Listen to Patients, not PCPs, on Radiology Report Access
Technological change is driving historic changes in how health care is delivered and paid for, and quite often radiologists, because they are on the leading edge of many of these technological advancements, are caught in the middle. One important example is in the area of giving patients direct access to their imaging test results. Advocating for more access are certain patient groups, health IT leaders and the government. Just this month, Farzad Mostashari, the national coordinator for health information technology at the Office of the National Coordinator (ONC), and his colleagues wrote in Health Affairs about the many benefits of consumer e-health and presented the federal strategy to “promote advances in consumer e-health to increase patient engagement, improve individual health, and achieve broader health care system improvements.” Advocating for keeping things the same are many referring providers who are dealing with their own overwhelming changes and are understandably nervous about either give up their traditional tasks or taking on new ones at this time. In a survey of 229 primary care physicians (PCPs) published in the Journal of the American College of Radiology this month, 95% of the PCPs said they thought that ordering physicians, not radiologists, should deliver the results of examinations directly to their patients. No specialist wants to upset his or her referral sources. Despite all the talk about the empowered patient making choices based on cost and amenities, the most important factor determining where a patient has a test or procedure done is still the recommendation of his or her doctor. However, your end customer is not the referring doctor but the patient. When you satisfy patients, you can often overcome the concerns of referring doctors. A great example is Metro Imaging, a radiology group with five outpatient imaging centers in St Louis, Mo. It launched a program in which patients could opt to receive their preliminary results following their exams, in as few as five to 10 minutes. At first referring physicians were dubious, but once their patients told them how much they appreciated getting preliminary results right away, they became much more receptive to the idea says Metro Imaging CEO Harley Hammerman, MD. (Read more here.) As patients become more used to getting all types of test results electronically through personal health records (PHRs), there will be an inevitable shift from patients viewing this as a fantastic bonus to a right they are entitled to — and woe to PCPs and specialists who are not ready when that day comes. How do I know this? Because I’ve been that patient. I have three beautiful children and had three perfectly normal uneventful pregnancies. However, for the first two kids (my girls), my full ultrasound reports were available through my PHR almost immediately. For my third child (my son), I had to switch to an OB in another state without a PHR component to her practice’s EHR system, and boy did it lead to frustration and confusion. Me: Can I have access to my ultrasound report. Her: It’s normal. Me: I know. I still want to see it. Her: Why? It’s normal. Me: Well, because I’m used to getting it and I want it! Needless to say, I didn’t get my wish, and I’m still mad about it.