Sharing critical test results via text message could be a quicker, more efficient way to facilitate communication between radiologists and primary care physicians, according to recent data from the Seoul National University Medical Research Center in South Korea.
MRIs, ultrasonography and other imaging techniques are so commonplace in modern clinical practice that radiology reports have become part of almost every physician’s workflow, but a lack of structured reporting guidelines means the communication process between staff members can get messy, corresponding author Chang Min Park, MD, PhD, and colleagues wrote in the Journal of the American College of Radiology.
This is especially problematic when it comes to life-threatening conditions like ischemic bowel disease, acute aortic syndrome or massive hemorrhages, the authors said.
“To initiate critical management and improve the management results in these cases, timely and prompt communication between the radiologists and primary care physicians is as important as the accurate and meticulous interpretation of imaging tests,” Park et al. wrote.
The field needs a standard for reporting critical results based on both urgency and clinical relevance, the researchers said. For their study they took advantage of Seoul National’s critical test result (CTR) notification system, which automatically alerts primary care physicians via text message when a radiologist inputs “CRS transmission”—the hospital’s code word for “urgent”—into a case file.
Notifications were classified as either CTRL1, CTRL2, CTRL3 or were unclassified, the authors wrote. CRTL1 was the most severe level of urgency, relating to issues that could potentially be immediately life-threatening. Unexpected findings that could possibly lead to morbidity or mortality fell under CRTL2, while CRTL3 findings had potentially substantial negative consequences but didn’t need to be treated as urgently.
Park and co-authors focused on their institution for the study, a tertiary hospital with 1,786 beds and a CTRN system that was first established in October 2011. Their research, which took place between June and September of 2016, found that automated text messages could be a valuable tool in keeping staff informed and interconnected in the clinical environment.
While the majority of cases were classified as CRTL3, actions were taken as a result of text message alerts in 82.4 percent of cases without any delayed CTRN-related morbidity, the authors said. Primary care physicians didn’t take any action in just 13.7 percent of cases.
“This could imply there might be a gap between primary care physicians and radiologists regarding the critical findings, and communication is necessary to reduce this difference,” Park and colleagues wrote. “The CTRN system is an important component of the imaging value chain for both optimizing management of patients and preventing malpractice originating from radiologic reports.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.