Internet links patients with radiologists

Diagnostic radiologists rarely have the opportunity to communicate directly with patients, but use of the Internet may drastically change that.

Although the federal government has mandated standards for delivering mammography results directly to patients, it has no such standard for any other radiological specialty.

To address that gap, Dr. Kimberly Applegate, an associate professor of radiology at Indiana University School of Medicine, organized a special RSNA focus session at the 2003 meeting.

"Radiology will be in a better position if we realize how important it is to communicate with patients with the new electronic media," Applegate said.

The session addressed the idea of providing patients with immediate and direct access to their radiology reports in an effort to improve patient safety and doctor-patient relationships. Concerns about this approach include the added expense of initiating and maintaining such a system and the possible harm to relationships with referring physicians.

One presenter, Dr. H. Hugh Hawkins, director of Proscan Women's Imaging in Cincinnati, noted that his efforts to improve patient communication are viewed as a value-added service that increases patient loyalty and market share.

Panelist Dr. Annette J. Johnson, an assistant professor of radiology at Indiana University, related a worst-case scenario that was originally presented in a 2001 report from the Institute of Medicine. The report, titled Crossing the quality chasm: a new health system for the 21st century, relates the case of a Ms. Martinez, who had excellent healthcare providers but suffered a long-lasting disability that was preventable. From inadequate follow-ups on an abnormal mammogram to lost laboratory tests, the system failed her. At various points in Ms. Martinez' ordeal, inadequate handoffs of important clinical data caused information to fall through the cracks.

Johnson contended that if this patient had had access to her health information, she would have been aware of serious breaches in her medical care as they arose and could have intervened before it was too late.

Radiologists could assume some of the responsibility for informing patients by providing access to a secure Web site where patients might access their report, Johnson said. Critical patient information would be less likely to disappear, patient safety and satisfaction would increase, and a better doctor-patient relationship would result.

This type of system would require more work for overburdened radiologists, but the benefits would outweigh the inconveniences, she said. Imagers could better protect their turf if patients recognized radiologists' contribution to their healthcare.

Patients at Brigham and Women's Hospital already have online access to much of their medical information. The hospital has developed a portal through which patients can access specific parts of their medical record, using a password. Brigham and Women's intends to make radiology data available later this year, said Dr. Ramin Khorasani, vice chair of radiology.

Much of the system's $2.5 million cost was expended for security and authentication protocols. The 11,000 patients who have signed up thus far report high satisfaction, Khorasani said.