Addressing the Incidental Findings Gap in Radiology
Advances in imaging technology such as CT scans and MRIs have greatly improved radiologists’ ability to view the human body in clear detail, helping with early detection of health issues. A byproduct of this process is a significant increase in incidental findings. An incidental finding is a medical condition that is discovered unintentionally during a scan that is being performed for an unrelated reason. It can show up in any part of the body, such as the brain and the lungs, and can include anything from a nodule or tumor to a cyst or something else. Not all incidental findings represent serious health conditions, but it’s always better to get it checked out sooner rather than later to increase one’s chances of a more successful outcome in the event that medical treatment is required.
There are numerous examples where incidental findings in reports fall through the cracks due to a lack of tracking and communication, which can result in lawsuits and loss of life. One such case is that of Mark James, whose family was awarded a $7.5 million settlement over a delayed lung cancer diagnosis. In 2017, James received a CT scan at the University of Illinois Hospital for an issue with his kidneys, but while reading James’ scan the radiologist discovered a mass on his lungs. Although the radiologist recommended additional reports, he didn’t share the information with James, who returned in 2019 after experiencing pain and swelling in his shoulder and chest. A second CT scan revealed lung cancer that had metastasized and James died the following year.
To help prevent future incidents similar to James’ situation, the American College of Radiology (ACR) continues to seek help to develop a quality measure to address incidental findings care gaps. Recently, the professional medical society received a $341,000 grant for its work and has many radiologists participating in their studies. The ACR’s researchers are asking doctors to distribute questionnaires to customers and their families, with the hopes that the survey responses will lead to the creation of quality measures that will strengthen adherence to evidence-based follow-up recommendations. They also plan to issue more detailed guidance on care coordination for such scenarios.
The ACR is also working in tandem with the American College of Emergency Physicians to figure out methods for following up on incidental imaging. While there isn’t a universal protocol at present for communicating and addressing incidental findings, Within Health is an innovative platform that uses data mining techniques to identify incidental findings and then communicates those findings directly to referring doctors and patients. They are currently rolling out pilots with outpatient radiology groups and hospital systems across the country. To set up a demo with Within Health, click here.
