Radiology information systems (RIS) in conjunction with hospital information systems (HIS), picture archiving and communication systems (PACS), and radiology transcription service providers help radiology practices maintain accurate records and manage image archives. The RIS improves workflow and efficiency, resulting in fewer medical errors and promotes accuracy in diagnosis and transcription.
Heavy utilization of imaging technology is a major factor driving overall healthcare expenditure in the U.S., according to a new study published in the Journal of the American Medical Association (JAMA). Researchers found that the U.S. had the second highest number of imaging exams, and the second highest MRI and CT technology utilization rate, following Japan. Given the expanding role of the imaging, radiologists can play a larger role in patient management. M Health lab reported on a U-M survey which found that:
- 84 percent of patients were interested in meeting with a radiologist
- Patient comfort level was three times higher with the prospect of a radiologist interpreting an image versus a non radiologist physician
In fact, there is evidence that patient consultations in radiology can improve care and enhance the patient experience:
- Many patients want to know more about their medical tests, diseases and treatment. A radiology consultation clinic provides patients the opportunity to meet directly with radiologists and get a better understanding of the meaning and implications of their imaging findings.
- Radiologists can clarify details and answer any questions after delivering test results directly to patients, reducing anxiety for some patients.
- Reviewing the images with the radiologist is very meaningful because radiologists are trained to look at imaging from many angles, where other physicians look at it only from the point of view of their specialty.
- In addition to improving patients’ understanding of radiology reports, radiologists can also educate them about the practice of radiology and the risks and implications of radiation.
Radiologists can also benefit from communicating directly with patients:
- By going through imaging findings with patients, answering questions, and explaining ambiguous statements or clarifying misconceptions, radiologists can better understand patient perspectives. They can use the information to improve their practice.
- Interacting with patients on a regular basis can help radiologists produce better radiology reports.
- Educating patients on the importance of appropriate imaging follow-up can improve patient adherence. While this is typically the responsibility of the primary care physician, it could be beneficial for the patient to hear it from actual radiologist.
- Interaction with patients improves patient perceptions of radiologists and demonstrates the value of their services.
- Consultations improve relationships with referring physicians and enhance the role of radiologists.
The radiology department at Massachusetts General Hospital is an example of an organization that has successfully implemented consultation services (www.diagnosticimaging.com). The department offers complimentary consulting service for select patients. Residents contact the primary care physician (PCP) about patients with upcoming appointments and chronic issues as revealed in recent past imaging that can be impacted by lifestyle changes or medication. When the patient checks into the office, they are offered a 15-30 minute radiology consultation along with their PCP visit. According to the chief resident in radiology at Massachusetts General Hospital, Harvard Medical School who set up the program in early 2014, “The PCPs said it really impacted their patients, and completely changed their perspective of their health”. Radiologists also received e-mails from patients thanking them for their time and lauding the value of the interaction.
However, implementing radiology consultation clinics can be challenging, according to a new analysis published in the Journal of the American College of Radiology (www.radiologybusiness.com).
One barrier is location. Teleradiology provides a way for diagnostic radiologists to interpret images off-site. This means they don’t come into contact with patients.
Another hurdle, according to the study, is lack of time. Radiology operations are complex with many variables and challenges. Inefficiency in workflow impacts emergency departments, operating rooms, inpatients, and other healthcare providers. It can lead to longer turnaround times and slow delivery of results. Such challenges leave radiologists with little time for patient consultations.
Further, though radiologists may want to communicate directly with patients, this can affect the time available for image interpretation, a revenue generating activity. Most payers don’t reimburse radiology consultations. The authors suggest that this concern could be addressed by viewing direct consultations with patients as “value-adding activities that deserve proper compensation.” Another strategy would be to have a separate billing process for patient consultation.
The authors concluded that though additional work is needed before radiology-patient consultation become a reality, direct patient communication would benefit not only radiology and radiologists but also allow patients to participate actively in their care.
Patient consultations in radiology need to be properly documented. Transcription of the video recordings of consultations can be outsourced to a medical transcription service organization specialized in radiology transcription.