From the 2019 HVPAA National Conference
Mrs. Miriam Dowling-Schmitt (Spectrum Healthcare Partners), Dr. Christina Cinelli (Spectrum Healthcare Partners), Dr. Dan Greentree (Maine Medical Center), Ms. Jen West (Spectrum Healthcare Partners), Ms. Ashley Quinn (Spectrum Healthcare Partners), Mrs. Rebecca Murray (Spectrum Healthcare Partners), Mr. Phil Brown (Spectrum Healthcare Partners), Dr. Steven Winn (Spectrum Healthcare Partners)
Background
Radiology practices thrive when radiologists maximize time reading studies. Customer service demands on radiology are increasing and an inability to meet these demands is frustrating for referring physicians and other stakeholders. One area that is time consuming but is of utmost importance is the communication of critical findings, with a set of standards updated regularly by the ACR. Communication software can be purchased to assist radiologists but has limitations in functionality. Our multi-specialty radiology practice covers multiple hospitals and outpatient sites and has utilized the deployment of well-trained non-medical staff in support of radiologist communication. We call this service “OneConnect”.
Objective
The objective behind creating OneConnect was fourfold: maximize time spent by radiologists performing clinical studies, reduce time spent waiting to communicate results, effectively communicate critical results findings, and reduce communication issues related to critical findings.
Methods
OneConnect launched in January 2014 and has grown over the past 5 years. Currently, our practice consists of 39 radiologists serving 11 different hospitals/sites. OneConnect employs 4 people dedicated to handling communication requests Monday-Friday 0800-1730. The radiologist communicates with the OneConnect staff via a button in the PACS system labeled “Findings”. The Findings button is used to communicate critical, unexpected, or stat findings per ACR standards. Staff is trained to manage the queue of requests, contact referring providers, and create communication logs. Conversations are permanently logged in the OneConnect system and this information can be used for quality initiatives such as improving turnaround time for requests. It also is part of the documentation that the group presents to quality committees at each site of service. To validate this service, we identified and measured utilization and accuracy of OneConnect over time since implementation.
Results
Per ACR recommendations, critical findings should be communicated within one hour. Since implementing OneConnect, our radiologists have met this benchmark. In 2015, 97.6% were communicated within one hour, 98.1% in 2016, 97.7% in 2017, 97.8% in 2018, and 98.8% year to date in 2019. Net savings for the practice per year is $143,328 based on 2.2 uses per radiologist per day. Before launching OneConnect, critical findings reports were only available through audits of medical records. Since go-live, the practice has seen a 443.5% increase in volume of fully documented critical findings. Over 11,000 stat read findings were communicated through OneConnect in 2018, a 29% increase since launching in 2014. A total of 62 providers have used OneConnect since launching in 2014.
Conclusion
With implementation of OneConnect, the practice can provide better patient care, customer service, and ensure critical findings are documented appropriately in a timely manner.
Clinical Implications
Communication of critical findings to the appropriate referring provider is an area fraught with potential error. With OneConnect, the radiologist has assistance with communication and a log of each contact attempt documenting communication of the result. The OneConnect system has been shown to be worth the investment by the practice improving patient care and communication of results.
