Better track and ensure Radiologist recommendations are followed up for Head CT


Find the recommendation in the Radiology Report including what the recommendation is for and what the due date is. Use the specified time required to schedule that type of follow-up and when it is that amount of time before the due date, send a message directly to the Radiology Scheduler to follow-up in scheduling the patient for another Radiology Procedure. If the follow-up recommendation is to see another specialist they check in to see that the patient has seen or is scheduled to see the other specialist. When the recommended follow-up is completed the original case is marked closed. If the follow-up is not completed within a predetermined time frame (ex: one month) of the due date a message is sent directly to the original referring physician that includes who the patient is, the original report, what the recommendation was, and the due date that has passed. At one month past the due date the patient is also sent a message that includes the report, recommendation and how to schedule their follow-up. When the follow-up recommendation is completed the original case is marked closed.




Patient Facing Panel
Define-AI ID  22110006


Amanda Itliong
Lead Andrea Borondy Kitts

Panel Chair

Andrea Borondy Kitts

Panel Reviewers

Patient Facing Panel


Creative Commons 4.0 
Status Published

Clinical Implementation

Value Proposition

If we value the health of patients and believe that our radiology recommendations are required, we must find better ways to ensure that follow-up is specific and that it is completed. Patients are depending on our insight to monitor malignancies, follow the effects of treatment, or to gather further information to aid in medical decision making. We have a duty to to support individual patients and their referring physicians in reminders and/or scheduling. There is often a significant burden on our patients, especially those with chronic conditions to manage, to keep track of everything they need to do with each of their doctors and conditions. Mabotuwana, Hall, Tieder and Gunn (2018 have found that “failure to comply with imaging follow-up recommendations in a timely manner is common and can lead to delayed treatment, poor patient outcomes, unnecessary testing, lost revenue, and legal liability.”

Follow-ups are also important to support radiology business goals. Hence scheduling is  a necessary and valuable use of  time. Using AI to achieve the goal of ensuring that more follow-up recommendations are completed help radiologists to be both more ethical and more effective in their health practice with patients. 


A 41 year old female with extensive cancer history was found to have clustered cystic structures in the midline cerebellum. The interpreting radiologist recommended a follow-up Brain MRI with and without contrast in six months. Seven months later the patient has not completed or scheduled the follow-up Brain MRI. 

Workflow Description

The AI should require the interpreting Radiologist to include in each report a specific follow-up recommendation whenever possible along with a specific time frame for the recommendation to be carried out. This should be part of writing the report.  The AI algorithm should identify the relevant parts of the report including the specific recommendation with the type of future imaging needed, the specific body part for the follow-up, and the specified time frame. If there are multiple recommendations it should identify each of them. The cases of radiologist recommendations should then be tracked to ensure that follow-up is completed as prescribed. The case is closed when all follow-up recommendations are completed. Reminders about scheduling for open cases are first sent directly to the Radiology Scheduling team and then,  if there is no action,  future reminders are sent to the referring physician and the patient. 

Considerations for Dataset Development

Radiologist Report

Mine radiology reports for results and recommendations

Electronic Medical Records

Mine medical records for match of recommendation and follow-up; include time from radiology report recommendation to follow-up or to date when EMR is interrogated (i.e. if no follow-u)

Patient characteristics

demographics - age, sex, race/ethnicity, insurance type, zip code

Exam characteristics

type of imaging (e.g. X-ray, CT, US), reason for exam (e.g. cancer screening, surveillance, diagnostic, interventional), location of exam (e.g. ER, inpatient, outpatient)

Follow-up recommendation characteristics

referring physician consultation, specialist consultation, imaging exam type (e.g. CT, US, MRI), location of follow-up recommendation (e.g. in-patient, outpatient, free standing facility), distance to location of follow-up intervention

Technical Specifications



 Radiologist Report


head CT



Data Type

Structured Text



Body Region


Anatomic Focus

Motor areas of the brain and the middle ear

Radiologist Follow up Recommendation


Description of intervention and timeline for completion

Data Type


Referring Physician


Referring physician contact information (phone and email)

Data Type


Patient Information


Patient contact information (phone and email)

Data Type


Imaging Appointment Type


Type of required imaging appointment

Data Type


Value Set

[Breast mammogram, chest x-ray, thyroid ultrasound]

Imaging Facility Contact Info


Contact info for imaging facility scheduling team

Data Type


Value Set

[Breast mammogram, chest x-ray, thyroid ultrasound]

Primary Outputs

Summary of follow up


Summary of recommended follow-up intervention in patient friendly language

Recommended follow-up date


Suggested date for follow-up intervention

Recommended Follow-up info


Info on scheduled follow-up intervention such as date, location, contact information for questions and changes

Follow-up Procedure


Imaging test(s) and/or intervention(s)

Follow-up status


Status of follow-up completion - include date completed

Secondary Outputs

Reminder Status


Status of reminder notices to referring physician and patient

Future Development Ideas

Develop an algorithm to automatically schedule the recommended follow-up exams/consultations using information from the patient medical record on the patient providers and provider network. Send the scheduled appointments to the referring physician and the patient along with a patient friendly summary of the radiologist findings and recommended follow-ups. Provide an easy call-back number or link for patient to ask questions about the report and to reschedule the follow-up appointment if it does not work with their schedule. Send reminders to patients and referring physicians prior to the follow-up appointments. Monitor for patient adherence to follow-up appointments and follow-up as described previously if recommended follow-up is not completed. Add capability to track completion of the recommended follow-up tests at facilities outside of the network. The advent of increased interoperabiilty between electronic medical record systems will help facilitate this capability.