Concern comes with any new process or system change in healthcare, and the increasing use of online patient portals in radiology is no exception. However, worries about patient anxiety, an uptick in office phone calls or misinterpretation of reports seem to have been kept at bay, as the adoption of portals is offering a host of promising benefits for patients and radiologists alike.
What a patient wants
While the buzz about patient portals has largely focused on the technical and regulatory aspects of the innovation, examining the patient management side is critical in obtaining a holistic view on the topic. In investigating what patients want from their portals, most say they simply want easy access to their radiology exam results.
“There are multiple ways that patients want and need communication,” says Seetharam C. Chadalavada, MD, MS, radiology resident at the Hospital of the University of Pennsylvania in Philadelphia. “They want to feel more engaged with their healthcare and want data that they can understand.”
From May 2012 to October 2013, the Hospital of the University of Pennsylvania invited approximately 460,000 patients to participate in their patient portal. They had about 145,000 activated users, which is 31 percent of the patient pool, says Chadalavada. The demographics of those who participated in the portal were studied, revealing that 64 percent of participants were female and 36 percent were male. Among females, patients between the ages of 50 and 59 had the most activated accounts, while males between 60 and 69 years old had the highest number of activated accounts. About 53 percent of patients with activated accounts reviewed their lab results on the portal, which was similar to the 52 percent of patients who reviewed imaging results. Among the most popular studies viewed? Mammogram and chest x-ray results.
Corey W. Arnold, PhD, assistant professor in-residence at the University of California-Los Angeles, adds to Chadalavada’s ideas about patient engagement. “In particular, they have a desire to view lay explanations of their imaging test results, and feel that they would be better able to understand their medical information after viewing their actual medical images,” he says. However, Arnold also notes that some patients avoid viewing any of their information so as not to increase their anxiety about their medical problems.
Other facilities are seeing similar success in engaging patients in portals. In just over a year since Wake Forest University Baptist Medical Center in Winston-Salem, N.C., implemented a portal, more than 30 percent of patients are registered users, according to Annette J. Johnson, MD, MS, professor of radiology and director of workflow improvement and quality in radiology at the Wake Forest School of Medicine. “Anecdotally, we have heard the most enthusiastic feedback from patients about their ability to send secure text messages to their providers, known as asynchronous communication, with quick response turn-around-times, and to request medication refills via the portal. Checking test results, both laboratory and imaging, via the portal also has been very popular among our patients.”
While access to data is key, ease of use is king. “Intuitive design and ease of use immediately come to mind as important features of patient portals,” says Jake Block, MD, associate professor of radiology and associate vice-chairman of clinical operations at the Vanderbilt University Medical Center in Nashville, Tenn. “However, one of the greatest qualities of these systems is the opportunity for patients to interact with their healthcare providers and their medical record in an asynchronous fashion.” Given the busy schedules of both providers and patients, portals offer a secure and efficient means for communication between the two parties.
Many laboratory and vital results are immediately available via the patient portals upon finalization, but the federal government’s Meaningful Use program dictates that some lab and radiology results be held two to four days prior to posting. Healthcare providers are given this time as an opportunity to review the results and contact patients with any particularly concerning findings before patients see them on their own. Some tests, like HIV results, are best delivered through direct contact and are never made available on the patient portal.
But Block questions the need for such an interim period. “Long delays in posting imaging results may not be necessary