ANCR Saves Time for Radiologists, Referring Physicians
By automating the communication about a particular category of critical test results between radiologists and referring physicians, a new web-based communication tool called Alert Notification of Critical Results (ANCR) streamlines what had been a time-consuming part of radiologists’ workflow and a disruption to ordering physicians’ schedules.
Yellow level alerts, the least urgent level of unexpected findings on imaging tests, must be communicated to the referring physician within 15 days. These alerts, which constitute more than 70 percent of critical findings, previously were communicated by radiologists to ordering physicians via page, the same way as more urgent red and orange alerts are communicated. With ANCR, ordering physicians are notified via e-mail of less time-sensitive findings, such as a lung nodule.
“ANCR can address not only the problem of workflow interruption, but also provides information in a manner that makes it much easier for the clinician to remember and arrange for proper follow up,” said Allen Kachalia, MD, JD, medical director of Quality and Safety and a BWH hospitalist.
ANCR improves the process for radiologists as well. The radiologist composes a report and clicks into ANCR from Centricity to alert the referring physician via e-mail. “The ANCR application runs a queue of all the alerts the radiologist sent that day and which ones have not yet been followed up by the referring physician,” said project manager James Bredin of the Medical Imaging IT team, which helped to build ANCR in collaboration with a vendor and with support from CRICO. “The radiologist can easily maintain those alerts and take steps to ensure that either the referring physician or another covering clinician receives the alert.”
The referring physician must click on an e-mail link to ANCR to acknowledge the alert and close the communication loop; otherwise, he or she receives follow-up e-mails.
“Optimal communication of results is an important national patient safety goal,” said Ramin Khorasani, MD, vice chair of Radiology. “By virtue of automating and integrating ANCR into the workflow, we can measure, monitor and continuously improve the application.”
ANCR was piloted in the Abdominal Section and has since rolled out across the main campus. Mammography, Ultrasound and community Radiology locations are due to bring ANCR online by the end of the year.