once the system triggers an alert, it then tracks completion of recommended follow-up for both incidental and expected findings. If action is not taken to schedule additional imaging or other follow-up, another alert is sent to prevent delays in care and improve patient outcomes.
Northwestern Medicine first implemented the technology in December 2020 to search for lung and adrenal findings, then prospectively tested it for more than a year. The results of that study are published today in NEJM Catalyst Innovations in Care Delivery, which is among the first prospective studies of an AI tool deployed in clinical practice.
