With patient satisfaction an increasing concern, radiology vendors and facilities are focused on improving the imaging experience.
For patients undergoing imaging procedures, the experience can be scary. The machine looks foreign and makes strange noises, and the room looks stark and sterile. And then there is the diagnosis to worry aboutMany imaging centers and hospitals are focusing on providing a better patient experience, thanks to manufacturing design innovations and a more thoughtful patient flow process. By allowing patients to select the room color, pick images portrayed on the walls, choose music and even aromatherapy scents, radiology staff are finding that patients are more relaxed and happier. And they’re spreading the word.Patient Control and DistractionThe idea of distracting the patient by making the radiology suite a friendlier environment began with efforts to please pediatric patients. GE produced the Adventure series, turning imaging rooms into jungle, camping and underwater scenes with wall murals and machine skins. The Ambient Experience by Philips also captured patient attention, with colorful lighting, video projection and sound.The features play out well with adults too, giving them a sense of control and positive distraction. Initially focusing on one patient group, pediatrics, allowed designers to get richer insights, which later broadened the concepts to a wider group.“We all want the same thing â we want to connect to a reality that’s less anxiety producing,” said Bob Schwartz, GE Healthcare’s general manager of global design and user experience. The patients get a sense of emotional control by letting them choose the environment, which gets them involved with the storytelling. “It may sound like it’s fluff, but it keeps you connected to a different world,” Schwartz said.By choosing the lighting, wall images, sounds and music, GE Healthcare’s SensorySuite “allows women undergoing mammograms to take their minds off the fact that their breast is being compressed,” Schwartz said.Mercy Medical Center-Perrysburg, in Ohio opened their outpatient imaging center in November 2013, using GE’s SensorySuite for mammography and GE MR Caring Suite. “It’s giving the patient more control of the situation, and that makes them feel more calm instead of fear of the unknown,” said Michelle Hanus, Mercy’s lead radiology technician. Patients like how the room looks with special lighting, and they can bring their own music on their iPhone or CD.Even making the room look serene or interesting is a good distraction. FONAR offers full room wall murals of nature scenes, cartoon or nursery rhymes for its Open Sky MRI machine.Lighting and Sensory ExperienceSeveral manufacturers offer sensory and/or lighting options for imaging exams. Siemens Healthcare sells the MoodLight panel for its MAMMOMAT Inspiration series, two of its SOMATOM CT series and two in the MAGNETOM MRI series. The machine’s full length LED panel lights up depending on the patient’s color choice, blanketing the room in that color, or changing colors every few seconds. Patients are also reassured to see their name and date appear on the LED panel during the mammogram, confirming her correct identification is captured, Lisa Sheppard, MD, radiologist at PINK Breast Center in Paterson, NJ, said.The sensory experience adds little to no extra time for radiology staff. Patients going for a mammography study with the GE SensorySuite pick the atmosphere they want on an iPad while in the exam room. Options include images on wall-mounted video screens, like nature, beach or waterfall scenes and related soundtracks like birds, waves crashing or crickets.With SensorySuite, patients can also choose a scent, like lavender or spice. The aromatherapy machine has different settings and only offers a subtle scent in the air. The machine won’t be used for patients sensitive to smell, and there aren’t any lingering scents in the room, Sandy Michalski, RT, manager for Mercy Outpatient Imaging Service in Ohio, said. They also give patients a scented bookmark with satin bracelet that they can wear during the mammogram for aromatherapy. While a lot of patients don’t wear them, “they’re impressed we have that all available. It’s in a pack that they can take home with them,” Michalski said.Their GE MR Caring Suite lets patients focus on projected images, like animals, the beach or a space scene, which Michalski said gives them something to focus on other than the MRI machine. The market for these lighting and sensory experiences is growing, Sean Hughes, vice president and chief design officer of healthcare at Philips Design, said. The Philips Ambient Experience is installed in more than 500 locations, he said.Increased BusinessUsing these features increases patient happiness and referrals. On Mercy’s patient satisfaction survey cards, patients write that they’ve had an incredible experience, that the facility and setting were beautiful, it was comfortable and the staff was nice, Michalski said. “We’ve taken those cards to the referring physician to say ‘this was the experience your patients had.’ We’ve started to see an increase in referral from those physicians.”Sheppard advertises the patient-friendly features of her Siemens MAMMOMAT Inspiration Prime Edition mammography equipment, including lower radiation doses and its optimal compression feature, which compresses the breast less than on typical mammograms. While Sheppard gets some patients from her advertising, mostly she’s seen an increase in word-of-mouth referrals from patients pleased with the exam and visit. “When someone leaves a mammogram and says ‘I had a great experience,’ it really means something,” Sheppard said.Overall ExperienceManufacturers and hospitals are focusing on the overall patient experience, not just the time they’re in imaging. When Mercy was planning their new outpatient imaging center, the concept was to provide a different experience than one would get in a hospital setting. They consulted with the global GE design team who walked them through the patient flow experience of the entire site. “We were trying to appeal to the different senses of the patient to get them in a more relaxed state,” Michalski said. That included using warm colors, a lot of natural light, an electric fireplace and floor to ceiling lights at the entrance. “It looks like a hotel lobby. They don’t feel like they’re walking into a healthcare setting,” she said.Philips, which also has a consulting practice, emphasizes to imaging clients that they should be thinking about more than just buying a piece of equipment, but also their market positioning and how they can appeal to patients. “Increasingly, the industry is more concerned with patient experience,” Hughes said. “It’s a metric they’re measured by.”By talking through solutions on site, Hughes said, Philips consultants meet with the people delivering the care. “That’s empowering because they have the feeling that they’ve designed it. We’re inventing the future together,” Hughes said.Design TheoryThe improvements made in equipment start with the manufacturing design teams, who focus on technical improvement, usability and the user experience. Their goal is to connect the functional technology features with the emotional benefits delivered to patients, families and clinicians. They look at it through the framework of the end-to-end user experience.Part of successful design is making sure that patients perceive the equipment to be reliable. “We want the equipment to look as though it can do the job it’s intended to do,” Hughes said. Machine appearance also matters for larger size patients who are concerned whether they’ll fit on it. It’s important that the imaging process doesn’t make the patient feel bad during loading and unloading “You want a patient to walk into a room and think ‘the equipment will hold me.’ You don’t want them to go in and wonder if it will fit them,” Lawrence Murphy, chief designer at GE Healthcare, said. “[Machines] have to appear to be substantial in size and character, right down to the casters that touch the floor,” he said.The machines can be made to look less imposing, though. “When we think of the monolithic frightening form of a medical device, they just stare at you with no emotion whatsoever. They’re not telling you you’re going to be okay. They raise your anxiety level,” Schwartz said. In this spirit, GE designers created its Revolution CT with natural grain wood paneling on the side to look more like furniture.Siemens MAMMOMAT Inspiration mammography machine series were also designed to look more comforting to patients, with soft, round edges, and offered in lime green, silver or pink.As designers, the teams do care about the aesthetic side. “There’s nothing wrong with saying we want our equipment to look cool as well,” Hughes said.Personal ServiceThere’s more than just technology involved with the patient experience. At the PINK Breast Center, Sheppard consults with her patients, showing them their films while comparing them with prior studies. She’ll talk about the radiation dose, giving her patient a dose card to take home. She talks with them about the equipment used, and shows the difference in the image quality and radiation dose between her newer Siemens MAMMOMAT Inspiration Prime Edition and her older GE Hologic. “My patients eat it up,” she said.Even though Mercy spent a lot of energy developing its new outpatient facility and getting patient-friendly equipment, “we put a lot of work into training the staff,” Michalski said. “This isn’t just about the equipment and the aesthetics. You can have all the technology in the world, but if you don’t have staff attentive to the patients’ needs, caring and really willing to go the extra mile, this would not work. The two in tandem has created a wonderful experience,” she said.
Findings showed a large mass in the right breast with low signal on T1WI and hyperintense on T2W and STIR images.
BIRADS IIIA and IIIB: Follow for 2 years (6 months, 1 year, 2 year), whereas mammo every 3 years; 24% of 1st time MRI given BI-RADS III; 0%â10% cancer rate (3% MSKCC: small invasive cancers, and DCIS)
It is important to remember that, as most MRIs of the breast are performed on high risk population, 17% of smooth masses on the first Â MRI were cancer.
Clinical history and correlation with mammography is always useful and can reduce assignment of BIRADS III category.
Caveat: if mammography or ultrasound is positive or palpable finding need to treat/biopsy/excise despite negative MRI.