8+ Signs Doctors Call With CT Scan Results (2023)


8+ Signs Doctors Call With CT Scan Results (2023)

Patients often wonder about the process of receiving diagnostic imaging results. Typically, a physician orders a computed tomography scan to investigate a specific medical concern. A radiologist, a physician specializing in interpreting medical images, then analyzes the scan and prepares a report. This report is subsequently sent to the ordering physician.

Timely communication of these findings is crucial for patient care. Prompt delivery allows for quicker diagnosis, initiation of treatment, and alleviates patient anxiety. Historically, results were relayed through physical mail or fax, potentially causing delays. Modern healthcare increasingly utilizes electronic health records and secure patient portals, facilitating more rapid communication. This shift towards faster information exchange has greatly improved patient experience and the efficiency of medical care.

This article will further explore the various communication methods used to deliver results, factors influencing response time, and what patients can expect. Additionally, it will address common questions and concerns patients have regarding this process and offer guidance on how to best navigate this aspect of medical care.

1. Result Communication Methods

Result communication methods play a central role in the process of informing patients about CT scan findings. Whether a physician opts for a direct phone call, utilizes a patient portal, or employs other communication strategies significantly impacts the patient experience and the overall effectiveness of care. This connection between communication method and patient outcome is particularly critical when dealing with time-sensitive diagnoses or emotionally charged results, such as suspected malignancy. For instance, a patient awaiting results related to a potential cancer diagnosis requires a sensitive and personalized approach, often best delivered through a direct conversation with their physician. Conversely, routine follow-up scans with expected findings may be efficiently communicated through a secure patient portal or electronic messaging system.

The choice of communication method should also consider the complexity of the findings. Straightforward, unremarkable results might be conveyed through a concise written report, while complex or nuanced results often necessitate a more detailed explanation, potentially involving a consultation with the radiologist. Furthermore, patient preferences and accessibility play a role. Some patients may prefer digital communication, while others may require phone calls due to limited technology access. Understanding these diverse needs and tailoring communication accordingly is crucial for providing patient-centered care.

Effective result communication hinges on clarity, timeliness, and empathy. Establishing clear protocols for different scenarios ensures consistency and reduces the risk of miscommunication or delays. Timely delivery of results, especially in urgent cases, allows for prompt intervention and can significantly impact patient outcomes. Finally, communicating with empathy and sensitivity, particularly when delivering challenging news, is paramount for building trust and supporting patients through their healthcare journey. Navigating these complex factors effectively underlines the importance of well-defined and adaptable result communication methods in modern healthcare.

2. Physician Responsibility

Physician responsibility regarding diagnostic imaging results, such as CT scans, encompasses several crucial aspects. While radiologists interpret the images and generate a report, the ordering physician bears the ultimate responsibility for communicating those results to the patient and formulating a corresponding plan of action. This responsibility stems from the physician-patient relationship and the physician’s role as the primary coordinator of the patient’s care. A critical component of this responsibility involves determining the most appropriate communication method. For instance, a critical finding requiring immediate intervention necessitates a direct phone call, potentially followed by a prompt consultation. Less urgent results, particularly routine follow-ups, might be appropriately communicated via patient portals or secure messaging systems.

Several factors influence the specific approach taken. The nature and severity of the findings significantly impact the urgency and method of communication. A suspected malignancy requires a different approach compared to a benign cyst. Patient preferences and accessibility also play a role. Some patients may prefer digital communication, while others may require a phone call due to limited technology access or health literacy. Moreover, established practice guidelines and legal requirements influence how results are conveyed and documented. Failing to communicate results appropriately can have significant consequences, including delayed diagnosis and treatment, increased patient anxiety, and potential legal ramifications. Conversely, effective communication fosters trust, improves patient compliance with treatment plans, and contributes to better health outcomes.

In summary, physician responsibility in communicating CT scan results extends beyond simply relaying information. It involves a careful assessment of the findings, consideration of patient-specific factors, adherence to established guidelines, and a commitment to timely and empathetic communication. This multifaceted responsibility highlights the crucial role physicians play in ensuring patients receive the information they need to make informed decisions about their health and well-being. Successfully navigating this responsibility requires not only medical expertise but also strong communication skills and a dedication to patient-centered care.

