Electronic Health Record Closed-Loop Communication Program for Unexpected Nonemergent Findings

Area of Science:

• Medical Informatics
• Radiology
• Health Communication

Background:

• Traditional reporting of unexpected imaging findings often fails to ensure patient or provider notification.
• A robust closed-loop communication system is essential for timely follow-up and patient safety.
• Electronic health records (EHRs) can facilitate auditable communication pathways.

Purpose of the Study:

• To design and evaluate an EHR-integrated Unexpected Findings Navigator (UFN) program.
• To ensure closed-loop communication for nonemergent unexpected imaging findings.
• To assess the program's effectiveness in managing subsequent patient care steps.

Main Methods:

• Developed an EHR-integrated UFN program with dedicated navigators.
• Navigators facilitated communication of unexpected findings to providers and patients.
• Retrospectively reviewed 12 months of data (October 2019-October 2020) for program metrics and patient demographics.

Main Results:

• 3542 examinations yielded unexpected findings; median patient age was 62 years.
• Potential neoplasms were the most common unexpected finding (11%).
• Median time to patient notification was 12 days; 2127 additional imaging studies and 1078 referrals were facilitated.

Conclusions:

• The EHR-integrated UFN program achieved near-complete success in notifying providers and patients of unexpected findings.
• The system effectively facilitated necessary follow-up actions, improving care management.
• Both radiologists and providers found the UFN program useful.