The final rule of the 21st Century Cures Act took effect last month, requiring providers to offer patients prompt access to their medical information, including radiology reports, with normal embargo periods potentially violating new information-blocking provisions.
While a majority of hospitals offer online portal access to such information, there’s nearly no standardized practice across radiology departments, according to a special report published Tuesday in Radiology. Out of 70 of the top U.S. hospitals, 34% reported an embargo period of 1-3 days, with most others falling within the 4-indefinite range.
It’s common for physicians to hold off on immediately releasing reports in order to coordinate care and consult with clinicians, among many other reasons. And while there are those who oppose real-time access—whether due to the above concerns, patient confusion, security, or feasibility—rads are best served to adapt to these new rules, the authors argued.
“Given the benefits to patients, radiologists, and possibly institutions in providing early access, radiologists should embrace the final rule as a positive step in patient autonomy,” Jonathan L. Mezrich, with Yale Medicine’s Department of Radiology and Biomedical Imaging, and colleagues explained.
There’s been plenty of confusion regarding these interoperability regulations, which went into effect just last month. The American College of Radiology has gone back and forth with the Office of the National Coordinator for Health IT, seeking answers; and the college’s last alert on March 25 claimed the ONC’s most recent update only “muddies” prior clarity.
With this in mind, Mezrich and his Yale colleagues performed a “secret shopper” telephone survey of U.S. News & World Report’s 83 top hospitals of 2019-2020. Surveyors posed as patients’ family members to ask about e-portal services and policies.
They received 70 responses, but not every institution answered each question. Nearly all (91%) provided patients access to their reports via online portals. Thirty-four percent released info after 1-3 days; 13% did so after 4-6 days, and 9% waited 7-14 days. There were 20% that held off “as long as necessary” and 23% did not know.
Additionally, 52% of hospitals first send reports to patients’ treating clinician to review, while 22% did not.
There are many benefits to early access, the authors noted, including placing individuals in charge of their care, ensuring things aren’t missed, preventing errors, and decreasing the chance radiologists’ interpretations and follow-up guidance are overlooked.
While it may take a team-based approach to care, residency training changes and patient-friendly reporting, reforming embargo periods can ultimately lead to more face-to-face time.
“Greater interface with patients through early receipt of radiology reports may even prove beneficial to the field of radiology, as patients will have a greater awareness of those providing their care … and may pave the way for other avenues of patient interaction,” the authors explained.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.