The Challenge

UTMB Health faced significant challenges in managing incidental pulmonary nodules (IPNs)—a common finding on chest imaging averaging hundreds of cases weekly. The review process for each patient was time-consuming, often taking an hour or more of manual auditing, leading to a backlog of patient cases. Additionally, there was no mechanism to triage urgent versus routine follow-up patients. This meant UTMB was consistently several months behind in ensuring patients received necessary care.

The Solution

To address this, UTMB partnered with Bunkerhill Health to implement a workflow specifically designed for near-real-time navigation of pulmonary nodules in Bunkerhill’s Carebricks platform. This solution offered several key functionalities:

• Guideline Alignment: Radiology recommendations for nodules based on size were cross-referenced with national guidelines and UTMB's standard operating procedures.

• Risk Stratification: Carebricks analyzes nodule size, stability over time, patient-level predictors, and calculates a Brock risk score directly from the patient's record to help prioritize patients needing immediate evaluation.

• Follow-Up Assessment:Carebricks cross-checks imaging findings with patient history to confirm which cases still require follow-up, automatically filtering out ineligible patients and surfacing only those who need navigator review.

• Navigator Support: Structured encounter notes to notify patients and ordering providers are tailored and sent automatically through the EMR. Follow up recommendations, timeline, and completion are included in one easy dashboard.

A look at their success

Implementation of the Carebricks workflow yielded immediate and substantial improvements:

• Streamlined Case Reviews: Reduction of false positive cases for navigators went from an average >600 case reviews per month to 200 case reviews with 10% needing navigation.

• Accelerated Triage: IPN cases are now triaged 80% faster, with highest risk patients being prioritized over routine follow-ups.

• Reduced Staffing Needs: Where once four navigators struggled to keep up with IPN follow-up, today the workflow can be managed by a single navigator using Carebricks as a force multiplier. UTMB has chosen to keep a human in the loop for now, but the workflow is designed to support full automation whenever a health system chooses to scale further.

• Improved Patient Care: Patients, especially those with rapidly growing nodules or high Brock Risk scores, are reached within 48 hours of radiology reporting, significantly shortening the path to biopsy or consultation for evaluation.

This transformation shifted IPN navigation from a reactive, manual process to a proactive system, ensuring patients receive timely care and allowing navigators to focus more on patient interaction rather than administrative tasks.