Radiology Follow-Up Recommendation Tracking Software Compared

The short answer: Radiology follow-up recommendation tracking software reads signed reports, pulls out every "repeat CT in 6 months" style recommendation, puts it on a navigator worklist and chases it until the exam is scheduled or a clinician closes it. The products US health systems shortlist are Rad AI Continuity, PowerScribe Follow-up Manager (Microsoft), Inflo Health and Eon. None publishes a price, and none holds an FDA clearance, because none of them reads images.

This page is for the person who owns the problem: a radiology director, a quality lead or a lung program manager who has been asked how many recommended follow-ups their department actually closes, and could not answer. The published numbers explain why the question gets asked. In an Intermountain study of CT pulmonary angiograms, only 29% of incidental nodules were followed up, and nodules mentioned only in the findings section were followed up 0% of the time (Blagev, JACR 2014). At UC Davis, adherence to CT follow-up recommendations was 39.1% (Hansra, JACR 2021). The ACR's own improvement materials put it plainly: about half of recommended follow-up exams are never performed.

Vendor descriptions come from each vendor's product pages, read October 14, 2026. FDA status comes from the openFDA 510(k) database, searched by applicant and device name the same day. Federal purchase data is from USAspending.gov, award types A to D, every recipient name read by hand.

Radiology follow-up tracking software compared

Treat the outcome row as marketing until you see it on your own data. Every vendor measures "completion" differently: some count a scheduled exam, some a performed one, some count a clinician's note that follow-up is not needed. Ask which definition sits behind the number before you compare them.

Montage Follow-Up QC, Siemens Proactive Follow-up and Softek Discovery360 also appear in RFPs. Optellum Virtual Nodule Clinic comes up in lung programs, but it is a different kind of product: a nodule risk score with an FDA clearance (K202300, March 2021) rather than a tracking system.

Which follow-up tracking software fits which department?

The honest split runs along what you already own. If your radiologists dictate in PowerScribe, Follow-up Manager reads the recommendation at the point it is written, which is the cheapest integration you will ever get. If the problem is that follow-ups leave radiology and disappear into primary care, the products that live in the EHR (Inflo, and Rad AI's Epic and Cerner integration) reach the ordering side better. If the pressure comes from a lung screening program and its registry reporting, Eon was built for exactly that workflow.

Size matters too. The Brigham measured that 3.2% of its reports, 5,682 of 176,498, recommended additional imaging (DeSimone, JACR 2023). Another JACR study put the share at 10.6%. Multiply your annual volume by those two figures and you have the range of open loops a tracking system will carry. A department reading 150,000 studies a year is looking at roughly 5,000 to 16,000 recommendations a year, which is a navigator team, not a spreadsheet.

Is follow-up tracking the same as critical results communication?

No, and buying one expecting the other is a common mistake. Critical results communication handles findings that need action in minutes or hours, such as a pneumothorax, and proves the clinician was told. Follow-up tracking handles findings that need action in months, such as a 7 mm nodule, and proves the exam happened. Different clinicians, different timelines, different software. The products for the urgent side are compared on our critical results communication software page.

Why does the report itself decide whether follow-up happens?

Because every tracking product starts by reading the report, and a recommendation it cannot find does not get tracked. The Intermountain result is the one to remember: nodules described only in the findings section, with no recommendation in the impression, were followed up 0% of the time. Even with a specific instruction, only 29% were. Tracking software catches what is written clearly. It cannot rescue a recommendation that was never written, or one buried in a hedge.

That is where we fit. Radiological.ai drafts the structured report into your own template while the radiologist reads, and a structured template puts the recommendation where software expects it: in the impression, with the interval, the modality and the guideline it follows. The radiologist edits and signs every word. The tracking system downstream then has a clean, consistent field to read instead of free text. For the lung side specifically, the AI lung nodule detection page covers how suspected nodules are flagged on the first read, and structured radiology reporting covers the template design.

What should a follow-up tracking contract include?

• The closure definition, in writing. Scheduled, performed, or clinically dismissed. Your quality reports will use whatever the contract says.
• Who does the outreach. Some vendors supply the software only; your navigators make the calls. Others offer outreach as a service. Price the people, not just the license.
• Integration in both directions. Reading recommendations out of the report is half the job. Writing the closure back into the EHR is what lets a clinician see it.
• Extraction accuracy on your reports. Ask for a retrospective run on a few thousand of your own signed reports, with misses counted by a radiologist, before you sign.
• What happens with patients who move. A patient who leaves the system is the most common open loop. Ask how the product closes it, and how it documents that you tried.
• Volume-based pricing terms. With no published prices, expect a quote tied to study or recommendation volume. Bring your annual count so the quote is comparable.

How much does follow-up recommendation tracking software cost?

No vendor in this category publishes a price, and the federal record is empty: USAspending shows no prime awards to Rad AI, Eon or Inflo Health. What drives the quote is volume and staffing. A license priced per study or per tracked recommendation is the common shape, and if the vendor also does the outreach, that service is usually the larger part of the bill. The fairest way to compare quotes is cost per closed loop, which needs the closure definition above to mean anything.

The other side of the ledger is real. Failure to follow up is a recurring theme in diagnostic malpractice, and benchmarking from Candello, the malpractice data collaborative, found communication failures in about 40% of the cases it reviewed for 2014 to 2024. The ACR Learning Network collaborative showed what a working program does: across seven sites, guideline adherence rose from 62.3% to 89.0% and patients receiving the recommended imaging rose from 41.4% to 61.1%, with the best results at sites that had robust tracking systems and dedicated care coordination teams (Wandtke, JACR 2025).

Do you need a dedicated product, or can the EHR do it?

A small practice can start in the EHR with a discrete recommendation field and a report run each week. That works until volume makes the weekly report too long to work through, which on the figures above happens quickly. The usual sign you have outgrown it is that nobody owns the list. If your navigators already split open items by service line or site, a tool that can route each open follow-up to a named owner keeps the queue from turning into a shared inbox that nobody empties. Dedicated products earn their price when they add the outreach, the escalation and the audit trail on top of that.

Whichever you choose, the input matters as much as the tracker. A recommendation written the same way every time, in the impression, with an interval, is what makes any of these products work. That is the part our assistant does in the reading room, at $199 per radiologist per month on the Practice plan. Upload a study above to see a structured draft with the impression laid out the way a tracker can read it.