RSNA: Don't forget referring docs in patient portal process

CHICAGO—As patients increasingly have access to imaging reports through online patient portals, it is highly important that referring physicians also receive radiology results in a timely manner to ensure patient care is not delayed, according to research presented at the annual meeting of the Radiological Society of North America (RSNA). With the recent focus on interoperability and the creation of the Integrating the Healthcare Enterprise Integration profiles to solve issues associated with patient access to medical information, patients have been receiving their radiology reports directly through Internet portals. This is bringing about positive and negative implications for healthcare, remarked Nogah Shabshin, MD, MBA, of the University of Pennsylvania in Philadelphia. Positives of patient access to radiology reports through portals include the support of patient rights, more involvement and responsibility from patients, and faster results and workup. However, said Shabshin, “Patients can open reports of bad news, or Google the results and misunderstand them. This can be disastrous and lead to delay in patient care.” Shabshin and colleagues thus designed a descriptive study in which they investigated if patients with abnormal studies who did not access their reports online received their results, and examined if they returned to the referring physician for further workup and treatment. The study involved a telephone survey of 1,594 patients who had an abnormal CT or MRI and had received a password for the internet portal but had not logged in. Fourteen percent of the patients who did not log into the portal did not receive the results despite their availability. Of the 1,374 patients that did get the results a different way, 14 percent did not return to their referring physician. “These results can be explained by patient anxiety and denial, the assumption that the doctor will call if results are abnormal, a misunderstanding of the report, or lack of internet access in older patients,” remarked Shabshin. Because patients are directly receiving radiology reports and have easy access to medical information, radiologists need to learn how to cope with this, said Shabshin. “Imaging departments need to ensure that results are sent to and received by the referring physicians and this information should be documented,” concluded Shabshin. “When reporting a significant abnormal finding, the radiologist should notify the referring physician in person and document it. They need to take into account that the patient may not have received or had access to the report, may not have understood it properly, and may not return to the doctor under the assumption that they will be contacted by their medical provider.” Future studies will systematically evaluate the causes behind patients’ lack of report accessing, as well as examine different age and socioeconomic groups.