3. Radiologist Interpretation

Radiologist interpretation forms the cornerstone of the process culminating in patients receiving CT scan results. Radiologists, physicians specializing in medical imaging, meticulously analyze the scans, identifying normal anatomical structures, recognizing deviations from the norm, and correlating these findings with the patient’s clinical history. This interpretation is then formalized into a report, which serves as the basis for the referring physician’s communication with the patient. The accuracy and thoroughness of the radiologist’s interpretation directly impact the quality of care patients receive. A missed subtle fracture, for example, could lead to delayed treatment and potential complications, while a misidentified nodule might cause unnecessary anxiety and further investigations. The report itself is a structured document detailing the radiologist’s observations, including measurements, descriptions of any abnormalities, and a conclusive impression. This standardized format ensures clarity and facilitates effective communication between the radiologist and the referring physician.

Furthermore, the radiologist’s expertise extends beyond simply identifying abnormalities. They consider the clinical context provided by the referring physician, which helps prioritize findings and tailor the report to the specific patient’s situation. For example, a small lung nodule might be given less significance in a young, healthy patient compared to a patient with a history of smoking. In complex cases, radiologists may consult with other specialists, such as oncologists or surgeons, to ensure a comprehensive and collaborative approach to diagnosis. This collaborative effort ensures the patient benefits from a multidisciplinary perspective, optimizing the diagnostic process and subsequent treatment planning. The timeliness of the radiologist’s interpretation also plays a crucial role. Rapid turnaround times, particularly for urgent cases, enable prompt diagnosis and treatment initiation, potentially significantly impacting patient outcomes. For instance, swift identification of a stroke on a CT scan allows for timely administration of thrombolytic therapy, potentially minimizing long-term disability.

In conclusion, the radiologist’s interpretation is an indispensable link in the chain of events leading to patient notification of CT scan results. Their specialized knowledge and meticulous analysis ensure accurate and clinically relevant information is available to the referring physician. The quality, timeliness, and comprehensiveness of this interpretation directly affect the quality of patient care, underscoring the critical role radiologists play in modern healthcare. Challenges remain, such as increasing imaging volumes and the need for ongoing professional development to keep pace with technological advancements. Addressing these challenges ensures the continued delivery of high-quality imaging interpretation, ultimately benefiting patients and contributing to improved healthcare outcomes.

4. Electronic Health Records

Electronic health records (EHRs) have significantly transformed how medical information is managed and accessed, directly impacting the communication of CT scan results. EHRs provide a centralized digital repository of patient data, including medical history, laboratory results, imaging reports, and physician notes. This readily available information plays a crucial role in how, when, and what information is communicated regarding diagnostic imaging.

  • Result Delivery and Access

    EHRs facilitate rapid and secure transmission of radiology reports, including CT scan results, directly to the ordering physician. This eliminates delays associated with traditional methods like fax or mail, enabling faster diagnosis and treatment. Furthermore, many EHR systems integrate patient portals, allowing patients direct access to their results, often eliminating the need for a phone call for routine findings. This empowers patients and promotes active engagement in their healthcare.

  • Communication Tracking and Documentation

    EHRs offer a robust mechanism for tracking communication related to patient care. The system can record when results were made available, when they were accessed by the physician, and when patients viewed them through the portal. This comprehensive documentation is vital for medico-legal purposes and provides valuable data for quality improvement initiatives. For example, analysis of communication patterns might reveal delays or bottlenecks in the process, prompting interventions to optimize workflow and enhance patient care.

  • Enhanced Care Coordination

    EHRs facilitate seamless information sharing among healthcare providers involved in a patient’s care. This is particularly beneficial when multiple specialists are involved, as in the case of a complex diagnosis requiring input from oncologists, surgeons, and radiologists. Access to shared information, including CT scan results, ensures everyone is working with the same data, promoting informed decision-making and coordinated care delivery. This eliminates potential communication gaps and promotes a more integrated and efficient approach to patient management.

  • Data Analysis and Research

    The structured data within EHRs provides opportunities for data analysis and research aimed at improving diagnostic accuracy and patient outcomes. Aggregated data from numerous CT scans, linked with patient demographics and clinical outcomes, can be used to develop predictive models or identify best practices. This data-driven approach can lead to advancements in diagnostic imaging techniques and refine the process of communicating results to patients, ultimately enhancing the quality and effectiveness of healthcare delivery.

