In the years since the announcement of the federal meaningful-use program, the radiology community has been abuzz with discussion about how to meet several of the challenges that it has presented: interoperability with referring physicians; sharing not just of radiology reports, but of full imaging datasets as well; and recording of patient health information that had not previously been considered the domain of radiology. One goal of the program is less frequently discussed, however: deepening patient engagement and empowerment through encouraging the use of personal health records (PHRs). A 2011 study¹ showed that under 10% of US residents had taken advantage of the multitude of PHR options available to them. With meaningful use giving providers incentives to offer the service to patients, however, that tide might be beginning to turn. Jennifer Staley is the technical director at Tri-City Radiology (Kennewick, Washington); through its RamSoft RIS/PACS, which the organization is using to attest to meaningful use, Tri-City Radiology has been able to make the HealthVault PHR from Microsoft available to its patients. “RamSoft offered HealthVault to our patients for us, and it’s working very well,” Staley says. “Almost every patient requests access to it.” RIS–PHR Integration Though not always as strongly emphasized as other goals of the program, engaging patients and families is, in fact, the second of five health-policy priorities that the Office of the National Coordinator for Health Information Technology’s policy committee uses to shape the meaningful-use rules. “Although their health information will ultimately be shared through [electronic health record (EHR)] technologies, until this is available patients can share this information by handing providers a hard copy or by allowing providers access to their health information via a PHR or patient portal,”² the DHHS notes. In recognition of this priority, in October 2011, RamSoft upgraded its PowerServer RIS/PACS product to include integration with HealthVault; the RIS/PACS automatically transfers all patient data to the PHR, allowing patients to see the same reports as their referring physicians, after a two-day hold. “What patients see is exactly what is sent to the referrer,” Staley explains. “The two-day hold is built in, in case there is bad news,” offering the referring physician the chance to reach out to the patient and contextualize the information before he or she sees it in the PHR. Prior to implementing the meaningful-use module of the PowerServer RIS/PACS in October 2012, Tri-City Radiology offered its patients two options for the receipt of study results: a mailed report or a report sent to the referrer (or both). The addition of delivery to HealthVault as an option has enhanced the organization’s service to patients, Staley says. “Their primary-care physicians’ offices have been doing this as well, so patients have been requesting it,” Staley says. “They love being able to know, right away, what their results are. Imaging exams can be very anxiety inducing, so patients appreciate that they can get that information online.” Engaging and Empowering Patients Offering PHR access is one of several ways that Tri-City Radiology has been working to engage and empower its patients. Staley notes that the four-radiologist group has not raised its prices in a decade: “At this point, we’re charging a third of the rates of some of our competitors,” she says. “Our radiologists are really happy about that. They know that right now, everybody is looking for cost savings.” To help patients take control of their imaging costs—and to market its own low prices—Tri-City Radiology recently added price-comparison information to its website (tricityradiology.com). “We have our most common procedures and their prices right there, and we’ve heard a lot of positive feedback from patients who saw the website and came to us because of our prices,” Staley says. In the future, the practice intends to market its PHR offering similarly. “If potential patients knew they could have their results in two days, they would jump all over that,” she says. “Now that they pay so much of their health-care cost out of pocket, things like that are much more important.” As part of its meaningful-use attestation, the radiology group has also set up HL7 connections between its RIS/PACS and the new EHRs of local clinics, enabling the organizations to share health information freely for the convenience of patients. “It was a little expensive, but we’d set up another one if anyone asked,” Staley says. “Although it’s not about the money, we are now where those clinics send all their imaging. Overall, we’ve gained business, and we’ve seen enough reimbursement to pay for the interfaces.” Aside from troubleshooting calls from a few confused patients, Staley has heard only positive feedback regarding the availability of HealthVault—indicating that though PHRs have been slow to catch on, the patients who do get access to them enjoy using them. She says, “We’ve been offering this for more than a year now, and in general, patients have responded very well. They like having all these new tools at their disposal.” Cat Vasko is editor of ImagingBiz.com and associate editor of Radiology Business Journal.
Radiology Results Delivered Electronically: Engaging Patients Through PHRs