Exiled in a basement reading room, radiologists work alone intently, silently at computer screens that provide the only source of light – this stereotype casts radiology as one of the least person/patient-centered medical specialties. Although there is an element of truth in that stereotype, the radiology community is working to evolve into a patient-centered practice. The profession is addressing expectations for patient experience and satisfaction, as well as engagement with referring physicians, through improved communication and accessible resources.
One new resource is a library of patient-friendly summaries of the American College of Radiology (ACR) Appropriateness Criteria (AC). Written and reviewed by medical experts, the original ACs are evidence-based guidelines that promote appropriate use of imaging for diagnosis or treatment of conditions based on the symptoms, medical history and health status of the patient. There are approximately 300 ACs available on the ACR website. Although the ACR ACs are freely available online, they are not intended to be easily understood by laypeople.
In early 2018, the ACR began publishing brief summaries of specific ACs written for patients and their families, in language that is more accessible than that used in the physician versions. Each summary is approximately 250 words long. So far, 17 patient-friendly summaries have been published.
An ACR committee led by a physician oversees the project, but the summaries are written by selected laypeople and patient advocates. The patient-friendly ACs can be accessed directly by patients, and they also are meant to be used by physicians in shared decision-making and generally for patient education.
Twitter chat focused on patient-centered radiology
The patient-friendly summaries came to my attention in background materials supplied for a recent Twitter chat on the topic of patient-centered radiology. The chat, which covers different topics in patient empowerment, occurs under the hashtag #patientchat every other Friday at 1pm ET. #Patientchat is sponsored by the Patient Empowerment Network, a non-profit organization dedicated to supplying cancer patients and their care partners with knowledge and tools to help them manage their care.
Jennifer Kemp, M.D., a leader in patient-centered radiology, joined the #patientchat. Dr. Kemp is vice president of Diversified Radiology of Colorado, a practice that is developing experience with patient-centered care and reports high levels of satisfaction from referring physicians. As described in a case study published by the ACR in September, many years ago a radiologist practicing with Diversified Radiology started including the reading room phone number in his reports. He’d heard complaints that he and other radiologists on his team were hard to reach, so he decided to make it easier. At the time, those reports were seen only by referring physicians. When patients began to see the reports directly, through patient portals, radiologists were understandably concerned they’d be swamped with phone calls. They weren’t, and over time, nearly all radiologists in the practice followed suit.
The case study reports that Dr. Kemp was responsible for taking the phone number initiative from a growing, voluntary program to standard practice. Listing a phone number on reports is expected but not mandated, and individual physicians may choose, for example, which phone number to list. The practice supplies radiologists with a number of standard report templates, all of which include a place for contact information.
The number of calls radiologists receive from physicians and patients varies according to the setting and patient mix, but radiologists at Diversified generally feel positive about the program. Being available by phone creates some interruptions but improves relationships with physicians and patients. In the case study, Craig M. Kornbluth, MD – the radiologist who unwittingly launched this program 10 years ago – reflects on the isolation of past practice:
Radiologists were traditionally like the Wizard of Ox, behind the curtain; nobody knew what we really did.
Like all efforts to transform healthcare, pursuing patient-centered radiology practice triggers a domino effect of changes to work habits, relationships, business resources, and organizational culture, which will take time and patience to implement fully.
‘Radiologic Technologists Look to ‘ACE’ Patient Engagement,’ a post on EngagingPatients.com
The Radiology Information Resource for Patients, from the Radiological Society of North America, Inc.
‘Radiologists Are Reducing the Pain of Uncertainty,’ New York Times
‘Patient- and Family-Centered Care,’ a special issue of JACR, the journal of the American college of Radiology