How Patient-Centered Care Is Changing Radiology

President Barack Obama's health care law ushered in the era of patient-centered care. This philosophical shift fundamentally changed health care, from the payment structures to the waiting-room furniture configurations.

The medical imaging industry reacted accordingly, leveraging key organization to facilitate a uniform, specialty-wide change. Today, pieces continue to fall into place. Imaging departments and practices are slowly adjusting to this new reality.

An Industry Reacts
In 2010, at the dawn of the Affordable Care Act, researchers from the Department of Radiology at Massachusetts General Hospital quantified the average patient experience for a study published in the Journal of the American College of Radiology. The researchers evaluated radiology-related patient complaints from April 1999 to December 2010. Approximately 60 percent of unsatisfied patients said diagnosticians had failed to provide patient-centered care. Many complaints specifically highlighted problems related to doctor-patient communication.

Industry experts have long been aware of this issue. For example, in 2005, health care researchers said waiting had become a major problem within the specialty, reported The New York Times.

"We believe that there is no defendable reason why a patient should wait for several weeks – agonizing over whether he or she has cancer or whether a cancer has spread – when the defining imaging result is available within hours after the completion of the examination," wrote researchers in a 2006 article published in the journal Radiology. "We believe that the time has come to change the current mode of practice in which diagnostic radiologists rarely communicate directly with patients."

The patient-centered care revolution brought about that change, reported Radiology Business. Now, imaging departments and practices make an effort to open doctor-patient communication channels. The University of Michigan Health System distributes contact cards to patients. The cards provide contact information for relevant staff members, a list of every procedure performed and a projected timeline for result delivery. Additionally, when equipment problems arise, the university's imaging department consults affected patients before reshuffling appointments. The institution also issues copious patient surveys and feedback cards.

"There's just a lot more openness and fewer communications barriers," Dr. Ella Kazarooni, chair of the Radiology Service Excellence Program at the University of Michigan, said in an interview with Radiology Business. "We are so close to what we do as providers, that we cannot be truly patient-centered unless we get perspective from patients themselves."

This trend has also had an immense effect on the imaging experience.

{I'd combine this paragraph with the sentence above} Nurses now provide mid-scan distractions for particularly nervous patients. Waiting rooms offer more comfortable furniture and feature softer lighting. Staff members, technicians and physicians speak in gentler tones.

The patient-centered care revolution influenced pediatric imaging environments, as well. Children's Hospital of Georgia covered its walls in vibrant art, installed customizable multicolored lights in its X-ray rooms and added heated padding to its magnetic resonance imaging machine. The hospital also installed a park and outdoor fountain for young patients and their families.

"The pediatric radiology department is a place where children come to get their imaging studies done. We view patients and their families as our partners," Dr. James Rawson, chair of the hospital's radiology department, said in an interview with a Fox affiliate in Georgia. "They were partners with us in the design of all of this and that's why I think this is a better experience for them because they talked and we listened."

These initial developments are encouraging but more large-scale work lies ahead. Key organizations within the specialty have joined this secondary push.

In 2014, the Radiological Society of North America established the Radiology Reporting Initiative to improve doctor-patient communication, reported The New York Times.

In June 2015, the American Society of Radiologic Technologists launched a patient-centered, online education initiative for medical imaging professionals, reported AuntMinne.com. The program covers a variety of topics from elderly care to patient cultural differences.

And, one month later, the American College of Radiology introduced the Commission on Patient Experience, a committee designed promote industry-wide, patient-centered care practices.

"This commission will provide tools necessary to advance and promote high-value, patient and family-centered radiologic care," Rawson, chair of the committee, said in a news release. "Our work will help enhance radiologists' understanding of, and participation in, new practice and payment models that promote patient-centered care."

Room For Improvement
Despite these advances, patients still clamor for more information. A recent study published in Journal of the American College of Radiology revealed that most patients want access to their radiology reports, reported Reuters. Normally, physicians provide images to their patients but not radiological reports which often include extra details about the scans.

"Today's patients can be extremely sophisticated and educated consumers of care with 24/7 access to information through a variety of channels," Dr. Ruth Carlos, a professor of radiology at the University of Michigan, said in an interview with the wire service. "The desire to see their full report fits with this desire for information."

Earlier this winter during the RSNA's annual meeting, researchers from the University of California, Irvine reiterated this need and broached the topic of speed as it concerns result reporting. The research team surveyed users of available image-sharing patient portals and found that, despite their improved access, patients still yearned for a quicker image-delivery system. Additionally, 57 percent of respondents said they wanted more face time with their radiologists.

"When they answer why, it's because the [radiologist] is the first person to know the findings and not because they know the interpretive expertise of the radiologist," Dr. Eduardo Hernandez-Rangel, the researcher who presented the results during the RSNA event, said in an interview with AuntMinnie.com. "But think about your patients, and think about them whenever they are in the waiting period to get their results. Patients struggle and feel a lot of stress and [anxiety] just waiting for the answer."

According to industry experts, informatics platforms must adjust to fit the expectations of increasingly empowered patients. These streamlined platforms would not only improve communication channels but also propel the patient-centered care movement into new territory.

"With more patient access to information through portals, presented in a language they understand, patients will come to understand radiology's role in their care and will feel more empowered to have a say in it," Rawson said.

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