Patient Portals’ Path to the Mainstream

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The process of obtaining radiology reports likely seems outdated to many patients. When they need to book a flight, check bank account balances or assess their stock portfolios, chances are they turn to a web browser. Meanwhile imaging results communication continues to wallow in the dark ages of phone and mail. However, patient portals can make radiology reports available online.

The technology for creating a patient portal to access radiological information isn’t particularly new. Some facilities have had reports available online for years. But patient portals seem braced to go mainstream in radiology.

The reason for this emerging trend is two-fold. First, healthcare is becoming increasingly consumer-driven, with practices needing to differentiate themselves from competitors and offer patients what they want. And what they want, it turns out, is online access to radiology test results.

One pilot study, conducted at Wake Forest Baptist Medical Center in Winston-Salem, N.C., found that patients largely wanted online access to their detailed imaging reports as soon as possible. The findings, published April 2012 in the Journal of the American College of Radiology, showed 88 percent of study participants wanted either immediate access or three-day delayed access for normal results. Even for seriously abnormal studies, more than 80 percent still wanted online access by the third day, if not sooner.

Enter Meaningful Use

The other force pushing the spread of the patient portal is Meaningful Use (MU). Stage 2 final rules require more than half of a provider’s patients be given online access to health information, and 5 percent of a practice’s patients must use a portal to access, print, share or download records. Some medical societies, including the American Medical Association, complained the participation requirement was patient-driven and thus outside the control of the practice. Despite these protests, a number of practices have been spurred into action.

“Once we made the decision to get certified for Meaningful Use, it became a requirement to [offer a patient portal],” says Alan D. Kaye, MD, CEO of Advanced Radiology Consultants in southwestern Connecticut. Using a portal that went operational in August 2011, Advanced Radiology Consultants offers patients online access to reports. About 40-50 patients per day access the portal, and the number continues to grow.

Aside from providing patients the ability to view health information online, patient portals could help satisfy a number of other criteria from both the eligible professional (EP) and eligible hospital/critical access hospital (EH/CAH) MU Stage 2 objectives list, including:

  • Record demographic information (EP & EH/CAH);
  • Record smoking status for patients 13 years old or older (EP & EH/CAH);
  • Provide clinical summaries for patients for each office visit (EP);
  • Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient, if appropriate (EH/CAH);
  • Provide summary of care record for each transition of care or referral (EP & EH/CAH); and
  • Use secure electronic messaging to communicate with patients on relevant health information (EP).

The trailblazer

In 1999, well before MU began devouring the time of CIOs around the U.S., Beth Israel Deaconess Medical Center (BIDMC) in Boston launched the world’s first patient portal providing, among other information, access to imaging reports. Approximately 55,000 patients per month access their health data through Patient-Site, with the goal of 250,000 per month, or about half of BIDMC’s active patients, explains Henry Feldman, MD, from the divisions of internal medicine and clinical informatics at BIDMC.

“It makes the conversation richer with the patients,” says Feldman. Because patients have easy access to the bottom line findings of an imaging study, they ask more substantive questions. “This removes the sort of secretarial layer of medicine results reporting and elevates the conversation between patient and doctor to the meaning of the results, which is, of course, what we’d much rather talk about.”

PatientSite is limited to radiology reports because of the massive bandwidth strain that would occur if patients tried to download images. It also would require additional licensing fees from the PACS vendor. However, patients haven’t asked for the full images, says Feldman. “You’re welcome to walk into our film library and get a copy on CD if you need to bring it somewhere,