The integration of EHRs has fundamentally reshaped the communication landscape surrounding medical imaging results, including CT scans. From accelerating result delivery to facilitating data-driven insights, EHRs play a vital role in enhancing communication efficiency, patient engagement, and the overall quality of care. While challenges remain, such as ensuring data security and addressing interoperability issues, the continued evolution of EHR technology holds significant promise for further optimizing the communication of CT scan results and improving patient care.

5. Patient Portals

Patient portals represent a significant shift in how individuals access and manage their healthcare information, including the results of diagnostic imaging like CT scans. These secure online platforms offer a direct connection to one’s medical record, influencing when and how patients receive information, and thus directly impacting the traditional dynamic of physician-delivered results. Exploring the multifaceted role of patient portals provides valuable insight into the evolving landscape of healthcare communication.

  • Accessibility and Convenience

    Portals offer convenient 24/7 access to medical records, eliminating the need to wait for phone calls or office visits for routine results. This accessibility empowers patients to take a more proactive role in their healthcare management. For example, a patient awaiting follow-up CT scan results after a minor injury can conveniently view them on the portal, potentially reducing anxiety and eliminating the need for a phone call. This self-service approach can free up physician time for more complex cases.

  • Timely Notification and Reduced Anxiety

    Many portal systems offer automated notifications when new information, such as CT scan results, becomes available. This eliminates the uncertainty of waiting for a call and can reduce patient anxiety, particularly in less urgent situations. For instance, a patient monitoring a stable condition through regular CT scans can receive timely notifications and review results promptly, potentially avoiding unnecessary worry and phone calls to the physicians office.

  • Enhanced Physician-Patient Communication

    While portals offer direct access to results, they also facilitate communication with physicians through secure messaging features. Patients can ask clarifying questions about their CT scans, request further information, or schedule follow-up appointments, fostering a more collaborative approach to healthcare. This asynchronous communication can be more convenient for both patients and physicians, allowing for considered responses and reducing interruptions during clinic hours.

  • Potential Challenges and Limitations

    Despite the advantages, patient portals present certain challenges. Not all patients have equal access to technology or possess the necessary digital literacy to navigate these systems effectively. Furthermore, the potential for misinterpretation of complex results without direct physician guidance necessitates careful consideration of what information is appropriate for portal release. For critical findings, direct physician communication remains essential to ensure accurate understanding and appropriate emotional support.

The increasing prevalence of patient portals has undeniably transformed the communication of CT scan results. While these platforms offer significant benefits in terms of accessibility, convenience, and patient empowerment, they do not entirely replace the crucial role of direct physician communication, particularly in situations involving complex or critical findings. The optimal approach involves a balanced utilization of both portals and direct communication, tailored to individual patient needs and the specific clinical context, ultimately aiming to deliver high-quality, patient-centered care.

6. Timely Notification

Timely notification of CT scan results is a critical aspect of patient care, directly influencing treatment decisions and patient well-being. The speed at which results are communicated hinges on various factors, including the urgency of the situation, the complexity of the findings, and the communication methods employed. This exploration delves into the multifaceted nature of timely notification and its implications within the broader context of result delivery.

  • Urgency of Clinical Situation

    The urgency of the clinical situation dictates the acceptable timeframe for result communication. Critical findings, such as evidence of a stroke or active bleeding, necessitate immediate notification, often involving direct physician contact. Conversely, routine follow-up scans for stable conditions may tolerate a longer notification period, potentially utilizing patient portals or electronic messaging. The clinical context determines the appropriate communication method and urgency, prioritizing patient safety and timely intervention when necessary.

  • Communication Methodologies and Efficiency

    The chosen communication method significantly impacts the speed of notification. Direct phone calls, while effective for urgent situations, can be time-consuming and challenging to coordinate. Electronic communication through patient portals or secure messaging offers rapid dissemination of information, particularly for routine results. However, reliance on electronic methods requires patient access to technology and comfort with online platforms. Selecting the optimal communication method requires consideration of both efficiency and patient-specific factors.

  • Complexity of Findings and Interpretation

    Complex or unexpected findings often require further consultation between the ordering physician and the radiologist, potentially delaying notification. This deliberation ensures accurate interpretation and appropriate next steps, particularly in cases with nuanced or ambiguous results. Simple, unremarkable findings can be communicated more rapidly, as they require less interpretation and discussion. The complexity of the results influences the time required for accurate assessment and communication.

