Propelled by everything from regulatory requirements to patient centricity, all roads point toward direct communications with patients by radiologists.
The days when radiologists could live in the shadows of the reading room are gone. Now, increasingly, imaging subspecialists of all types are expected to be out in plain sight, interacting directly with patients.
This expectation arises in part from radiology’s sense that it needs to demonstrate ever-greater value in the eyes of customers and payors, something achievable by joining the march to patient-centricity. The need for greater visibility also has its roots in regulatory pressures—the requirements of the federal Meaningful Use program, for instance, in which radiology is financially rewarded for making medical records electronically available to patients and successfully coaxing a sufficient number of those individuals to log on to a patient portal.
Radiology departments and practices are finding it essential to communicate with patients more frequently, facilely, and fully. But in order to have patient interactions and results deliveries that are on par with current expectations, those organizations also are discovering that they must re-engineer comfortably familiar processes and protocols, adopt new ways of working, and even embrace cultural change.
Interactions with patients
Patients today live in a world where people engage in social intercourse about matters both profound and trivial using a variety of electronic communications channels: phones, email, texting, Instant Messaging, Skype, Facebook, Twitter. Significantly, all of this chatter occurs absent the kinds of time delay associated with the sending and receipt of letters via traditional postal mail.
Radiologists like Mark Alfonso, MD, say it is therefore only natural for patients to want to be able to converse with imaging clinicians during preparation for, progress of, or follow-up to an exam. These patients have questions—questions about the study and the results, and they want answers yesterday, if possible.
Alfonso, immediate-past president of Riverside Radiology and Interventional Associates, Inc., in Columbus, Ohio, believes radiologists need to be able to answer those questions as and when they arise. To do that, radiologists need to be more available to and accessible by patients. “The more we are in the position to talk to patients and share information with them, the more empowered those patients will be in the long term,” he says.
Susan D. John, MD, professor and chair, department of diagnostic and interventional imaging, University of Texas Health Science Center at Houston (UTHealth) Medical School and chief of diagnostic and interventional imaging, Memorial Hermann-Texas Medical Center (TMC), contends that the need for radiologists to communicate with patients has always existed but only in recent years has its importance come to the fore.
“PACS and other informatics systems, while responsible for greatly advancing our medical specialty, contributed to making us less accessible to patients by pushing us into remote reading rooms,” she says. “Then, as healthcare shifted more to the integrated delivery system model, we realized that we were going to need to have greater contact with patients to fit in.”
As Chicago-based healthcare attorney W. Kenneth Davis, Jr., JD, sees it, better communication with patients is at bottom a quest by radiologists to gain a better seat at the reimbursement table. “The more that radiologists can drive the process of healthcare delivery—as opposed to merely being along for the ride—the more valuable they become to their hospitals, referrers and payors,” says Davis, a partner in the firm of Katten Muchin Rosenman, LLP. “Radiology practices wishing to survive must provide the highest-quality care. Doing so will help them emerge as the most desirable healthcare-delivery partner possible. One way to become the imaging provider of choice is by improving communications with patients.”
Assuming radiologists need to step up their communications with patients, under what circumstances should such dialogue take place? And who should initiate it: the patient or the radiologist? Some say the radiologist should always be alert to opportunities to take the lead, but only start the conversation when there is bad news to impart. Others say, yes, take the lead, but only if you’ve something encouraging to convey.
N. Reed Dunnick, MD, chair, department of radiology,