4 Take-Home Messages for Returning to Normalcy

Despite escalating case numbers nationwide, radiology, as a whole, is steadily marching toward the normal resumption of imaging activities. And, groups that are further along this road can serve as a guide for those just beginning re-open their doors to more patients, said a group of industry experts.

Knowing what other institutions from a broad cross-section of the industry can be invaluable in designing a recovery plan, said a team from Henry Ford Health System, Beth Israel Deaconess Medical Center, and the University of California-San Diego. This group outlined some of the over-arching themes of radiology’s COVID-19 recovery in a July 12 article published in the Journal of the American College of Radiology.

This snapshot from academic departments could help other groups successfully navigate the continued wave of cases, they said.

“The challenge facing radiology in revitalizing our workflow is transitioning from an unprecedented multi-week decline in services to a new normal, without any relevant historical data or roadmap available for how to proceed,” said the team led by Daniel Siegal, M.D., a musculoskeletal radiologist at Henry Ford Health System. “Imaging workflow must adapt to new spacing testing, and cleaning expectations, and these changes must be consistent and clearly communicated to patients, referring physicians, administrators, health systems, and staff.”

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To determine how radiology departments nationwide have launched into their own COVID-19 recoveries, Siegal’s team sent a 14-question survey to 114 department chairs. Of the recipients, 38 responded, and their experiences mirrored what has been reported throughout the industry.

Roughly one-third indicated their imaging volume dropped by more than 65 percent, and more than 60 percent of chairs said they had to close outpatient imaging facilities to comply with state and hospital requirements. An additional 25 percent furloughed or laid off up to 20 percent of their non-physician staff.

Overall, based on their responses, Siegal’s team culled four take-away messages about successful recovery.

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Teleradiology is expanding. Survey respondents reported being thankful for expanded remote reading capabilities. Not only did the technology protect the workforce, but respondents also pointed to the increased reading capacity it provided.

Re-opening plans are similar. Most institutions implemented similar safety features, such as temperature screenings and altered waiting room workflow. Others also included reviewing orders, prioritizing patients, telephone screening, utilizing a site checklist for social distancing, and securing infection control sign-off as part of their plans. Differences did appear, however, in how facilities added capacity – some extended hours, added hours to the weekend, or others spaced out appointment times.

Completed exams are a key metric. Many institutions kept track of completed exams as a predictor of recovery. They pointed to September 2020 as a deadline for when 70 percent of pre-COVID-19 volume will likely be reached. Most – 63 percent – predicted they would surpass pre-pandemic levels some time this year. To help forecast recovery, some used internal tools, such as Excel data tables, and others hired outside consultants to help with planning.

COVID-19 changes are likely permanent. Many respondents said they felt the teleradiology and teleconferencing aspects associated with the pandemic will be incorporated into the specialty long-term. They pointed to continued needs for fluid communication, flexibility, and adaptability as more and more patients feel safe enough to venture back into healthcare environments.

Although the road ahead through the pandemic could be lengthy – and the reductions in imaging volume have been significant – the team emphasized that learning from each other will continue to bolster bounceback in the industry.

“We have begun to recover from the first volley. We know what next steps to take, and what data to monitor. What we don’t knows, is what comes next,” the team said. “Nevertheless, as we prepare to ramp up, we must not forget the past, and carefully understand ways to minimize the impact should this occur again.”