EMR-based messaging tool helps patients connect with radiologists

Allowing patients to communicate directly with radiologists through an online portal helps them stay informed and feel more engaged, according to a case study published in the Journal of the American College of Radiology.

Patients want access to their radiology reports, the authors noted, but are often unable to fully understand them. This is where radiologist participation could be beneficial, both for patients and their ordering providers.

“Although patients generally favor speaking with their own physicians about results of radiology studies, many physicians are ill equipped to answer specific imaging questions if it is out of their area of expertise,” wrote Morgan P. McBee, MD, department of radiology and radiological science at the Medical University of South Carolina in Charleston, and colleagues. “Additionally, patients’ second most preferred method to understand an imaging study’s result is to ask a radiologist.”

The researchers developed their system at a large academic children’s hospital that already used an integrated electronic medical record (EMR) with a built-in patient portal. Before implementation, patients could view their radiology reports through the patient portal for some examinations immediately. For some other examinations, including CT and MRI scans, the results were embargoed for 48 hours. Patients had the option of sending a direct message to their ordering provider—not the radiologist—through the EMR.

The new system was developed with help from a working group of various stakeholders from the facility. Patients were allowed to ask questions about both completed examinations and upcoming examinations. Questions were sent to an inbox within the EMR and could be read by one of many radiologists as opposed to only the specialist who read that specific study. Of the team’s seven primary goals for its new system, five were achieved. The two goals that were not fully realized were, “Patients should be able to initiate a question directly from a radiology report, if the report has been finalized, and from the order sheet, if the report has not been finalized or if it is embargoed” and “Questions should require minimal data entry by patients.”

Once the system went live, the authors observed its use from Oct. 3, 2017, to July 31, 2018. The messaging capabilities were announced on the hospital’s blog and, later, social media platforms.

Overall, more than 168,000 studies were performed on more than 69,000 patients during the testing period. In that time, 88 questions were received, which represented 0.13% of all patients seen within the department. Eighty-six of the 88 questions were related to studies that had already been completed.

“Because the form is located on the page of the portal that lists results of already completed studies, it is unlikely that patients would know to look in this location if they have a question about a future study,” the authors wrote. “If the question form were located in the scheduling section of the portal, we believe that we would receive more questions before imaging.”

While 47% of the patient questions were about the availability of imaging results, 20% were asking for clarification and 13% were wanting to view the images.

McBee and colleagues noted that their workflow had some built-in limitations—the shared inbox for all radiologists was a source of potential confusion, for example—but that 70% of radiologists still used the system to respond to a question with a median turnaround time of 5.1 hours.

“Several of the radiologists have anecdotally reported satisfaction with being able to improve patients’ and families’ understanding of their radiology reports,” the authors wrote.