01 the business
Hospital radiology department
150,000 studies a year
Radiologists often recommend follow-up imaging for incidental findings, such as small lung nodules. The recommendation lives in the report text. Months later, nobody knows whether it was acted on.
02 before
The problem
Radiologists often recommend follow-up imaging for incidental findings, such as a small nodule. The recommendation sits in the report text, the referring doctor may not act on it, and months later nobody remembers it was made.
- Recommendations are not tracked anywhere.
- Referrers may miss them in long reports.
- Coordinators search reports by hand when audits ask.
03 the build
What the AI does
- Step 1: Reads finalised radiology reports for follow-up recommendations, using the wording your radiologists use.
- Step 2: Records the recommended test, timeframe and responsible clinician in a tracking list.
- Step 3: Notifies the referring clinician and checks whether the follow-up has been ordered.
- Step 4: Sends reminders as the due date approaches and escalates overdue items to a named coordinator.
- Step 5: Closes items when the test is done or a clinician records that it is not needed, with the reason.
paused: waiting for a person to approve
How it was put together
- Read finalised reports for recommendations using radiologists' own wording.
- Recorded test, timeframe and responsible clinician in a tracking list.
- Notified referrers and checked whether the follow-up was ordered.
- Escalated overdue items and closed them only with a clinician's recorded reason.
04 human in the loop
Where a person stays in charge
Radiologists write the recommendations, and clinicians decide whether to order the follow-up. The tool tracks what was written and never adds or changes a recommendation.
- Radiologists write recommendations; the tool never adds or changes one.
- Clinicians decide whether to order follow-up.
- Closures need a clinician's recorded reason.
05 rollout
From kickoff to live in 8 weeks
- Weeks 1–3Agree recommendation phrases and coordinator role with radiology.
- Weeks 4–6Back-check six months of reports and start tracking new ones.
- Weeks 7–8Switch on notifications and escalation.
06 after
What changes
Recommended follow-ups are either done or deliberately closed, rather than forgotten. Coordinators work from one list instead of searching reports.
Assume 150,000 studies a year, with follow-up recommended in 3% of reports.
150,000 × 3% = 4,500 recommendations a year, each now tracked to an outcome instead of left in report text.
What to measure
- Recommendations captured.
- Follow-ups ordered on time.
- Overdue items and time to close.
- Coordinator time per item.
07 evidence
What the research says
Across 19 studies, between 6.8% and 62% of laboratory tests and between 1.0% and 35.7% of radiology tests were not followed up, with harms including missed cancer diagnoses.
Around 1 in 10 patients is harmed in health care, and more than half of that harm is preventable.
World Health Organization, Patient safety fact sheet (opens in a new tab) · 2023
08 lessons
Mistakes to avoid
- Missing phrasing. Learn how your radiologists write recommendations.
- Silent closure. Every item closes with a reason.
- No coordinator. Tracking needs an owner.
09 questions
Common questions
- Does it read images?
- No. It only reads the finished report text.
- How often are imaging follow-ups missed?
- A systematic review found between 1.0% and 35.7% of radiology tests were not followed up in outpatient settings.