Shared decision-making (SDM) plays a key role in patient-centered care. And according to a new analysis published in the American Journal of Roentgenology, it’s a process radiologists can be more involved in than they may think.
“On the surface, SDM is relevant only to clinicians who make decisions in partnership with patients,” wrote lead author Kendall Cooper, Morehouse School of Medicine in Atlanta, and colleagues. “That is a misconception; radiology and radiologists can play an important role in SDM.”
Cooper et al. conducted a “targeted literature review” and detailed how radiologists can play a key role during each phase of the SDM process.
1. Improve patient access to information
Giving patients access to their own medical records provides significant value, the authors noted, yet “many institutions are noncompliant” with federal regulations about such access. Patients may be given a CD of medical images even though they have no way to access the data on that CD, for instance. And patient portals are gaining popularity throughout the United States, but certain challenges still exist when it comes to truly getting all patients to use the technology. So what can radiologists do?
“Radiologists can make better use of patient portals with regard to SDM in several ways,” the authors wrote. “They can play a role in facilitating portal enrollment by disseminating information regarding availability and access to the portal. Advocacy for development of programs targeting specific racial and ethnic groups can also increase patient access to medical information.”
Radiologists can also work to help patients receive their own test results more quickly than in the past. Natural language processing can help speed up that process, the authors wrote, by at least reaching out to patients right away when they have “normal” results.
2. Improve patient comprehension of information
If a patient is going to be viewing their own radiology report, they need to understand what they are reading and what various medical terms mean. Again, Cooper and colleagues explained that radiologists can help with this aspect of SDM.
“Use of multimedia-enhanced radiology reports can facilitate patients' ability to understand the information conveyed,” the researchers wrote. “Components of such a report include conclusions presented in lay language, hyperlinks to glossaries and medical illustrations on the web and annotated images. With improved readability and comprehension of radiology reports, patients can become more involved in their own care and develop a sense of autonomy.”
3. Help communicate the actual findings and diagnosis to the patient
Appraising information is different from simply comprehending it—this is where the radiologist’s actual findings need to be explained. The researchers noted that appraising medical information is the most effective when a provider and the patient discuss the topic in person. This means SDM could lead to consultations suddenly being a much larger part of the average radiologist’s day-to-day schedule.
“Expanding radiology consultation programs will likely require radiologists to sacrifice relative value units and maybe even accept lower income, but this may be outweighed by providing a highly valued service to patients, increasing radiologists' visibility among the care team, and adding meaning to radiologists' perception of their work,” the authors wrote.
4. Help the clinicians, and the patients, reach a final decision
Radiologists don’t often get to help with making the final decision—unless the decision specifically involves medical imaging, of course—but they can still help with this stage of the process. A radiologist could help with the development of patient decision aids (PDAs), for example.
“PDAs can help clinicians communicate such criteria to patients to obtain their buy-in and compliance,” the authors wrote. “Radiologists could improve on the quality of PDAs by adding information regarding evidence-based use of imaging modalities and accurate delineation of benefits and disadvantages of modalities and procedures, such as exposure to ionizing radiation, need for sedation, interventional procedure risks, and wait times.”