Close the Loop on a Critical Imaging Finding
Who / when: the Radiologist reading a study who spots a finding the ordering team must hear about urgently, with the ordering Physician on the other end. A critical imaging finding is a result that cannot wait for the routine report to be read — a clinician must be told and must confirm they heard it.
The loop has two beats, both the radiologist’s: set the assessment to critical and sign (which raises the pending finding on its own), then phone the ordering clinician and record what they read back. The notification never carries the finding itself — the human conversation does that, and the read-back proves it landed.
-
Radiologist — open Imaging → Report Authoring (titled Radiology Report) for the study. Use “Open Images” to read the DICOM images in the viewer (DICOM is the medical-imaging standard) without leaving the report. Write the Findings and Impression — both are required to sign.
-
Radiologist — set the Assessment Category to “Critical” (or “Highly Suspicious”). The confirm dialog warns you that signing will raise a critical-result notification to the ordering clinician.
-
Radiologist — press “Sign & Finalise”, then enter your 6-digit eSign PIN (your electronic signature, separate from your password) and press “Sign Report”. Signing locks the report, releases it to the ordering clinician and the patient record, and raises a Pending critical finding.
-
Radiologist — open Imaging → Imaging Critical Results. The new finding sits in the list as Pending. Open it (or use the notify action).
-
Radiologist — telephone the ordering Physician and tell them the finding. Ask them to repeat it back to you so you know it was understood.
-
Radiologist — back on Imaging → Imaging Critical Results, choose the Method you used (Phone Call, In Person, or Secure Message) and record the read-back — what the clinician repeated to you. Submit. The row moves Pending → Notified → Acknowledged, and the recipient, method, and read-back text are audited.
What happens next: the signed report is already released to the ordering Physician and on the patient’s chart, and the study images stay viewable in the PACS Viewer (the image archive). With the read-back recorded, the finding shows the full closed loop — who was notified, by what method, and what they confirmed. The lab side runs the same closed-loop control for critical lab values, and the report you just signed reaches the ordering clinician through the imaging report workflow.