  • Impact on Patient Anxiety and Treatment Initiation

    Timely notification significantly impacts patient anxiety and the timely initiation of treatment. Delayed communication can lead to increased patient stress and uncertainty, particularly when awaiting results related to potentially serious conditions. Prompt notification, conversely, facilitates rapid treatment initiation, potentially improving patient outcomes. For instance, a timely diagnosis of a pulmonary embolism through a CT scan allows for prompt anticoagulation therapy, minimizing the risk of complications. The speed of notification is intrinsically linked to patient well-being and the effectiveness of medical intervention.

In summary, timely notification of CT scan results is a multifaceted issue with significant implications for patient care. The urgency of the situation, communication methods, complexity of findings, and impact on patient anxiety all influence the speed and method of notification. Balancing efficiency with the need for accurate interpretation and clear communication ensures patients receive timely information, facilitating prompt treatment decisions and optimal health outcomes. Optimizing this process requires continuous evaluation and adaptation to leverage technological advancements and best practices in healthcare communication.

7. Abnormal Findings

The presence of abnormal findings on a CT scan significantly influences the communication process between healthcare providers and patients. While normal results often follow established notification procedures, abnormal findings frequently necessitate a more personalized and nuanced approach. This distinction stems from the potential implications of such findings, ranging from minor anomalies requiring monitoring to serious diagnoses necessitating immediate intervention. Understanding how abnormal findings impact communication protocols is essential for both patients and providers.

  • Direct Physician Contact

    Abnormal findings often warrant direct contact from the ordering physician. This allows for a detailed explanation of the results, addressing patient concerns and outlining next steps. For instance, the discovery of a pulmonary nodule might prompt a direct call to discuss the finding’s significance, potential diagnoses, and the need for further investigations like a biopsy. This personalized approach ensures patients receive clear and empathetic communication, reducing anxiety and fostering informed decision-making. Direct contact also allows the physician to assess the patient’s emotional response and provide appropriate support.

  • Expedited Communication for Critical Findings

    Critically abnormal findings, such as evidence of internal bleeding or a large mass suggestive of malignancy, necessitate expedited communication. Rapid notification enables prompt intervention, potentially significantly impacting patient outcomes. In such cases, direct physician contact is crucial, ensuring timely initiation of treatment and addressing any immediate patient concerns. For example, the detection of a brain bleed on a CT scan would trigger immediate communication to the referring physician, facilitating rapid transfer to a neurosurgeon and timely surgical intervention.

  • Coordination of Care and Specialist Referrals

    Abnormal findings often require coordinated care involving multiple specialists. The ordering physician may need to consult with radiologists, oncologists, surgeons, or other specialists depending on the nature of the abnormality. This collaborative approach ensures a comprehensive evaluation and appropriate management plan. For example, the discovery of a suspicious liver lesion on a CT scan might necessitate consultation with a hepatologist and potentially a referral for a biopsy or surgical intervention. Efficient communication between specialists is crucial for timely and effective patient care.

  • Documentation and Follow-up

    Meticulous documentation of abnormal findings, communication with the patient, and subsequent management plans is crucial. This documentation ensures continuity of care, facilitates communication among healthcare providers, and serves as a valuable resource for future reference. Furthermore, abnormal findings often require ongoing monitoring and follow-up imaging. Clear communication about the recommended follow-up schedule, including the rationale and potential implications of the findings, is essential for patient compliance and long-term health management. This detailed approach promotes proactive management and allows for early detection of any changes or progression of the identified abnormality.

In conclusion, the presence of abnormal findings on a CT scan significantly alters the communication pathway. The emphasis shifts towards direct physician involvement, expedited notification for critical findings, coordinated care with specialists, and meticulous documentation for ongoing management. This responsive approach, tailored to the specific nature of the abnormality, underscores the commitment to providing patient-centered care, minimizing anxiety, and facilitating timely and effective interventions. By understanding the connection between abnormal findings and communication protocols, patients and providers can navigate the diagnostic process more effectively, ultimately leading to improved health outcomes.

