Study: Radiology portal pros outweigh cons for patients

Information about radiology test results frequently are requested via patient portals, if available. The problem is that this information continues to be very difficult for many patients to understand.

According to a study published in the Journal of the American Medical Informatics Association, this is an argument for the development of new ways to share radiology information with patients. In the article, Corey Arnold, an assistant professor at UCLA's David Geffen School of Medicine, and colleagues suggest using an "interpretive layer" between clinically-generated information and consumer-centric disease explanations to help patients better understand illnesses they are dealing with.

The authors implemented an electronic portal for patients with primary brain tumors--a patient population that has a tremendous need for information and requires a large amount of both initial and follow-up imaging.

This system, the authors explained, includes explanatory layers of information between the patient and clinical data. Each layer provides "a lay explanation and overview of the layer immediately below, forming a hierarchy of progressively more specific information views that ultimately link to individual source reports' findings and associated imaging studies," the authors wrote. "These layers help to mediate between professional and patient health perspectives, using concepts, illustrations, and key radiology images designed for a consumer audience."

The patient radiology portal utilizes three information orientations: a problem orientation summarizing radiologic interpretive findings; a temporal orientation showing the evolution of disease via imaging; and a source orientation providing patients with annotated versions of their radiology reports. "These three perspectives," the authors wrote, "allow a user to navigate their radiologic information, allowing for the selective drilling down to the original image interpretations."

The authors demonstrated the system at the Radiological Society of North America's annual conference in 2011, at which time observers recognized its value in educating patients about their disease state, helping them review their diagnosis and treatment, and enabling them to share their record with family members and other supporting individuals. However, there also were concerns that patients still were exposed to information beyond their comprehension, and that issues regarding patient misconceptions and understanding could ultimately create more work for physicians.

And while steps can be taken to prevent issues regarding patient misunderstanding and clinician workload increases, the potential for these issues cannot be completely eliminated, the authors concluded. "There are, and will always be, risks in allowing patients direct access with their records, but evidence indicates that these potential risks are outweighed by the benefits provided by such a system to an engaged patient."

As part a discussion at last year's RSNA conference, radiologist Richard Taxin of Delaware County, Pa.-based Crozer-Keystone Health System outlined the pros and cons of giving patients direct access to their results, saying that oftentimes, doing so can result in more confusion and anxiety for patients.

In contrast, however, Curtis Langlotz, a radiologist and medical director of information services at the University of Pennsylvania Health System, talked about the success of a three-month pilot program one hospital in his system rolled out that enabled patients to access abdominal imaging, breast imaging and interventional radiology studies over a patient portal. While radiologists preliminarily were concerned that they would be flooded with patient phone calls about their results, Langlotz said that the hospital received only four patient calls over the three months, none of which were related to the report types used in the project.

To learn more:
- here's the abstract in JAMIA

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