Is better care a JPG away?

December 12, 2008
Greg Freiherr

Cruising one of the vendor booths at the RSNA meeting, my eye skipped from the exhibit in front of me to the paper tablet cradled in the arm of the media handler who accompanied me. There, nestled in a matrix of times, contacts, and booth locations, was my picture. Beside it appeared my title and the day and time I was to show up.

Cruising one of the vendor booths at the RSNA meeting, my eye skipped from the exhibit in front of me to the paper tablet cradled in the arm of the media handler who accompanied me. There, nestled in a matrix of times, contacts, and booth locations, was my picture. Beside it appeared my title and the day and time I was to show up.

It was meant, of course, to allow this handler and the others who would follow to greet me with confidence that they were, indeed, using the right name when they said hello. My first thought, however, was "Good God! They couldn't find a better picture than that?" What if-horror of horrors-the folks who were meeting me for the first time had formed an opinion about me on the basis of this picture?

Just how important, I wondered, is a picture? Very, according to researchers at the Shaare Zedek Medical Center in Jerusalem. In a presentation at the RSNA meeting, they said that including a patient's photo with imaging exam results may enable a more "meticulous reading" of radiological images as well as a more personal and empathetic approach.

"Our study emphasizes approaching the patient as a human being and not as an anonymous case study," said lead author Dr. Yehonatan N. Turner.

If my experience at the vendor booth is any indication, Turner may be on to something. For me, the booth tour was a positive experience. But, then again, so were all of them. These experiences, however, were mitigated almost certainly by the direct interaction I had with my handlers, an option that radiologists seldom have with patients. For them, a picture may be a reasonable alternative that may be good for everybody involved.

In their study, the Israeli radiologists added mug shots to the PACS files of 318 patients referred for CT exams. The photographs appeared automatically when the patients' files opened. After interpreting the results of the exams, the 15 radiologists participating in the study stated in questionnaires that they felt more empathy towards the patients after viewing their photos. They said, additionally, that the photographs sometimes revealed medical information such as suffering or physical signs of disease.

Most telling was a comparison of interpretations in which radiologists read images with and without patients' pictures attached. In this comparison, they served as their own controls to uncover unexpected abnormalities in radiological images. In the 318 studies accompanied by patients' photos, the radiologists found incidental findings in 81. When those same radiological studies were read three months later without the mug shots, only 20% of those incidental findings were reported.

The researchers noted that adding patients' photos did not lengthen the time radiologists spent reading the images. Attaching these images will not impact productivity, so faced with this kind of upside, why wouldn't providers include pictures with their files? Would it be so difficult, considering the proliferation of digital cameras and webcams, to snap a shot of a patient when they check in for a procedure?

I know that if a healthcare provider asked to include my picture with a file, I would be happy to comply…as long as I got to take a look at it first.