Keeping patients from falling through the medical-imaging cracks

Every day in hospitals around the country, thousands of patients undergo CT, MRI, X-ray and other kinds of scans, producing detailed images of their bodies. Specially trained doctors "read" those images to look for problems, and then send a report of what they've found to each patient's own doctor.

But every once in a while, a new study finds, a patient falls through the cracks -- the victim of an incomplete handoff between doctors. If that patient's scan happens to show signs of cancer or another serious problem, the results could be disastrous. Fortunately, the study also shows, it may be possible to prevent such occurrences.

In a paper in the April issue of the American Journal of Roentgenology, a prominent journal for medical-imaging specialists, or radiologists, researchers from the University of Michigan Health System and the VA Ann Arbor Healthcare System report the results from their first year using an innovative automatic system at the Ann Arbor VA hospital.

In all, they show, the system kept eight patients with serious signs of trouble on their scans from falling through the cracks, including five who turned out to have cancer. And while the handoff between radiologists and other physicians took place correctly for the vast majority of 395 patients whose scans revealed potential cancers, the authors say their findings show the value of an inexpensive "safety net" system to catch those few patients who might otherwise be missed.

"We know anecdotally that these problems happen around the country, and in fact they are the source of abundant malpractice litigation," says author Charles Marn, M.D., chief of radiology at the Ann Arbor VA and an associate professor of radiology at the U-M Medical School. "We developed this system after a situation that occurred at our own institution, and this one-year experience already shows that it has helped. We hope that other hospitals can use these findings to develop their own response

Contact: Kara Gavin
University of Michigan Health System

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