The information-blocking provision of the 21st Century Cures Act is designed to spearhead interoperability and enhance patients’ access to health information. To prepare for this upcoming change, many provider groups are considering eliminating the typical delayed release of radiology reports via online portals.
The idea is that a few days or a week allows referring providers to coordinate care for patients before they fret over potentially abnormal imaging findings. As part of the Office of the National Coordinator for Health IT’s new regulations, however, delaying access to personal health information is subject to penalties of up to $1 million per offense. Organizations must comply with new mandates by April 5, but enforcement of such rules is still pending.
Importantly, there hasn’t been a concrete ruling on whether this imaging embargo period will constitute information-blocking, Massachusetts General Hospital radiologists wrote Tuesday in JACR.
The American College of Radiology in October reached out to the ONC for guidance, with the latter noting providers aren’t required to proactively release rad reports to patients who haven’t requested it. But in practice, the ONC said this could mean a patient gains access “in parallel” to when the ordering clinician has results.
“With respect to patient-level … access, many hospitals plan to respond to the information-blocking provision in part by eliminating radiology report embargoes, among other strategies for promoting data accessibility,” William A. Mehan Jr. MD, MBA, and colleagues with MGH-affiliated Harvard Medical School, explained on Feb. 16. “Radiologists may struggle to understand and prepare for the impact of immediate patient report access via online portals on their practices, referring providers, and patients.”
Below are a few strategies to help.
1. Including a short lay summary at the end of reports can reduce their complexity and enhance patients’ comprehension. Likely suitable for larger private practices, this method may disrupt radiology workflows. Available artificial intelligence algorithms can scour report findings to create digestible summaries.
2. Adding a direct patient message to indicate normal or abnormal findings with accompanying next-step recommendations in the report conclusion can also lower patient anxiety. This is likely achievable for most provider groups with a small IT investment for a voice-dictation system.
3. Redesigning operations to decrease the lead time between patient imaging studies and appointments to, say, 48 hours reduces the time individuals have to view abnormal results before speaking with their doctor. This may help limit their anxiety and excess calls to providers and doesn’t necessarily require extra funding or staffing.
4. Promoting direct contact with radiologists by including their phone number in the report has proven to produce a “manageable” number of calls with minimal workflow disruptions while enhancing radiologists’ job satisfaction. Opportunities to speak directly with imaging providers and rad-staffed clinics have both been shown to appease patients and help them understand their results.
5. Incorporating lay-language translations of complicated terms into digital radiology reports, complete with pictures and links to patient-centric info sources, “holds the potential for real patient understanding of their imaging findings … in an accessible format,” the authors wrote. This is likely for resource-rich practices due to large IT and financial needs.
Read the entire article published Feb. 16 in the Journal of the American College of Radiology here.