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Monitoring follow-up on radiologic findings using an informatics application

Project status



Hanna Zafar, MD, MHS 

Tessa Cook, MD, PhD 

Darco Lalevic, MCIT 

Charlie Chambers, MCIT 

Mitchell Schnall, MD, PhD

Innovation leads


Innovation Accelerator Program



More than 400 abdominal imaging studies are performed daily across Penn Medicine. A missed follow-up appointment can result in delayed cancer diagnosis or other serious implications for patients with indeterminate or suspicious lesions identified in abdominal imaging reports. 

The Department of Radiology at the Hospital of the University of Pennsylvania (HUP) implemented a standardized lexicon for reporting focal lesions in 2013. However, there was no system to aggregate and monitor providers' follow-up recommendations and determine whether patients had scheduled, completed, or missed appointments.


Penn Medicine's Automated Radiology Recommendation Tracking Engine (ARRTE) enables automated monitoring of patients who need follow-up evaluation based on radiologist recommendations.

ARRTE uses radiology reports to identify patients with findings of possible cancer as well as those needing follow-up imaging, other downstream testing or care based on imaging findings in the abdomen and pelvis. The system then mines data from Penn Medicine’s Radiology Information System to determine if the recommended follow-up is scheduled, completed, or neither scheduled nor completed and pushes results to a centralized dashboard. 


ARRTE effectively and efficiently identifies patients who need follow-up based on radiologist recommendations. The platform is in use at HUP, Pennsylvania Hospital, and Penn Presbyterian Medical Center. The team is currently exploring ways to improve communication with referring clinicians and increase follow-up completion rates.