If you were to design the ideal patient portal that also included diagnostic imaging, it would make sense to convene a group of stakeholders — patients, caregivers, and referring physicians and radiologists — to determine what features each group would value.

The American College of Radiology (ACR) Commission on Patient- and Family-Centered Care (CPFCC) has convened exactly such a group of individuals to collaborate to improve the delivery of care to patients and their families in radiology. In particular, the informatics committee has been able to use commonly available technology to facilitate collegial discussions among these separate, yet related, stakeholder groups.

Resources for Patient- and Family-Centered Care

The Institute for Patient- and Family-Centered Care describes four concepts of patient- and family- centered care: respect and dignity, information sharing, participation, and collaboration. The ACR Imaging 3.0™ initiative emphasizes the importance of the radiologist’s participation before, during, and after an imaging study or image-guided procedure.

Tasked with compiling a list of resources radiology practices can use to better align themselves with these principles, the various members of the ACR CPFCC – including patients, referring physicians, and radiologists — had the opportunity to share ideas in a collegial, non-adversarial fashion. Each group not only discussed the challenges they face in their respective roles, but also suggested improvements to the process and interactions.

The role of informatics in this process quickly became the focus of discussion. Patients and caregivers described the frustrations they encountered when trying to:

• Share images with referring physicians or between facilities
• Obtain, consume, and understand their own and their family members’ radiology reports
• Directly contact and speak to radiologists about upcoming imaging as well as findings and results

Both referring physicians and patients spoke about their desire to provide feedback to radiologists regarding the usefulness of an imaging report. An email chain among patients, referring physicians, and radiologists on the CPFCC provided a unique opportunity for the stakeholders in the process to have a candid, direct discussion about these issues. The four tenets of patient- and family-centered care were repeatedly mentioned during the conversation.

Adaptive Response

In reviewing the exchanged messages, it became clear that, as our patients and their family members increasingly avail themselves of electronic access to their medical records, the way we currently practice radiology must adapt.

Radiology reports have historically been written with other physicians as their intended audience. As such, they contain medical jargon and do not always clearly describe the implications of the results for patient management. Our patients’ input as to the design of patient portals and the availability and accessibility of radiology results (and the radiologists who perform the interpretations) is important, and should impact future practice.

When it comes to their radiology-related care and access to their radiology results, patients will have different needs based on prior health care encounters, acute illness vs chronic disease, socioeconomic status, level of education, Internet access, and desire for information.

Our proof-of-concept initiative demonstrates that even simple technology such as email can be highly effective in connecting radiologists, patients, and caregivers in a meaningful discussion.

For more information about harnessing the power of informatics, please review the article in the December 2016 JACR Special Issue: Patient- and Family-Centered Care.

Cook TS, Krishnaraj A, Willis MH, Abbott C, Rawson JV. An Asynchronous Online Collaboration Between Radiologists and Patients: Harnessing the Power of Informatics to Design the Ideal Patient Portal. J Am Coll Radiol December 2016;13(12 Pt B):1599–1602.