An important component in improvement is a tracking system. Dr Abeln describes the essentials of such a system as well as the laws and regulations relating to primary care physicians' and radiologists' roles and responsibilities in its implementation. A patient comes to see a primary care physician with a breast-related complaint. The physician takes a history, does a physical examination, and refers the patient for a mammogram. Good patient care dictates the need for a well-tuned system that includes tracking of patients referred for mammography to ensure that all the necessary steps are completed in a timely manner.
Tracking is also a key to risk management.
Its potential impact in this regard is particularly notable because breast cancer diagnosis accounted for more medical malpractice claims in the decade 1985-1995 than did any other disease or condition. This law requires that to operate legally, mammography facilities must be accredited through a process that looks at many aspects of their operation. As the basic step in fulfilling this requirement, each mammography facility must include an audit of medical outcomes in its quality assessment program. Integral to this audit are the systematic collection and analysis of mammographic results plus their correlation with biopsy results. This allows generation of periodic reports that provide radiologists with an objective measurement of their interpretive skills.