Radiology reporting: There's room for improvement

In healthcare, communication is everything.

In the absence of reliable and accurate communication, particularly between providers, patient care quality can quickly devolve into a nightmare scenario. Take, for instance, a communications breakdown that took place between radiologists and doctors as described in today's issue of FierceMedicalImaging. According to Dushyant Sahani, M.D., a radiologist at MGH, a group of patients who had received radiology reports from a referring physician were convinced they had terminal conditions. As it turned out, all but one case involved innocuous findings that had been poorly conveyed between providers--and as a result, poorly communicated to patients.

The experience was a traumatic one for many of the patients involved; several, according to Sahani--who provided them a second opinion--broke down and cried tears of relief upon hearing that they weren't going to die

Such heartache certainly could and should have been avoided. The use of clear and precise language should always be a top priority for all providers, including radiologists.

Attempts to improve such processes, however, need to improve, first.

Case in point: In 2009, researchers from Vanderbilt University surveyed pediatricians in the Nashville area to see how those pediatricians interpreted terms radiologists used to describe certain chest radiograph findings. They found that in many cases, what they thought were fairly simple and straightforward terms were misinterpreted to the extent that it could have led to inappropriate treatment. As a result the decision was made to use consistent, precise language in radiology reports to avoid any confusion.

However, that decision was only a regoinal one. Recently, a survey of primary-care providers by researchers in the department of radiology at MGH found that the second most important component of radiology reports--though far behind diagnostic accuracy--was clarity of language. What was also interesting about that survey was that the respondents, by a large majority, were opposed to providing radiology reports directly to patients. One of the reasons for that stance was concern that patients are ill equipped to understand the information in a typical report, which could result in creating unneeded patient anxiety--the the exact problem Sahani helped to resolve.

But, should it be that difficult for patients to understand what lies in their radiology reports? Of course not.

In their study, published in February in the Journal of the American College of Radiology, the MGH researchers, led by Andrew Gunn, M.D., listed several recommendations that should facilitate the communication of radiology report findings. For example, the authors concluded, the reports should include "patient-friendly" language and contain a radiologist's email address or phone number to facilitate open communication between radiologists and referring physicians. And, the authors added, radiologists could dedicate a specific period of time during the day to consult with referring physicians.

However radiologists choose to approach the issue of improving radiology reporting, I agree with Gunn, who said that radiologists must keep in mind that they are not generating their reports for other radiologists. Instead, he said, they must take into the account the preferences of referring physicians, as well as patients. - Mike  @FierceHealthIT

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