JACR: Radiology reporting must become more patient centric

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According to a study published in the April issue of the Journal of the American College of Radiology, revisions are necessary to increase the patient centeredness of care in the area of radiology reporting, with regard to giving patients greater access to their personal health information and lowering patient anxiety due to report timing.

In seeking physicians’ perspectives on radiology reporting systems and addressing current problems with physician reporting methods, researchers from the Wake Forest University School of Medicine in Winston-Salem, N.C., said that effects on both patients and radiology reports should be considered. They also surmised that timing on part of the physician should be optimized.

Lead author of the study Annette J. Johnson, MD, MS, and colleagues selected participants--consisting of eight radiologists and seven referring physicians--for their two focus groups. The physicians’ views on direct patient access to radiologic test results were considered by the researchers in order to test the possibility of radiologists using the Internet to communicate rapid online imaging results directly to patients,

The authors found that most participants were dissatisfied with current reporting systems, in which it is common to briefly share test results with patients on a verbal basis days or weeks later, explained the authors.

While both radiologists and referring physicians were aware of this issue and most believed that patients should have access to personal health information in order to take responsibility for their own health care, most physicians believed that direct online access for patients could result in other issues.

"The greatest concern revolved around patients' ability to understand written reports,” said Johnson. “Participants predicted that patients, who may not fully comprehend the report's content or place its meaning into proper context, would experience increased anxiety if they did not have prompt access to a physician to assist them in understanding the results and implications.”
The authors also noted that the study participants felt that the demands on the physicians’ time that may stem from online result access “could not realistically [be] accommodated,” as it may lead to increased required consultative time on the part of radiologists. Physicians believed this might lead to problems for the patient-physician relationship, as this could potentially “limit physicians’ opportunity to adequately prepare for patient consultative visits or calls and would reduce opportunities to mitigate patients’ anxiety and guide management decisions appropriately."

Both focus groups favored any system for direct patient access that could incorporate a time delay and be tested for effect before being implemented, the researchers found.

“Further investigation will be required to develop a system that provides patients with direct access to test results, while giving RPs the opportunity to communicate with their patients about test results. Any attempted system revisions will also need to consider the crucial issue of timing for patient access to online results,” concluded Johnson and colleagues. “The physician insight from this study should serve as a guide as we begin our improvement efforts.”