While it sounds straightforward, designing a tool that met the stringent requirements of the King Faisal Specialist Hospital & Research Centre was not, in fact, simple. “Our goal as a healthcare enterprise is to provide the highest level of healthcare and the best patient experience. We deal with very complex pathologies and treatments: for oncology, cardiology, complex transplants of organs and stem cells …,” says Mr. Bin Dayal. “The tool had to support not only the creation of the notification by the radiologists but also the acknowledgment by the treating physician, plus the possible escalations. So we needed to involve different stakeholders in its development, including radiology, clinical affairs, medical affairs, and informatics, to ensure there were no gaps in the process.”

One major hurdle to overcome was addressing the many different workflows throughout the hospital.
“Outpatient flows differ from inpatient flows; emergency flows have specific needs etc. Before creating the tool, we had to define all the possible workflows in all the departments. We had to determine how the notifications would be sent, how acknowledgment would be handled, and what escalation levels to include,” explains Akram Maghrabi, PACS Administrator.

The level of detail to consider was enormous; he continues: “Take one ‘simple’ question: Who should receive the notification? As an example, a patient comes into the ER. The ER physician orders a chest X-ray and notices something concerning. He calls in the pulmonary team, who send the patient for a CT. In this case, if there is an actionable finding, who will receive the notification: the ER doctor or the pulmonary specialist? Our conclusion was that you have to follow the responsibility: if the ER physician has passed the patient into the care of the pulmonary specialist, then the latter has the responsibility and should receive the notification. But as you can see, we had to consider every possible situation and define where the responsibility lies.”

Follow-up of notifications is just as complex. “What happens if the treating physician doesn’t view the finding? In the end, we developed three escalation levels for each workflow. That is how carefully we worked out the design for the Actionable Findings module.”

The Actionable Findings module was successfully rolled out in a soft launch at King Faisal Specialist Hospital in Jeddah in three stages, he describes. “The first month, we launched it in the ER; the second month, in family medicine; the third month, we did the official go-live for the entire hospital.” Following the successful launch in Jeddah, the Actionable Findings module was then rolled-out to King Faisal Specialist Hospital in Medina.

The radiologists and treating physicians already see a big difference from the module. “It enables us to communicate efficiently without interrupting the workflow of the radiologist,” says Dr. Zia. “We did a small satisfaction survey within the hospital. On a scale of 1 to 5, the radiologists scored the tool 4.67 in terms of ease of use. And 85% of all the physicians (radiologists and treating physicians) said they believed the tool would help improve patient safety.”

“Actionable findings are something most hospitals have to deal with. Because we made the tool ‘physician-oriented’, it could fit well in any healthcare environment, I believe. This was tremendous work that King Faisal Specialist Hospital & Research Centre and AGFA HealthCare achieved, and we are very proud that it may improve patient care in many different hospitals.”