8. Standard Procedures

Standard procedures governing the communication of CT scan results ensure consistent, reliable, and patient-centered care. These procedures address various aspects of the process, from the initial ordering of the scan to the final communication of results. Understanding these established protocols offers valuable insight into how healthcare providers strive to deliver timely and accurate information to patients, optimizing both the diagnostic process and subsequent treatment planning.

  • Established Communication Pathways

    Standard procedures often dictate preferred communication pathways for different scenarios. Routine, unremarkable findings may be communicated via patient portals or secure messaging, while critical or unexpected findings necessitate direct physician contact. These established pathways ensure efficient information flow and prioritize timely intervention when necessary. For example, a suspected fracture identified on a CT scan might trigger an automated notification to the ordering physician, prompting a direct call to the patient to discuss the findings and arrange follow-up care. Conversely, a routine follow-up CT scan showing stable findings might be communicated directly to the patient via the portal.

  • Documentation and Record Keeping

    Comprehensive documentation is a cornerstone of standard procedures. Detailed records of the scan order, radiologist interpretation, communication method, date and time of notification, and patient response are essential for medico-legal purposes and continuity of care. This meticulous record-keeping facilitates communication among healthcare providers, tracks patient progress, and provides valuable data for quality improvement initiatives. For instance, tracking communication times for critical findings can identify potential delays and inform strategies to expedite the notification process.

  • Responsibility and Accountability

    Standard procedures clearly define roles and responsibilities in the communication process. The ordering physician holds ultimate responsibility for ensuring patients receive their results and understand their implications. Radiologists are responsible for accurate and timely image interpretation and report generation. Nurses and other healthcare staff may play a role in facilitating communication and answering patient questions. Clearly defined roles ensure accountability and minimize the risk of miscommunication or oversight. This clear delineation of responsibility is crucial for providing safe and effective patient care.

  • Patient Education and Empowerment

    Standard procedures increasingly emphasize patient education and empowerment. Providing patients with clear information about the CT scan process, expected timelines for result communication, and available communication methods promotes informed decision-making and reduces anxiety. Many institutions provide educational materials explaining how to access results through patient portals and what to expect regarding follow-up communication. Empowering patients with knowledge enhances their engagement in their own healthcare and fosters a collaborative relationship with their healthcare team.

These standard procedures, encompassing established communication pathways, meticulous documentation, defined roles, and patient education, aim to optimize the communication of CT scan results. Adherence to these protocols ensures consistency, minimizes errors, and promotes patient-centered care. By streamlining the flow of information and empowering patients, standard procedures contribute significantly to the effectiveness of diagnostic imaging and overall healthcare quality. Furthermore, these procedures are not static but rather evolve alongside advancements in technology and healthcare delivery, continuously striving to improve the patient experience and optimize outcomes.

Frequently Asked Questions

This section addresses common inquiries regarding the process of receiving computed tomography scan results, aiming to clarify typical practices and alleviate potential concerns.

Question 1: How long does it typically take to receive CT scan results?

The timeframe for receiving results varies depending on the complexity of the scan, the workload of the radiology department, and the urgency of the clinical situation. Routine scans often have results available within one to three business days, while urgent scans can be interpreted within hours. Patients should inquire about expected turnaround times when scheduling their scan.

Question 2: Will the doctor always call with results, or are there other notification methods?

While direct physician contact remains common, particularly for significant or unexpected findings, other communication methods are increasingly utilized. These include secure patient portals, electronic messaging systems, and in some cases, traditional mail. The preferred method often depends on the nature of the findings, patient preferences, and established institutional procedures.

Question 3: What happens if the CT scan reveals abnormal findings?

Abnormal findings typically prompt direct communication from the ordering physician to discuss the results, their potential implications, and recommended next steps. This might involve further investigations, specialist referrals, or initiation of treatment. The specific course of action depends on the nature and severity of the abnormality.

Question 4: If results are not communicated within the expected timeframe, what should one do?

Contacting the ordering physician’s office or the radiology department is recommended if results are not received within the anticipated timeframe. They can provide an update on the status of the report and address any concerns regarding potential delays.

Question 5: Are patients able to access their CT scan images directly?

While access to the written report is often available through patient portals, access to the actual images may vary depending on institutional policies and technological capabilities. Patients should inquire about image access procedures if they wish to review them directly.

Question 6: How does the communication process differ for routine versus urgent CT scans?

