Ophthalmology Outcomes
Neuro-ophthalmology
The Neuro-ophthalmology Service diagnoses and treats a wide variety of disorders that affect the cranial nerves and orbit, many of which require advanced imaging.
Learn more about the Neuro-ophthalmology ServiceProviding Imaging Results to Patients
During the calendar year 2022, the Neuro-ophthalmology Service ordered and performed 412 outpatient neuroimaging scans (MRI and CT scans). Follow-up rates reflect the length of time from when the scan was performed to when the ordering clinician was able to successfully reach the patient (not necessarily the first outreach to the patient).
Of the 412 imaging studies included in the 2022 analysis, scan follow-up rates were as follows:
85 scans (20.6%) were documented as reviewed with the patient within one business day, 113 (27.4%) within two business days, 202 (49.0%) within seven calendar days, 249 (60.4%) within 14 calendar days, and 285 (69.2%) within one month.
To the best of our knowledge, there are no ophthalmology studies that report the percentage of patients who receive imaging results at specified time points. The Veterans Health Administration published guidelines in 2009 stating that all test results should be given to patients within 14 calendar days after the test results are made available to the clinician. Similar guidelines have been published in the European community.1-3
Of the 412 scans that were ordered by a clinician in the Neuro-ophthalmology Service and also completed at Mass Eye and Ear in 2022, 350 scans (85.0%) had documentation of when the patient was notified of the test results. Similar results were reported for calendar years 2013, 2016, 2017, 2018, 2019, 2020, and 2021 during which time 94.9% (354/373), 98.1% (406/414), 92.8% (425/458), 92.3% (406/440), 92.2% (482/523), 87.2% (499/572), respectively, of scans had documentation of follow-up with the patient. A review of the literature revealed that clinicians document their follow-up with patients for 64.3% to 100% of scans ordered.4-5
The rate of reporting results to patients within seven calendar days has been decreasing over the past several years. This may truly represent decreasing communication or may instead represent difficulty with documentation in the electronic medical record. As a result, efforts are in place to change this system to ensure closed loop communication on imaging results.
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Providing Imaging Results to Patients
1. Singh H, Vij MS. Eight recommendations for policies for communicating abnormal test results. Jt Comm J Qual Saf 2010; 36(5): 226-232.
2. Sittig D, Singh H. Improving test result follow-up through electronic health records requires more than just an alert. J Gen Intern Med 2012; 27(10): 1235-1237.
3. Rosenberg RD, Haneuse SJ, Geller BM, et al. Timeliness of follow-up after abnormal screening mammogram: variability of facilities. Radiology 2011; 261(2): 404-413.
4. Callen JL, Westbrook JI, Georgiou A, et al. Failure to follow-up test results for ambulatory patients: a systematic review. J Gen Intern Med 2012; 27(10): 1334-1348.
5. Casalino LP, Dunham D, Chin MH, et al. Frequency of failure to inform patients of clinically significant outpatient test results. Arch Intern Med 2009; 169(12): 1123-1129.
