The persistent nudge of government policy has undoubtedly pushed the health-care world into modern times. Whether welcome or not, mandates such as meaningful use have made concepts such as patient engagement a priority among RIS/PACS design teams across the country. Even without rules and regulations from government entities, the organic evolution toward greater patient involvement has mirrored the free flow of information inherent in the smartphone revolution.
“Patient engagement is being driven by meaningful-use adoption, but I think we are also at a crossroads. In fact, we’ve probably actually passed that crossroads,” says David Wild, director of medical informatics, FUJIFILM Medical Systems.
Easy access to data in so many other aspects of life, Wild explains, has enhanced convenience and productivity. The result is that people expect the same level of easy access in their health-care lives, and for many, that means mobile access to data.
“Look at the integration of biometric data-capture devices for health care, such as the Fitbit ® (and how it can piggyback with your mobile device),” Wild says. “The Nike FuelBand, with its yellow, green, and red lights, can have an impact on behavior. The wearable technology can influence people to make sure they show up on time to appointments. Eventually, you will see wearable devices and mobile devices encapsulating health-care information that is disseminated to radiologists at the point of interpretation.”
Push to the Future
Push notification, on smartphones and/or wearable devices, has the theoretical (and actual) ability to bring unprecedented speed and awareness levels to health-care information. “People can be proactive with their own care, if you give them notification and access to information,” Wild says. “As a result, they can follow up on their own care conveniently.”
The problem for patients and physicians alike, Wild says, is usually the sheer number of moving parts. A man who injures his neck, for example, might go to a primary-care physician, a radiologist, a specialist, and a surgeon.
After seeing so many physicians, he might be admitted to the hospital, which might (or—more likely—might not) have access to data from the preceding points of care. As part of the continuity of care, the patient, Wild believes, must be part of the process, with unfettered access to his or her personal health information. “From there, you give that transparency of data, and you let responsible people behave responsibly,” Wild says. “I think that is what is going to happen, the majority of the time. That’s why it’s so important, in patient engagement, to provide access to accurate information quickly.”
The patient portal—a tool likely to be used widely in getting patients to access their health data electronically (a meaningful use stage 2 requirement)—will make it easier for patients to engage with the radiology practice. It’s no small cultural change, but the shift is on, and Wild believes that the industry is starting to get on board. Part of the challenge, he says, is that referring physicians typically read a radiology report from the bottom up, but patients will read it from the top down, first reviewing the findings.
“The bottom of the report always says, ‘Here is what I think,’ with the impression,” Wild says. “The patient reads the findings before reading what the physician thinks. Physicians read what the radiologist thinks before they get into the details. There are certain pieces of information patients are not well equipped to understand, but it doesn’t mean you should not give them the information and give them an opportunity to be proactive about helping disseminate it among the providers, who may be overloaded with information.”
Push notification capability in the Synapse RIS is enabling radiologists and radiology department personnel to “subscribe” to specific patients and follow them through the department via alerts that arrive when, for instance, a patient needs to be protocoled or a patient-hold pending a preliminary report is in order. “Somebody needs to keep a pulse on a patient if there is a possibility of a negative result, and the referring physician is waiting for the results,” Wild says. Fujifilm calls the feature Synapse Pulse.
Engaging at the Gate
When it all works well, this entire IT experience can assist radiology practices in engaging patients—from the point of entry to preparing for the exam, accessing results, and obtaining follow-up care. For