Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Diagnostic Radiology, 601 N. Caroline Street, JHOC 3235-A, Baltimore, MD 21287, United States of America.
Mercy Catholic Medical Center, Radiology Department, 1500 Lansdowne Ave, Darby, PA 19023, United States of America.
Clin Imaging. 2021 Nov;79:20-23. doi: 10.1016/j.clinimag.2021.03.015. Epub 2021 Mar 22.
We aim to study if direct patient notification in accordance with the Patient Test Results Information Act (Act 112) in Pennsylvania leads to decreased loss to follow up and prompt management of actionable imaging findings.
For this IRB-approved study, radiology reports were randomly identified using the Nuance mPower™ search engine. The actionable finding group (prior to Act-112) contained 300 patients for which a voice notification was sent by radiologists to alert ordering physicians about significant imaging findings. The PTRIA group (after Act-112) contained 300 patients who were mailed a standardized letter one day after the final report was issued. The electronic medical records were reviewed to evaluate how patients were managed.
There was no difference in loss to follow up rates and time to follow up completion between the two groups. In both groups, 34% of patients were lost to follow up in transition of care from generalists to specialists; 24% cases were lost to follow up when imaging findings were not in the area of the initial ordering provider expertise.
The goal of Act 112 is to increase patients' role in the timely management of their significant medical conditions and prevent medical errors, specifically loss to follow up. Our study suggests that presumed patients' awareness does not contribute to improved follow up rates or decreased time to a follow up visit. 13% of patients are lost to follow up in both groups. A tracking system is required to prevent delayed management of the significant findings.
我们旨在研究宾夕法尼亚州是否按照《患者检验结果信息法案》（第 112 号法案）直接通知患者，这是否会降低随访流失率并促使对可采取行动的影像学发现进行及时管理。
本项经机构审查委员会批准的研究使用 Nuance mPower™搜索引擎随机确定放射学报告。在 Act-112 之前的可采取行动的发现组（行动前组）中，有 300 名患者的放射科医生会发出语音通知，提醒开单医生注意重要的影像学发现。在 PTRIA 组（行动后组）中，有 300 名患者在最终报告发布后的第二天会收到标准化信函。查看电子病历以评估患者的管理情况。
两组患者的随访流失率和随访完成时间没有差异。在两组中，有 34%的患者在从全科医生到专科医生的治疗过渡中随访流失；24%的患者在影像学发现不在初始开单医生的专业领域时随访流失。
第 112 号法案的目的是增加患者在及时管理其重要医疗状况中的作用，防止医疗失误，特别是随访流失。我们的研究表明，假设患者的意识并不能提高随访率或减少随访就诊时间。两组中有 13%的患者随访流失。需要一个跟踪系统来防止对重要发现的管理延迟。
