Don’t leave patients out when discussing patient portals

Online portals where patients can schedule appointments with physicians or contact providers are becoming more common, but many don’t include patient medical images or a way to contact radiologists. If practices are planning on building such a system, they shouldn’t leave patients out of the process.

In a study published in the Journal of the American College of Radiology (ACR), Tessa Cook, PhD, MD, of the University of Pennsylvania’s radiology department, and her coauthors discussed the experiences of the informatics committee on ACR’s Commission on Patient- and Family-Centered Care (CPFCC).

All committees with CPFCC include radiologists and referring physicians, but also involve patients as equal members. For informatics, the focus was coming up with a list of resources radiology practices could use to better align themselves with the principles of the commission: respect and dignity, information sharing, participation and collaboration.

This topic was discussed in a rather informal setting: an email chain, which evolved over the course of three weeks involving 41 messages being exchanged between 27 members of the committee.

“Patients described the expectation that radiologists will communicate results to them and that both they and their physicians, who ordered the imaging, in turn, should have the ability to provide feedback to radiologists as to the utility of a particular interpretation,” Cook and her coauthors wrote. “Radiologists and patients both debated the nature of the feedback and compared a simple social media–type ‘thumbs up’ button with a more detailed survey.”

Because the email chain lasted for weeks, participants could not only address the initial questions, but engage in a substantive, evolving conversation. For example, when proponents of a one-click feedback option argued that system would provide a quicker response to a specific reports, referring physicians argued a simple “thumbs up” or “thumbs down” would only lead to a phone call or e-mail to get more detailed information.

Both referring physicians and patients suggested radiologists need to better explain the reasoning behind an imaging order. One option was all subspecialities to follow the lead of mammography and give an interpretation both for the referring physician and a separate, simplified explanation for the patient.

In their conclusion, Cook and her coauthors said these conversations need to continue if radiology is going to be included in patient portals. And since it’s the patients who will need to use these systems, their suggestions are invaluable.   

“Including the input of patients, family members, and other caregivers when developing patient-facing services such as patient portals is absolutely essential,” Cook and her coauthors wrote. “Although these individuals may not have formal medical or informatics training, they bring a unique perspective to the problem that is extremely valuable when shared with radiologists and informaticists in a congenial atmosphere.”