Managing Incidental Findings

Valeria Makeeva, MD; Kirsten Schofield, MS; Melissa Davis, MBA, MD; Nadja Kadom, MD


Appl Radiol. 2021;50(6):22-26. 

In This Article

Best Practices for Managing AIFs

Managing AIFs is complex; ensuring completion of any recommended follow-up is vitally important (Figure 2). The process starts when the radiologist detects and determines that a lesion on an image is an AIF and issues a recommendation for follow-up review, which is then accompanied by a closed-loop result communication to clinicians. Follow-up is tracked and documented upon completion.

Figure 2.

Tracking workflow. The workflow starts in Phase 1 when the radiologist issues a follow-up recommendation and signs the report. In Phase 2, a dedicated tracking team uses natural language processing tools to identify reports containing follow-up recommendations and enters them into a tracking system. A due date is determined based on the report signature date and the recommended follow-up time interval. Phase 3 starts after a recommendation has passed its due date. The tracking team reviews patient charts to ascertain completion of recommended follow-up. If completion has not been documented and no rationale is provided, the tracking team alerts providers and/or patients to the missing follow-up and/or to schedule the follow-up. The process ends when follow-up has been completed (adapted from Irani 2020).4