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Time Is Spine: A Novel Radiology Reporting System for Optimizing Spine Oncology Decision-Making and Reducing Time to
Colbey W Freeman1,2, Raghav Mattay3,4, Charles E Kahn3,2
1From the Department of Radiology (C.W.F., R.M., C.E.K., L.L., A.H.), University of Pennsylvania, Philadelphia, Pennsylvania colbey.freeman@pennmedicine.upenn.edu.
Background And Purpose:
Patients with spinal metastases are at risk of instability and cord compression, requiring prompt diagnosis and timely intervention. Effective communication between radiologists and treatment teams is critical to ensure timely treatment. Thus, we developed a novel dictation macro incorporating findings of spine oncology imaging and a linked automated notification system to accelerate spine oncology referrals and enhance care delivery.
Materials And Methods:
A spine MRI dictation macro was developed incorporating MRI-relevant elements of the Spinal Instability Neoplastic Score and an expanded Epidural Spinal Cord Compression scale into a Spine Oncology Imaging Score (SOIS). Finalized reports containing the macro triggered an automated email notification to a multidisciplinary spine oncology treatment team. Neuroradiologists were educated about the macro, but its use was optional. The time between MRIs to follow-up spine oncology clinic visits and subsequent treatment was compared for outpatients with and without the macro in a Cox proportional hazards model.
Results:
Between April 2021 and February 2023, two hundred seventy-four outpatients with spinal metastasis had MRI reports with the macro. Among these, 213 (77.7%) had follow-up visits related to the MRI findings, and 154 (56.2%) received treatment. During this same period, 152 outpatients had MRI reports that did not use this macro, 117 (77.0%) had follow-up visits, and 58 (38.2%) received treatment. After we controlled for SOIS, age, visit department, and treatment type, use of the macro was associated with earlier spine oncology visits (P = .004) and treatment (P = .03).
Conclusions:
The implementation of a structured spine oncology macro combined with an automated notification system to a specialized spine oncology team significantly reduced the time to consultation and treatment in patients with spinal metastases. This change suggests that incorporating structured reporting tools with critical elements like SOIS, coupled with an efficient notification system, can enhance clinical workflow and expedite decision-making in oncology care.
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