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ACR Closing the Results Follow Up Loop Project Comment period closes soon on 172021
To all Radiologists,
Please consider submitting your comment on the ACR Closing the Results Follow Up Loop on Incidental Findings Project, before the deadline of 1/7/2021. If implemented as proposed, it has the potential to implement time consuming, rigid metrics on reportings, tracking and documenting the communication and follow up of multiple incidental findings.
For each incidental finding needing follow up imaging, they want the report to include “Refers specifically to an evidence-based source for the follow-up recommendation.”
They will also measure a variety of metrics, including the percentage of direct communications of that recommendated follow up imaging study to the referring provider/responsible party within 1 day for emergent findings, and 5 days for nonemergent findings.
I can see myself spending large part of my day contacting the providers and documenting that, and have much less time to look at images to finding the pathology on the images. While the intent is good, this will take significant time and energy away from our primary clinical duty of picking up important pathology on the images.
This proposal will place the primary burden of follow up imaging on the Radiologist, rather the ordering provider. The primary responsibility for ordering the recommended follow up imaging study is the ordering provider who ordered the imaging study.
This is the ACR website to look at the proposal. You can click on the link on that webpage to submit your public comment. Perhaps the link on the copied paragraph below may take you direclty to the proposal and the comment page. Thank You.
[link=https://www.acr.org/Practice-Management-Quality-Informatics/Performance-Measures/Excellence-Initiative]https://www.acr.org/Pract…/Excellence-Initiative[/link]
[i]Public Comment Period Now Open[/i]
Supported by the Gordon and Betty Moore Foundation Diagnostic Excellence Initiative, the Closing the Results Follow-up Loop Quality Measure Set focuses on the follow-up of treatable incidental findings and includes use-case measures for pulmonary nodule and abdominal aortic aneurysm incidental findings. Also contained within the set are communication measures applicable to radiologists, ordering clinicians, and patients.
During this public comment period, ACR is specifically interested in receiving input on the measures feasibility in practice, data capture, and ability to measure the intended actions, among other measure-specific questions. ACR requests that comments include specific details on the quality measures to ensure the measures are actionable and useable in practice. ACR will accept comments through January 7, 2021.
To view the preliminary draft measure set currently under public comment, please [link=https://www.acr.org/-/media/ACR/Files/Quality-Programs/Moore-Fnd/Web-Draft-Specifications-for-Public-comment-period.pdf]click here.[/link] If you’d like to provide feedback on this measure set, please [link=https://www.surveymonkey.com/r/closingthefollowuploop]click here [/link].
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19 Replies
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Agree. These are mostly terrible ideas. Do they want our reports to read like academic articles providing literature support for every size cutoff & recommendation? They also want to further shift the impetus of ensuring followup to the radiologist from the clinician. Don’t we do enough??
Please vote to oppose these ill-conceived measures.-
What authority does the ACR have over the way a radiologist chooses to practice?
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Well when you get sued and they say its standard of care per the ACR to do this , thats some authority
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Quote from IR27
Well when you get sued and they say its standard of care per the ACR to do this , thats some authority
Exactly right. All these initiatives do is give attorneys an angle in court. The ACR should start an initiative to confirm it is the clinicians responsibility to read and follow up on any report they order. That would solve the problem.
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Just have a resident or a PA call it to the provider. No big deal.
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Quote from Dumb Luck
Just have a resident or a PA call it to the provider. No big deal.
Not the point. I call, send IMs in the EHR etc. It’s good practice. It’s another layer. The point I am making is that when the ACR adds reporting requirements and other details it makes that “standard of care” and fodder for attorneys. Like I said, the standard of care that the ACR should be fighting for is that providers read and act on the reports for studies they order.-
the ACR is not the [i][b]”standard of care”![/b][/i]
Thousands of American radiologists do not belong to the ACR.
I am an radiologist-osteopath for 35 years. I have my own society to belong to.
How can anyone claim that I have to adhere to somebody else’s societal guidelines (BTW – not ‘standards’. That was changed about 20 years ago after heavy pressure – as I recall)
BTW – the new term is [b]Practice Parameters,[/b] not [b][i]Standards, or Guidelines.[/i][/b] A little more palatable, in my opinion.
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The acr is obviously in bed with an AI company that will do this for a price. Its about time that we disown these organizations. They are nothing without there memebers.
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WRTO. Take it up with the courts. ACR guidelines are used all of the time. It doesnt matter what you think or if you belong.
