AJR: Patients want rad results immediatelyand radiologists can help

Most patients believe radiology results are communicated too slowly. However, this provides radiologists an opportunity to increase their visibility and involvement in patient care, argued the authors of a study published in the March issue of the American Journal of Roentgenology.

Directly communicating results to patients positions radiologists as participating and equal partners in the healthcare process and has been shown to positively impact health outcomes, while the “uncertainty caused by the delayed communication of results can also be detrimental to patient health and has been associated with substantial biochemical distress,” put forth Pat A. Basu and colleagues from the department of radiology at Stanford University School of Medicine in Palo Alto, Calif.

Citing a lack of data regarding patient preferences for speed, source and medium for communicating radiology results to patients, Basu and co-authors administered surveys to 557 patients undergoing CT or MRI exams, receiving completed surveys from 129 patients and additional partially complete responses.

Of 225 responding patients, 41 percent said they preferred that the referring physician, rather than the radiologist, communicate the radiology findings, whether normal or abnormal. Meanwhile, 33 and 26 percent of patients said that they preferred to hear normal or abnormal findings, respectively, from whichever provider would be quicker. Six percent of patients preferred to hear abnormal findings from the radiologist and 27 percent from both physicians, while 12 percent wanted the radiologist to communicate normal findings and 14 percent wanted to hear from both doctors.

According to the authors, near-majorities of patients would consider the average academic radiology department’s 33-hour report turnaround time to be unacceptably slow. “To achieve an ‘acceptable’ rating from 95 percent of patients, all results would need to be communicated within a few hours, which is much faster than the length of time many patients currently wait for results from their referring physician,” the authors wrote. Their institution Stanford had an average report turnaround time of 18 hours.

The authors also found that just 8 percent of patients prefer to receive the radiologist’s normal findings in-person, with 25 percent preferring the telephone. For abnormal findings, 35 percent of patients preferred phone calls, 30 percent by whichever method would be quickest and 21 percent in person. Seven percent of patients preferred to receive abormal reuslts by e-mail, 4 percent by standard mail and 2 percent by fax.

Basu and colleagues hypothesized that patients might have believed that an additional appointment would be required for in-person communication of results, leading to lower preference for this method.

Basu and co-authors highlighted the prominence of speed in patient preferences, seeing it as an opportunity to fend off the commoditization of radiology. “[A] visible radiologist is central to developing a patient-centered radiology [practice],” they wrote.

“Because most patients want their CT and MRI results as soon as possible, our study uncovers an important opportunity for radiologists in CT and MRI to play a more visible clinical role, increase patient satisfaction and improve the quality of healthcare by communicating results sooner.” Radiologists’ reporting of results would help meet patient preferences in providing quicker communication of findings, the authors argued.

Given the American College of Radiology’s (ACR) findings that 50 percent of patients are unaware that radiologists are physicians, Basu and colleagues were not surprised that more patients preferred to receive their results from referring physicians than from radiologists.

The authors provided a demographic breakdown of their patients so that other institutions could compare and assess the likelihood of generalizing the authors’ findings to other facilities, while noting the limitations of their single-institution survey.

The authors reiterated that their survey “suggests that radiologists have an important opportunity to change the current practice mode and fulfill their role as clinicians who are important members of the patient’s healthcare team. The strong preference of patients to receive their CT and MRI results promptly should ultimately help erode cultural, historical and operational barriers to direct communication between the radiologist and the patient.”

Noting that longitudinal studies suggest that radiologists’ and technologists’ immediate reporting of results to patients can increase referral volume, the authors concluded that the “short-term costs of direct communication are much less than the long-term effects of remaining invisible.”