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

Tracking Systems

Several US radiology practices use hybrid tracking systems that employ a mix of staffing and advanced IT tools (Figure 2).[4]

These systems may identify reports containing follow-up recommendations either by asking radiologists to flag reports with specific searchable phrases (eg, "#follow") or by having tracking staff search independently for keywords and phrases.[4] These tools may work manually or employ natural language processing (NLP) capabilities. The tracking team manually enters incomplete follow-up cases into an electronic database, and IT tools may be used to determine the date by which a given follow-up should be completed.[4] For overdue cases, the responsibility for ordering follow-up care is typically reassigned to the clinical team.[14,24,39–42]

Tracking system scalability remains a challenge, owing mainly to the need for support staff. No consensus currently exists among medical specialists and administrators regarding responsibility for oversight and financial accountability for tracking systems.[43] As an unintended consequence, underfunded tracking programs may focus only on a handful of incidental finding categories, such as lung nodules.[24,44–51]