Low adherence to radiology follow-up recommendations is widespread across the US healthcare system

Literature indicates that 35% of imaging recommendations for follow-up care are not fulfilled. To better understand the scope and consequences of this problem, Agamon worked with several hospitals in the US to examine their data and identify solutions. After analyzing 3 million radiology reports, we found that the actual number of unfulfilled imaging follow-up recommendations is much higher than existing medical literature states. More than 55% of patients do not adhere to radiology follow-up recommendations. With the help of the Agamon Coordinate platform, these hospitals were able to ramp up their overall follow-up rate, improve patient care, and increase revenue.

Failure to follow-up

Radiology reports often contain follow-up imaging recommendations to monitor the stability of potentially malignant findings, to ensure resolution of potentially serious disease, or for further diagnostic characterization. Failure to comply with imaging follow-up recommendations in a timely manner can lead to delayed treatment, poor patient outcomes, lost revenue, and legal liability. Unfortunately, we know this is more common than not.

Reasons for low adherence

Literature shows that more than 35% of follow-up imaging recommendations are not fulfilled1. Various reasons have been attributed to follow-up failure on b•ehalf of the referring physician, including:

• Missing the recommendations or not communicating it to the patient
• Concentrating on acute illness and neglecting incidental findings
• Loss of information during handover
• Patient failing to schedule or show-up for the follow-up appointment

Rate of missed follow-ups is higher in the hospital setting

In an effort to improve follow-up adherence rates and in collaboration with several US hospitals, Agamon deployed its Natural Language Understanding (NLU) technology and conducted preliminary analysis on 3 million radiology reports. We were able to extract specific key elements, including clinical findings, follow-up recommendations, and follow-up due dates. The results showed that 32% of the reports included follow-up recommendations, but only 45% of patients completed the recommendations. Meaning, 55% of patients did not return to follow-up on their radiologist's recommendations.

How to improve follow-up rates

Patient compliance with radiology follow-up recommendations is concerningly low. While some patients may fare alright without completing their medical care, others will eventually return to their physician with worse symptoms. Several studies have shown that providers can improve follow-up compliance rates by specifying explicit follow-up recommendations to the referring physicians.

Agamon’s end-to-end solution helps close the loop by allowing physicians to communicate findings with patients in a simple manner, facilitating an easy handover between care- teams, and making sure communication occurs without losing any information along the way. To ensure patients follow through, schedule follow-up scans, and complete the recommendations, the platform automatically integrates with the scheduling system and tracks the follow-up process, while alerting the care team about any changes.