How imaging providers in 1 state are responding to a major policy shift

A new law in Pennsylvania requires more out of imaging professionals—how are radiologists handling this dramatic change? 

The Patient Test Result Information Act (PA Act 112), signed into law in October 2018, requires imaging providers to directly notify outpatients within three months if they spot any significant abnormalities in their work. Rep. Marguerite Quinn sponsored the law after two of her constituents experienced such a scenario and later died when a provider failed to close the loop.

A new case study published in the Journal of the American College of Radiology examined how different providers are adapting to this new legislation, which officially goes into effect on Dec. 23, 2019. 

“Radiologists’ visibility as a member of the patient-care team will be increased, but challenges remain for radiologists to consistently define significant abnormality and recommend appropriate follow-up,” wrote Gregory Mittl, MD, department of radiology at the Hospital of the University of Pennsylvania, and colleagues.

The researchers gave several examples of how local providers are getting ready for this shift:

  • Penn State Health and Foundation Radiology Group has launched a “hard-stop approach,” requiring radiologists to indicate with dictation software whether a patient notification may be required under the new law.
  • Foundation Radiology Group inserts a sentence at the bottom of its patient reports, and the system creates an automated letter to the patient to satisfy the requirement.
  • University of Pennsylvania Health System and Radiology Group of Abington uses a voluntary approach where radiologists insert standardized language into their reports to flag patients, without a prompt, who must be notified under the act. They also send monthly report cards to radiologists, comparing their reporting numbers against peers.
  • Progressive Physician Associates has integrated its compliance with the law into its current notification system so that reading room coordinators can relay any notable test results to patients who have been flagged by radiologists in the electronic health record.
  • Geisinger Health, meanwhile, has developed a standard notification system across service lines for all emergency department, outpatient and point-of-care imaging exams performed by any clinician.

Mittl and colleagues noted that PA Act 112 offers some clear benefits to radiologists, including mitigating potential liability and making them a more visible member of the care team. However, it also presents challenges, with an absence of evidence-based follow-up guidelines, and more pressure placed on the imaging professional to flag any abnormalities.

This has been a “paradigm shift” for imaging professionals in Pennsylvania, they note, one that’s taken months of preparation. They anticipate similar laws to emerge in other states and urge colleagues to begin preparation as soon as possible.

“Imaging practices outside of PA can use this time to proactively develop notification systems using existing and potential results notification workflow. Open exchange of lessons learned and best practices in this first year of implementation will be of value to imaging facilities and the patients they care for, within, and outside of PA,” the authors concluded.