In 2016, a community hospital presented its methodology for communicating critical test results (CTR) at RSNA that resulted in a 94% improvement in communication lag times.  The methodology was tested at the hospital over a period of 9 months and was shown to reduce communication lag times from 0.9 days to 0.05 days in 6 months.

Pretty great results, right? Guess what the methodology was? 

Having an administrator FAX a completed radiology report and then call the ordering physician until the report’s receipt was confirmed.  The administrator also manually recorded communication attempts and completion times on a separate spreadsheet. 

Obviously, this is was not a new methodology. If these were the results of an older methodology un-assisted with the technology of today, think about what results we could really be achieving with a truly modern CTR management system.

Simplify, simplify, simplify

A process that’s easy to understand, easy to execute, and has only a few steps, will outperform sophisticated processes every time.

The community hospital got one thing right in the way that its methodology was easy to understand and execute. They used what they had on hand, which was one extra person, a fax machine, a phone, and a spreadsheet.    

It was easy to understand and execute, but not time or cost-effective. What about not needing the fax machine, the phone, or the extra person at all, and making the whole process much faster?

medQ has developed a Critical Test Result Management (CTRM) system that simplifies and streamlines critical result communication by integrating it right into the reporting solution (Reporting PLUS+) and automating it.

Critical Test Results – Easily Tracked, Automatically Recorded

Every part of the community hospital’s methodology is done in medQ’s Q/ris CTRM with just a few clicks, without the radiologist ever needing to leave the reporting window.

Once a critical result is found, before even finishing the report, the radiologist can click the CTRM button and all of the ordering physician’s possible contact methods will be shown.  The radiologist then contacts the ordering physician via phone, assigns an administrator to make contact, or simply allows the system to automatically send an SMS message to establish contact (based on the degree of severity, e.g., red, orange, or yellow).

In every case, an administrator is immediately notified that a critical test result has been found so as to provide follow-up communication to the ordering physician.

The Radiologist then closes out the CTRM notification section and finishes the report.  The report is automatically sent to the ordering physician once the report is signed.  All Critical Result communication attempts are automatically noted in the patient’s history and on the final report.

No matter what communication method is chosen by the radiologist, the multi-faceted communications protocol of the Q/ris CTRM also sends a text message to notify the ordering physician of the CTR and to call the radiologist. In cases where the ordering physician has access to a medQ physician portal, the message will also include a link to the portal where the doctor can find the finished report detailing the CTR along with relevant images.  The ordering physician can then acknowledge that they received the CTR notification in the portal.

The Follow-Up

In a perfect world, every doctor would pick up their phone when a radiologist calls with a CTR.  Of course, that doesn’t happen.  That’s when the Q/ris CTRM follow-up protocol kicks in.

All patient exams that had a critical finding that have not been acknowledged by the ordering physician are kept on a “CTRM Worklist” tab, clearly visible on the home screens in the Q/ris 3000 and Reporting PLUS+ solution.  This tab is highlighted in red if there is a CTR patient who requires follow up communication.

Automatic reminders display in front of administrators at regular intervals to ensure that every attempt is made, and recorded, to communicate the CTR to the ordering physician.

Closing the Communication Loop, Faster

In every process there is room for improvement.  The CTRM makes this easy by keeping track of your communication efforts and turnaround times.  By using the CTRM management reports, administrators can easily identify areas that need improvement and can work with ordering doctors to establish a better contact methodology.


Prompt and reliable communication of critical test results is more important now than ever.  The best communication processes are ones that are not only fast, but simple.

medQ’s integrated and automated Q/ris CTRM solution is a simple, fast, and JCAHO-compliant way to ensure your CTR findings are communicated to your ordering physicians without the radiologist ever needing to leave the reporting window. Administrators can easily conduct any necessary follow up on a CTRM-specific worklist.

medQ’s CTR Management solution is an optional module included in medQ’s complete reporting environment, Reporting PLUS+.