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To all, Thank you for your inputs. I encourage everyone to submit their comments to ACR by clicking on the public comments section on the bottom of my original post. We need as many Radiologists to submit their comments to prevent well meaning policy makers from instituting ACR policies that will have unintended consequences of resulting in worse patient care, because our time and attention will be taken away from looking at the imaging studies. On certain unusual cases, I have spent more than 1 hour of my time, calling 10 different phone numbers(waiting more than 30 minutes on hold for certain clinic operators to answer the phone call), paging/instant messaging more than 5 providers, with no response from anyone. Many Radiologists do not get any additional resources or help with these type of communication issues. Already at my work, for small number of critical findings, a Radiologist(cannot be a proxy) to provider phone conversation of relaying the critical findings is required at this local level, even though electronic medical records send automatic alerts of major and critical findings. We do not want such scenarios to be required or happen on a regular daily basis for unnecessarily large number of findings. Regardless of your opinion on ACR, a national ACR policy has a high probability of being adopted by other agencies and becoming a de factor standard of care. A small time spent now to submit your comments before 1/7/2021 may end up saving you and your colleagues significant amount of time for the rest of your career, and allows us to provide better patient care. Ultimately, we need less distractions from patient care. Even though they mean well, policy makers and bureaucrats do not know the unintended consequences of some of their proposals. Since Radiologists know what is best way to take care of patients, we need to give them our comments. Radiologists need as much time to look at the images of each patient’s imaging study, while minimizing distractions that may increase their risk of missing a subtle important finding that will be clinically significant. If we do not submit our comments, then we cannot complain that ACR will institutes a policy that will be negative to Radiologists and to patient care.
Please feel free to forward this information to other Radiologists.For your convenience, you can click on these 2 links to look at the proposal and to submit your comments.
To view the preliminary draft measure set currently under public comment, please [link=https://www.acr.org/-/media/ACR/Files/Quality-Programs/Moore-Fnd/Web-Draft-Specifications-for-Public-comment-period.pdf]click here.[/link]
If you’d like to provide feedback on this measure set, please [link=https://www.surveymonkey.com/r/closingthefollowuploop]click here [/link].Thank you.
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This sounds like ACR the current Communication Parameters, which were originally called Standards , then Guidelines , which perhaps were the dumbest documents produced by a professional organization that is regularity used to impugn its members in medial torts. The trial lawyers were amazed and laughing at the gift the ACR gave them.
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This sounds like ACR the current Communication Parameters, which were originally called Standards , then Guidelines , which were and are one of the the dumbest documents produced by a professional organization that are regularily used to impugn its members in medmal torts. The trial lawyers were amazed and laughing at the gift the ACR gave them.
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[u][b]Thread Enhancer[/b] [/u]- explain to me how those courts that you cite with such authority would want me – [b]an osteopathic radiologist[/b], that belongs to my own [b]American Osteopathic College of Radiology (AOCR)[/b], need to follow the Parameters of another foreign to me medical specialty organization – if I am not a member?
My lawyer and others have all told me not to join the ACR for that reason.
Please be so kind as to splain??? Do you have any examples or only hyperbole?
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‘Closing the loop’ is a CMS mandate. You could be a chiroquacktic radiologist or DO and the principle still applies.
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I voted and am surprised how many people support this stuff. At end of survey you see results. Please fill it out. 10 min here may save you 10 min times however many reports you dictate.
Are we to hire a PA just to help with this? Its no big deal??? Who pays for this free labor?? Magical ACR leprechaun with a pot of gold ? Should we begin a residency so we can have a resident ?
Who wants to work more for less?
Whats going to happen will be less time looking at images and more time elsewhere because the same amount of work needs to be completed working a set time. -
I voted and am surprised how many people support this stuff. At end of survey you see results. Please fill it out. 10 min here may save you 10 min times however many reports you dictate.
Are we to hire a PA just to help with this? Its no big deal??? Who pays for this free labor?? Magical ACR leprechaun with a pot of gold ? Should we begin a residency so we can have a resident ?
Who wants to work more for less?
Whats going to happen will be less time looking at images and more time elsewhere because the same amount of work needs to be completed working a set time. -
Thank you for commenting and letting your voice be heard. I totally agree that spending 10 minutes now to submit our comments will save many more hours in the future, and allow all Radiologists to spend more time providing better patient care. Our profession and patients are best served when all the working Radiologists voice their opinions. Policy makers and adminstrators do not have the experience of clinical medicine, and how their “well intentioned” policies will have unintended consequences of negatively impacting patient care. All Radiologists need less distractions so that they can concentrate on the many images to pick up the important pathologies, without being distracted trying to page or call multiple physicians to repeat what is in our reports already. The current standard that the ordering provider has the primary responsibility to follow up their imaging study results and order recommended follow up study needs to stay. They need to focus on optimzing how the ordering providers track abnormal imaging results and order the follow up studies that are recommended in our reports.
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I support the mental telepathy initiative the ACR is starting.
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Quote from jimmysworld
They also want to further shift the impetus of ensuring followup to the radiologist from the clinician. Don’t we do enough??
Could this be in part due to the expanded use of the term “clinician”?
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