Table 1 The standardized cardio-oncology patient scheduling and test result notification protocol. Established across our institution, this protocol serves as a comprehensive guideline and quality control mechanism for all cardio-oncology related scheduling and result notification processes, including consultation, imaging, and procedures. By providing consistency and reliability for patient care, this protocol ensures the highest quality of care for cardio-oncology patients

2.1—Patient referral and Imaging study workflow protocol standardization

2.1.1—Dedicate appointment slots in NIV imaging department to accommodate timely Strain Echo testing

2.1.2—Provide oncology offices a Cardio-Oncology order AID for direct scheduling capabilities for Cardio-oncology echos/peripheral studies with instruction to call central scheduling for all appointment requests (including urgent requests)

2.1.3—Cardio-Oncology patients should be scheduled for timely NIV imaging studies (in < 5 business days)

2.1.4—Cardio-Oncology patients should be scheduled for timely clinical visits (in < 10 business days)

2.1.5—New Cardio-Oncology referrals need echo prior to or on the day of visit (if no echo within last 4 weeks)

2.1.4—Participating Cardiologists should dedicate outpatient clinic appointment slots for cardio-oncology patients

2.1.5—Information to be obtained from Ordering oncology offices

 * Type of Chemo, frequency, and dose

 * Treatment start date

 * Date of next scheduled appointment

 * Name of ordering physician, contact information, & Fax #

2.2—Standardized Imaging acquisition protocol on approved software platforms

2.2.1—Sonographers are to reference our NEW Cardio-Oncology Echocardiogram Protocol

2.2.2—Vendors software and tech training for 3D/strain echo

2.3—Imaging report format standardization

2.3.1—Include the following information in the report, per ASE guidelines:

 • Echo performed on a ‘(type in) system’ version ‘(type in)’

 • ‘(type in date)’, EF ‘(type in)’, GLS ‘(type in)’%

 • On this study, there has been a ‘(type in)’% change in GLS compared to pretreatment baseline

2.4—Standard result notification protocol & outcomes tracking

2.4.1—Reading physicians should generate results of imaging studies and notify referring provider of normal results or results consistent with last study within 48 h via fax/Athena

2.4.2—Reading physicians should generate results of imaging studies and notify referring provider directly or on-call MD to explain abnormal results within 24 h (abnormal results include but not limited to CTRCDs

2.4.3. Evidence of CTRCDs, Per ASE guidelines, abnormal results for chemotoxicity:

 * Absolute Reduction of LVEF of > 10 points to below LLN set at 50%

 * Absolute decrease in LVEF > 16% from pre-treatment values

 * Relative GLS decrease > 15% from pre-treatment baseline