Urgent scans, often performed in emergency settings, prioritize rapid interpretation and communication. Direct communication between the radiologist and the ordering physician, typically within hours, is standard practice. Routine scans generally follow established communication protocols, often utilizing patient portals or less urgent communication methods.

Timely and clear communication of CT scan results is paramount for effective patient care. Understanding the various communication methods, typical timeframes, and procedures for addressing abnormal findings empowers patients to actively participate in their healthcare journey. Open communication between patients and healthcare providers is crucial for navigating the diagnostic process and ensuring optimal health outcomes.

For further information regarding specific procedures or concerns, consulting directly with the healthcare provider is always recommended.

Tips for Navigating CT Scan Results

Navigating the process of receiving and understanding CT scan results can be challenging. These tips offer guidance for individuals undergoing this process, promoting informed engagement and facilitating effective communication with healthcare providers.

Tip 1: Maintain Open Communication with Healthcare Providers

Open communication with the ordering physician is crucial throughout the entire process. Clearly communicate any specific concerns, questions about the procedure, or preferences regarding result notification. This proactive approach ensures patient needs and expectations are addressed effectively. Directly inquiring about anticipated turnaround times and preferred communication methods helps manage expectations and reduces potential anxiety related to waiting for results.

Tip 2: Understand the Various Communication Methods

Familiarize oneself with the various communication methods employed for delivering CT scan results. These may include direct physician phone calls, patient portals, secure messaging systems, or traditional mail. Understanding the advantages and limitations of each method, including potential delays or accessibility issues, allows for informed preferences and realistic expectations.

Tip 3: Actively Utilize Patient Portals (If Available)

If the healthcare system offers a patient portal, actively utilize its features for accessing results, scheduling appointments, and communicating with providers. Portals often provide timely notifications of result availability, reducing anxiety associated with waiting. However, recognize that portals do not replace the importance of direct communication with physicians, especially for complex or concerning findings.

Tip 4: Prepare Questions in Advance of Receiving Results

Before receiving results, prepare a list of questions to discuss with the physician. This organized approach ensures all concerns are addressed, facilitating a productive and informative conversation. Consider questions regarding the implications of the findings, potential next steps, and long-term management strategies. This proactive approach maximizes the value of the consultation and promotes informed decision-making.

Tip 5: Dont Hesitate to Seek Clarification

If any aspect of the results or the physician’s explanation is unclear, do not hesitate to seek clarification. Requesting further explanation or a follow-up consultation demonstrates proactive engagement in one’s healthcare and ensures a thorough understanding of the findings and their implications. Clear communication fosters a collaborative physician-patient relationship and promotes informed decision-making.

Tip 6: Be Aware of Potential Delays and Follow Up Accordingly

Recognize that unforeseen circumstances can sometimes delay the communication of results. If results are not received within the anticipated timeframe, contact the ordering physician’s office or the radiology department for an update. This proactive follow-up demonstrates diligence and ensures timely receipt of crucial information. Delays, while sometimes unavoidable, should be addressed promptly to minimize unnecessary anxiety and ensure timely management.

Following these tips empowers individuals to navigate the process of receiving CT scan results more effectively. Proactive communication, informed decision-making, and a collaborative approach with healthcare providers contribute significantly to a positive patient experience and optimal health outcomes.

This information provides general guidance and does not replace professional medical advice. Consulting directly with a healthcare provider is always recommended for specific concerns or questions related to individual medical conditions or diagnostic imaging results.

Communication of CT Scan Results

The question of physician contact regarding CT scan results encompasses a multifaceted process significantly impacting patient care. This exploration has highlighted the evolving landscape of result delivery, encompassing direct physician communication, patient portal utilization, and the influence of electronic health records. Factors such as result complexity, clinical urgency, and established protocols dictate communication methods, impacting both patient experience and timely intervention. The role of radiologist interpretation, the importance of timely notification, and the specific procedures for handling abnormal findings underscore the intricate nature of this critical communication pathway. Ultimately, effective communication ensures patients receive accurate, timely, and understandable information, facilitating informed decision-making and optimal health outcomes.

As technology continues to advance and healthcare delivery models evolve, continuous refinement of communication strategies surrounding diagnostic imaging results remains essential. Emphasis on patient-centered care, clear communication protocols, and seamless integration of technology promises to further enhance the delivery of these critical results, empowering patients and optimizing the diagnostic journey.